2003年03月29日 土曜日

Living in Fear of "SARS" in Hong Kong

by Justin Hall

Japan Abroad

Until recently, I had been concerned about what a war in Iraq would mean to the world. But now I am forced to worry more about a war of a different kind that is being waged closer to home.

The battle against "SARS," or Severe Acute Respiratory Syndrome, has become a top priority for the Hong Kong government and medical establishment, and rightly so. The atypical pneumonia has struck down over 400 people in the territory. And as of March 29, the death toll from the disease has risen to 11.

The picture is even grimmer in mainland China, where the deadly virus is believed to have originated. Officials there now admit as many as 800 people have been infected with SARS, mostly in the southern Guandong province. And to date, the World Health Organization says there are over 1, 300 SARS cases worldwide.

The Hong Kong government has finally come up with serious measures to try to stem the spread of the disease. It announced yesterday that over 1, 000 people who have had close contact with atypical pneumonia sufferers will be quarantined. And all schools would be shut down until April 6.

Although my son isn't old enough to go to school yet (he's only 16 months old), the SARS outbreak has worried me nonetheless. Today, as I went to a neighborhood grocery store to stock up on food, I couldn't help but notice the growing number of people actually donning surgical facemasks. Sadly, I was one of them. My feeling is that I'd rather be safe than sorry. Or at least, FEEL safer, even if the complete effectiveness of the mask is in dispute.

It's amazing how an invisible disease like SARS can impact your life. In a military war, as in Iraq, you can actually see tanks rolling in the desert and troops crawling toward their targets. But with SARS, you can�ft quite grasp who or what the so-called enemy is. Although the scientific community here and abroad is making progress in figuring what exactly the SARS is, until we get a complete picture and perhaps a possible cure, we will continue to live in uncertainty over our lives.

Not only am I one of many people wearing facemasks outdoors, I have also cut back on activities that would take me out of my home. My son hasn't breathed fresh air or played under the sun for several days now. My husband still goes to work, but not with his usual, cheery disposition, but with anxiety over what may be lurking behind the front door and beyond.

The threat of a serious disease such as SARS makes you think about things you don�ft normally think about. I passed by a drugstore a few days ago and saw a long line of people waiting to buy facemasks. Apparently, they've been flying off the shelves like hotcakes and some stores had been charging astronomical prices. In the midst of a health crisis, some people still choose to think about making money.

But there are also stories highlighting the good of humanity. Several hospitals in Hong Kong had been hard hit by the SARS, with many of their health workers coming down with the disease and therefore forcing institutions to shut down some of their services temporarily. But despite the risk of contracting the deadly disease, many doctors and nurses volunteered to look after already infected patients and kept themselves away from their own family in the process. I'm sure cynics would say it's their job to look after the sick, but they do have a choice. How many of us would do the same in a heartbeat?

It�fs stories like this that keep me going. Although I am taking precautions to avoid getting SARS, which has changed my lifestyle somewhat, life still does go on. And I have to have hope that the people in power and global health authorities are doing the best they can to fight this severe respiratory illness so it doesn't become a worldwide epidemic.

Posted by Justin Hall at 2003年03月29日 14:57

Comments
1- Mimi

Thanks for this story Karuna. I am actually just watching a CNN report on the stories that have not been covered because of the Iraq situation and SARS is at the top of the list. Hang in there.

2- yuka

Hitogoto de wa arimasen.

Three people have died of SARS in Toronto, Canada. As people travel all over the world, SARS quickly spreads. TV reporters keep telling us to wear surgical facemasks, yet the supply won't reach to my hand :-(

Two hospitals are closed, hundreds are in quarantine, and they're checking people who are *leaving* Toronto to see if they may spread the disease farther.

Only I can say is...
No more WARS: no more SARS.

3- jane

this is an amazing table/flow chart from the CDC tracking the <a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5212a1.htm#fig1">chain of transmission</a> among guests at one hotel.

the rest of the report is <a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5212a1.htm#fig">here</a>.

4- Mimi

Karuna, please keep us posted if you can. I just heard that there is a travel advisory out now for visiting Hong Kong. How are you all coping? Can't be easy to be trapped at home for such a long period with the little one.

