HEALTH-EAST ASIA: SARS Outbreak Draws Contrasting Responses

By Marwaan Macan-Markar Reprint | | Print |

Marwaan Macan-Markar

BANGKOK, Apr 4 2003 (IPS) - In the wake of a rapidly spreading killer disease, two East Asian countries of contrasting size are revealing how fast they are holding on to features that nations here are known for – saving face, and wearing a calm exterior to hide turmoil within.

The smallest of them, the efficient city state of Singapore, is doing exactly what the doctor ordered. No sooner had the early signs of severe acute respiratory syndrome (SARS) been detected, when it launched a well-publicised effort to combat the spread of the new disease.

The tough measures taken by the Singapore authorities ranging from shutting down all schools to ordering the over 800 people who have had contact with SARS patients into quarantine – affirmed a willingness to drop the tendency of going into denial to ”save face”.

Since SARS was first detected in Singapore last month, 95 people have been diagnosed with the disease and four people have died due to it, states the Geneva-based World Health Organisation (WHO).

In Singapore, those people ill with SARS, described as an atypical pneumonia whose actual origin remains unknown, were infected due to local chains of transmission, adds the U.N. health agency.

By contrast, the largest of the two nations, China, has in many ways held on to the values that Singapore ditched to face the deadly virus head on.

Beijing’s authorities opted to limit the flow of information on the spread of SARS, despite China being, according to WHO experts, the likely source of the virus and the worst hit by the disease.

As of this week, there are 1,190 cases of SARS that have been diagnosed in China and 46 people have died from the disease, says the WHO. The worst affected region is its south-eastern province of Guangdong, which has had 1,153 cases and from where, the WHO notes, the disease could have originated.

Cases have also been reported in the capital Beijing, Guangxi Zhuang Autonomous Region, and Hunan, Shanxi and Sichuan provinces.

On Thursday, after the WHO warned travellers about visiting Guangdong and the neighbouring Hong Kong Administrative Region due to the spread of SARS, China’s health minister Dr. Zhang Wenkang told the press that Beijing had the disease under control.

”The exact pathogen of SARS is still unknown and global cooperation is needed for successfully handling this disease,” he said, adding that it remains safe for travelers to go China and patients were getting well.

In fact, Beijing’s recalcitrance to be open about SARS, after global attention was directed towards China as the possible source of the disease, was reflected when it did not grant ready permission to a WHO team of investigators to visit Guangdong.

The WHO scientists finally arrived in Guangdong Thursday, but the spokesman for the team, Chris Powell, said that the group could be in ”for a long haul” in the search for the source of the virus.

Across East Asia, where places such as Thailand, Taiwan, Hong Kong and Vietnam have been named by the WHO as having SARS patients, countries are quickly realising the virtues of the Singapore model in disease prevention compared to China’s.

Thailand, for instance, went from an initial denial mode – even demanding that the U.N. health agency strike its name off a list of 18 countries with SARS – to a tough prevention programme this week.

Among others, the Thai government has threatened people who have been to the high- risk countries like Singapore or China to be quarantined for 14 days or face a six-month jail sentence and monetary fines.

Passengers arriving from the high-risk countries have to field a battery of questions from health officials at the airport. Thailand’s national airline is handing out masks to passengers as they board planes.

Thailand has seven patients with SARS and there have been two deaths due to the disease, states the WHO, adding that the country has no sign of the disease being transmitted locally like in Hong Kong or China.

The first death in Thailand over the weekend was that of Dr Carlo Urbani, the WHO infectious disease specialist who first identified the virus in Vietnam. Before he fell sick about four weeks ago in Thailand, Urbani had been treating a SARS patient in the Vietnamese capital Hanoi.

Ever since, Thailand has been on the WHO’s risk list of countries infected with SARS. ”I think we can have a small epidemic after Songkran,” says Dr. Bjorn Melgaard, the WHO representative in Thailand, referring to the country’s new year, which falls in mid-April and is celebrated, among other ways, by people dousing each other with buckets of water.

Public health officials are contemplating a course of preventive action they may have to pursue for Songkran, since the festival is expected to attract home thousands of Thai workers from Singapore and Hokg Kong, where 706 SARS cases and 16 SARS-related deaths have been recorded.

”We cannot bar them from coming (home),” says Supamit Chunsuttiwat of the department of communicable disease control. ”Songkran is so big a festival for Thai people.”

Similarly, worries are also rising as a Chinese ceremony of visiting ancestors’ graves nears on Saturday, when many Hong Kong residents cross over into China.

Meantime, health experts continue to be troubled by rapid spread of SARS across the world.

Since early March, when the WHO issued a global warning about the new disease, there have been 2,223 SARS cases recorded in countries as far afield as Canada, Germany and Britain and 78 SARS-related deaths.

According to the WHO, the first case of SARS was reported on Feb. 26, when a man was admitted to a hospital in Hanoi with a high fever, cough and mild sore throat.

”Over the next four days he developed increasing breathing difficulties, severe thrombocytopenia (low platelet count) and signs of adult respiratory distress syndrome requiring ventilator support,” it adds.

But the disease’s beginnings in China go back by more than three months. The WHO is investigating reports that the first outbreak of an unusual pneumonia in Guangdong occurred in November 2002, a fact that the Chinese government concealed from the international health community.