At the Epicentre

At the Epicentre: Hong Kong and the SARS Outbreak

Christine Loh
Civic Exchange
Copyright Date: 2004
Pages: 296
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    At the Epicentre
    Book Description:

    What was really happening as Hong Kong struggled with SARS? In At the Epicentre, the story of those extraordinary weeks unfolds with all its drama - personal, national and international, political, medical and scientific.The authors give us the whole picture: from a day-by-day calendar of events to the experiences of a SARS-sufferer; from the heroic efforts of the medical staff in the hospitals to the work of the pioneering global network of laboratories that the World Health Organisation (WHO) created; from the amazing shift to openness of the Chinese authorities to a detailed study of how the global media covered the story.It is a story of individuals, of Dr Gregory Cheng recounting how it felt to have SARS, of the concentrated and intense work of Professor Malik Peiris as he struggled to identify the virus, of Dr David Heyman of the WHO as he dealt with intense political pressures yet moved the international effort along at high speed.The impact of SARS on Hong Kong was enormous and far-reaching. At the Epicentre explores the economic consequences, the way the community responded, and what might be the long-term political implications for Hong Kong, for China and for the international community. The authors are rigorous but fair in their criticisms, recognizing that what seems clear now was not always so in the heat of the battle. But most important are the lessons they draw from the events and experiences for the next time, for the authors all recognize that SARS is just the first global epidemic of the new century.

    eISBN: 978-988-220-032-6
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
    (pp. vii-xiv)
    Christine Loh
  4. Calendar of Events
    (pp. xv-xxviii)
    William Chiu and Veronica Galbraith
  5. CHAPTER 1 Unmasking SARS: Voices from the Epicentre
    (pp. 1-16)
    Alexandra A Seno and Alejandro Reyes

    Dressed in a black sleeveless shirt and matching trousers, Virginia looked ready for a turn on a nightclub dance floor. But on the sweltering afternoon of 1 July 2003 — the sixth anniversary of the handover of Hong Kong from British to Chinese sovereignty — the restaurant manager was heading to Victoria Park to join a protest. Organisers billed the demonstration as a march against the national security bill that the Government of Chief Executive Tung Chee-hwa had proposed in accordance with Article 23 of the Basic Law, Hong Kong’s constitution. Yet the controversial legislation was certainly not the only issue on...

  6. CHAPTER 2 At the Frontline: The Medical Challenge
    (pp. 17-32)
    Moira Chan-Yeung

    The first new disease of the twenty-first century posed the threat of a major global epidemic. Within a week of reaching Hong Kong in February 2003, SARS spread to 11 countries in Asia, Europe and North America. Its relatively long incubation period — up to 10 days — meant that infected air travellers, many of whom did not show any symptoms of illness prior to boarding their flights, unknowingly carried the virus around the world.

    Scientists quickly identified the coronavirus as the culprit and broke its genetic code just five weeks after the onset of the SARS epidemic in Hong Kong (see...

  7. CHAPTER 3 Healing Myself: Diary of a SARS Patient and Doctor
    (pp. 33-42)
    Gregory Cheng

    Dr. Gregory Cheng is a Consultant Haematologist at the Prince of Wales Hospital (PWH). In early March 2003, he was one of a number of health workers at PWH to be diagnosed with SARS. The following is an account of his experiences and reflections during the outbreak.

    Have developed severe chills, rigour and muscle ache. Diagnosed myself as having the flu. Still went out for dinner, but had an early night.

    Many of the nursing staff and physicians [at Prince of Wales Hospital (PWH)] had similar flu-like symptoms. Joked around with them, saying, “You guys are not much better than...

  8. CHAPTER 4 The New Coronavirus: In Search of the Culprit
    (pp. 43-54)
    Moira Chan-Yeung and Christine Loh

    Virologist Klaus Stohr first had an inkling that trouble was brewing in November 2002. On a business trip to Beijing, the influenza programme manager for the World Health Organisation (WHO) was attending a routine meeting on China’s flu vaccination policy. Stohr heard a report from a Guangdong health care worker that several people in the southern province had contracted a severe flu with unusual characteristics. The WHO requested a sample of the virus from the Chinese, but testing of the specimen received by the UN agency did not show anything out of the ordinary.¹

    By January 2003, Hong Kong virologists...

  9. CHAPTER 5 The Public Health Viewpoint
    (pp. 55-80)
    Gabriel M Leung, Anthony J Hedley, Edith MC Lau and Tai-Hing Lam

    The SARS epidemic is already regarded as a defining moment in the evolution of communicable disease and will undoubtedly be seen as a milestone in the history of global public health. In 1969 the then US Surgeon-General confidently announced that “the book of infectious disease was now closed” and “that antimicrobial war had been won.” We have since been forced to acknowledge many times over just how flawed that optimistic vision was. The history of newly emergent communicable disease during the past three decades should be a caution to any health professional or government official who is tempted to declare...

  10. CHAPTER 6 The Numbers Trail: What the Data Tells Us
    (pp. 81-94)
    Alexis Lau

    SARS affected the daily routine of almost every person in Hong Kong — from schoolchildren kept at home for weeks to cleaners forced to work longer hours. The virus infected 1,755 people, with 299 dying of the disease.