5- karuna shinsho

mimi, thanks for your concern. honestly, i have been going bonkers over this, particularly on the issue of whether it's safe on the plane for justin. i've been talking to a lot of doctors and of course, none will vouch for its complete safety. but most say that the planes should be relatively safe, given that recent models(as opposed to 20 years ago) have air circulating from top to bottom, rather than front to back. that means it's less likely for pathogens to be passed around. and to date, doctors don't believe the virus is airborne(though it hasn't been ruled out). if people do get infected on planes, they say it's more to do with someone sneezing or coughing near you and the droplets get to you or the surfaces near you.
as for the situation here in hong kong, though the number of infection cases yesterday has been way below previous ones(20), some people are breathing a sigh of temporary relief. but the key problem(which has sparked the WHO travel warning) is an apartment complex where over 200 people had beeen infected. doctors don't know how so many people could have been infected so quickly. they think it has to do with something in the environment that helped the speedy transmission(ie. sewage, rats, etc.) so without knowing what happened there, everyone's erring on the side of caution. what compounds the problem is that 200 or so families had fled the complex before the place was quarantined, so in effect, we may have more infected people out there in the community spreading the virus.
on a personal note, it really has been stressful thinking about the possible consequences of this virus on our family. as i mentioned in the article, my son and i have pretty much been stuck in our home for the last week. i only go out to get food. my husband, though, still needs to go to work. having said that, i need to give the other side of the picture... that is, there are people out there that aren't as freaked out over this and are going out and doing their usual things, but taking precautions like washing their hands frequently and avoiding crowded places. i guess it's a matter of choice and one's comfort level over this virus. i tend to be more cautious than most, especially because there are so many question marks over this disease.
but after the u.s. consulate announced that family members of employees are authorized to leave, it pushed me to take action. despite my doubts and fears about the plane, i'm taking my son to japan. my husband still has to stay here, but we hope things will get better sooner than later so i can return home.

6- Mimi

Thanks for the update Karuna. I think I would be going bonkers too if I was with my kids in Hong Kong right now... Good luck with the flight.

7- karuna shinsho

hi folks,
just to let you know we made it to japan. we are laying low for 10 days to make sure we didn't catch any bug on the plane. i am sure we are fine, but just in case. haven't decided how long we will be here. i know the numbers show that my paranoia is unfounded, but i just couldn't take a chance, no matter how slim, for justin.
in any case, i think this incident shows us how amazing the international medical community has been in virtually identifying the virus and finding a diagnostic test in such a short time. the world can come together in times of such difficulty. but at the same time, i think it should teach some countries a lesson as to how to respond quicker to such a health crisis and to be more transparent about it(yes, i'm talking about china). when people's lives are at stake, there is no use talking about politics or the fear of tainting one's image.

8- Junko Sumiya

Karuna,

Glad to know you are safe and sound and back in Japan. Not that Japan is safe, I gather it's just a matter of time (There are at least several people with the doubt of contracting SARS). I guess there is no place that is really safe, but like you said, there's just so much that is still unknown about the virus, that precautions are a smart move even if they turn out to be unnecessary.

9- Han Ngo

I have been following the news about the new virus that affects the world wide especially in Asia. In the new today, they have indicated around 53 dead in China and more than
2,300 people have been infected worldwide. I&#30693; appreciated that you have dedicated your time to help out those patients. Also, remember to take a good care of yourself and well rested, so you can be able to help the patients in the best of your abilities. Again, thank you for your commitment and time in helping out in the worst time.

10- Nevin

What the media is not telling you about SARS:-
First, the 2.5% mortality rate of Sars in Hong Kong is dramatically lower than that of "typical" pneumonia here, which is around 12%. Sars has claimed over 20 lives in Hongkong as at 9.4.2003. Yet, almost all of the deaths where the age has been reported have been 60 plus, with at least 2 being 80 plus, and most of them were having, or a history of, other serious sickness. Fatal cases reported around the world are sporadic, except in China(source: WHO). The absolute statistics really do not make any sense unless we compare them to, say, the 65,313 people in the USA died from influenza or pneumonia in 2000 (source: Centre for Disease Control at: http://webapp.cdc.gov/cgi-bin/broker.exe).
The mystery around the mode of transmission apart from droplets and close contact with infected patients is the most agonising part of the illness. So is its contagiosity. Yet, there has not been a single known cases in Hong Kong that a person contract the disease by simply staying in a public environment. Consider the blokes gathered to cheer their teams in Hongkong Sevens 11 days ago. While the incubation period is typically 2 to 7 days (source: Hongkong Health Department at: http://www.info.gov.hk/dh/ap.htm), not any one of them has been reported sick of Sars since then, except for a suspected case of a Fiji player who had reportedly suffered a bad flu before arriving at Hongkong and stayed under the escort of a medical doctor throughout the event.
From the experience of Hong Kong, patients react favourably to ribavirin (a broad spectrum antiviral drug) and steroid treatment. In cases of earlier treatment, a success rate of over 90 per cent is being reported and more than 110 people have been discharged as at 9.4.2003 (source: Hongkong Health Department).
Three questions have to be addressed in assessing the relative risk from SARS:
1. How easy is it to catch (in the sense of developing symptoms) this pneumonia?
2. If you do catch it, what is the chance of being seriously ill (which I will define as requiring intensive medical care) or dying from it?
3. How do these risks compare with others that are accepted as a "normal" or "acceptable" level of risk in living in Hong Kong as in elsewhere?
Ckeck out an analysis at http://home.so-net.com.hk/~pns/ and find out what the media is not telling you about the illness. Stay alert but don't be flustered. In fact, the chance of contracting Sars is much lower than being run over by a car when crossing the road.