    Many important lessons must be learned from this experience. Infectious disease experts predict that SARS will most likely recur. Even if it does not, many more unknown viruses will surely emerge.¹ To help the community fight any similar public health threat, information and data should be as accurate as possible and released in a timely fashion. The more data there is, the more...

  11. CHAPTER 7 The Mystery of Amoy Gardens
    (pp. 95-116)
    Stephen Ng

    When residents of Amoy Gardens woke up on 21 March 2003, they had no idea that their nightmare had just begun. In the next four weeks, Amoy Gardens would attain unprecedented notoriety, becoming Hong Kong’s best known housing complex and a symbol of the mystery and terror associated with the new disease: Severe Acute Respiratory Syndrome, or SARS for short. By 25 April 2003, 329 residents had developed SARS, with 42 subsequent deaths.²

    Amoy Gardens is a lower middle-class housing complex in Kowloon Bay, East Kowloon, built over 20 years ago. It consists of 19 33-storey high-rise blocks, with eight...

  12. CHAPTER 8 How the Stunning Outbreak of Disease Led to a Stunning Outbreak of Dissent
    (pp. 117-138)
    Michael E DeGolyer

    In late January 2003 stories swept through Hong Kong of a mysterious respiratory disease in Guangdong Province. Guangdong authorities finally admitted that an outbreak of unusual pneumonia had infected 305 and killed 5 people since November 2002, but said that the situation was under control and posed no threat to public health in Guangdong, much less Hong Kong. Under the “one country, two systems” policy Guangdong authorities had no power to even communicate with their counterparts across the border in Hong Kong. In fact, it was not until the end of January 2003 that 24-hour travel across land barriers was...

  13. CHAPTER 9 The Politics of SARS: The WHO, Hong Kong and Mainland China
    (pp. 139-162)
    Christine Loh

    The lifting of the World Health Organisation (WHO) travel advisory for Hong Kong on 23 May 2003 caught everyone by surprise. Ever since late February the SARS outbreak had almost completely taken over daily life. There was a sense that although things might take on the appearance of normality again soon enough, in fact the ground had shifted under Hong Kong’s feet. As SARS roared through Hong Kong, it forced the city to evaluate the readiness of its institutions to deal with infectious disease — an issue that had received little real attention despite recent warning signs. During the avian flu...

  14. CHAPTER 10 SARS and China: Old vs New Politics
    (pp. 163-178)
    Christine Loh and YIP Yan Yan

    The 2003 SARS outbreak has already affected mainland China in significant ways and will likely continue to impact Chinese politics and society for some time in the future. While it was not a “Chinese Chernobyl,” it was a transforming experience for the Chinese state.¹ The SARS crisis highlighted many of the contradictions inherent in the model of development applied since 1979, when China began its modernisation in earnest after the end of the Cultural Revolution. These contradictions, such as the lack of priority given to public health and social development vis-à-vis economic advancement and the continuation of an official culture...

  15. CHAPTER 11 The Economic Impact of SARS
    (pp. 179-194)
    Stephen Brown

    Writing about the impact of SARS on the Hong Kong economy involves a great deal of crystal ball gazing. However, the outlook for the Hong Kong economy post-SARS does not look to be dramatically different from pre-SARS trends. In trying to assess the longer-term impact of the disease on Hong Kong, it is important to understand what the Hong Kong economy actually consists of, what drives it and where it fits in the international chains of connectivity that are increasingly important. In addition to exploring future development of the economy, it is important to understand how we got where we...

  16. CHAPTER 12 The Media and SARS
    (pp. 195-214)
    Christine Loh, Veronica Galbraith and William Chiu

    For the international media, the SARS virus was the next big story after the Iraq War. As SARS spread quickly around the world via Hong Kong, the medical, social, economic and political aspects of the disease were the subjects of extensive media coverage. At the outset, the lack of information about the virus led to some highly sensational reporting. This situation was compounded by the fact that SARS originated in China, where the government’s penchant for secrecy made it hard to get at the facts. Early reports were often incomplete and raised many worrisome questions. However, despite criticisms that the...

  17. CHAPTER 13 SARS and the Hong Kong Community
    (pp. 215-234)
    Christine Loh and Jennifer Welker

    The SARS experience in Hong Kong left residents with a sense of pride in their community. Despite the fear associated with the outbreak of an unknown disease that took many lives and affected thousands more throughout the city between the end of February and June 2003, the overall community response was mature, professional, generous and compassionate.

    By mid-April, people knew that they could no longer hide at home to escape SARS. There was a strong surge of civic energy to promote disease prevention and help each other get through difficult times. New civic networks and alliances were formed. Healthcare professionals...

  18. CHAPTER 14 Lessons Learned
    (pp. 235-250)
    Christine Loh

    SARS provided a dramatic demonstration of the global havoc that can ensue following the emergence of a new infectious disease. Public health authorities, doctors, nurses, other hospital workers, scientists and laboratory research staff around the world struggled to cope with SARS. Public panic was widespread in many parts of the world that were affected. Some government officials lost their jobs due to mishandling of the situation. The short-term economic impact was severe and painful. Hospitals, schools and many places of entertainment had to be closed, and travel advisories were imposed that greatly limited international travel.

    Now that the outbreak has...

  19. NOTES
    (pp. 251-280)
    (pp. 281-286)