11- karuna shinsho

nevin,
thanks for the reality check. as i said before, the statistics should keep paranoia at bay, but it's always hard when one is in the thick of it. whether it be due to wrong media focus or people's ignorance of facts, people in hk were quite caught up with the sars outbreak, perhaps too emotionally. for me personally, while in hong kong, i was constantly being bombarded by sars-related messages(ie. having the kid's playground in our apartment complex closed until further notice, then the pool being shut down for an indefinite period, followed by the apartment management informing us that bleach was being used in our toilet system to kill off potential traces of sars in the sewage) which can really affect you psychologically. i notice that in japan, the media doesn't focus on it much. of course, it's not really a problem here. but it does give my mind a break from all the bad news.

For me, one of the most striking aspects of this SARS epidemic was that China knew that they had something deadly and new on their hands as early as October 2002, but did not come clean until April 2003. Today there's comments from Chinese doctors who believe that the real figures are much WORSE than what the Chinese government is releasing.

This may end up being a seminal event for China with respect to greater disclosure of information more immediately. SARS seems like it will depress the Asian economies (especially China) by a significant few percentage points by even conservative measurements. What little growth we did have in Asia recently may be completely destroyed by fear and may end up being a VERY expensive lesson in both lives and dollars.

Good luck to Karuna & her family.

13- yuka

This SARS epidemic has caused several problems here in Torotnto. A few large hospitals and some doctors'offices have closed which made a serious problem:cancer or other critical patients' operations have been postponed. As Kanai-san mentioned above that the economies clearly slowed down, especially among Chinese communities. Yesterday Prime Minister Jean Chretien visited a Chinese restaurant in Toronto to try to allay fears that Asians are likely to carry SARS.

I heard that "ijime" toward Chinese Canadian students are happening in schools.

Effect of fear amazes me. So far 10 people died of SARS in Toronto.

14- yuka

This SARS epidemic has caused several problems here in Torotnto. A few large hospitals and some doctors'offices have closed which made a serious problem:cancer or other critical patients' operations have been postponed. As Kanai-san mentioned above that the economies clearly slowed down, especially among Chinese communities. Yesterday <a href="http://globeandmail.com/servlet/story/RTGAM.20030411.wsars0411/BNStory/National">Prime Minister Jean Chretien visited a Chinese restaurant in Toronto</a> to try to allay fears that Asians are likely to carry SARS.

I heard that "ijime" toward Chinese Canadian students are happening in schools.

Effect of fear amazes me. So far 10 people died of SARS in Toronto.

15- Jackie

Hi...I'm just one of those randam person who is in risk too of getting SARS....I don't see why you would care, but I'm doing a report on SARS and boy did this helped a lot....

Thanks u did a wonderful job...
GOOD LUCK OVER THERE! ^-^

16- kazem

please send for me picture of sarsillness.
have a good time

17- Junko Sumiya

Posting in Japanese.
いまだに日本にSARSの感染者が出ていないのはどうなのでしょう。たまたまラッキーだったのかもしれないけれどでもやっぱり時間の問題ではないかとも思う。国内線ではあるけど、最近良く飛行機に乗る機会があり、ホテルにも宿泊するので何だかいらぬ心配?をふとしてしまう。いらぬとも思えないけど。当然私より危険な状況でお仕事のため、旅行したりしなくてはならない人が大勢いるし、ましてや隔離中、治療中のアジアの病院で看病をしている人々はすごい人たちだと思う。
中国の国の対応が批判されている(されて当然)が、でも日本もBBSの時から進歩が感じられないのは私だけでしょうか。空港チェックも出国は発病者がいないからチェックしないとか。いないと発表/発覚していないは違うと思うんですが。

日本セントリックにならず、アジアのためにも早く解決、終結が見えるといいのですが…

ちょっと話はずれるけど、空港チェックといえば、韓国の地下鉄事件以来なのか、ここのところ空港チェックでペットボトルを持っていることを申告するようになった。ま、安全であれば申告でも何でもするけど、ペットボトル以外にも色々危険物は隠せるのでしょうに。ま、あのレントゲンみたいな機会はきっとちょっと知らないうちに進化して色々探知できるんでしょうね。

18- Ed Reid

I'm travelling to the UK from New Zealand via Hong Kong in mid-August and want to do a short stopover. I have until the end of May to book this. My wife thinks I'm mad. Is there any way I can find out if the SARS graph is rising or falling by then?

Thanks Ed

京都の生活百貨店「コーナン」でSars対策としてAgMoistという銀イオンスプレーというものを発売しておりました。そちらを念のため、まさかの時にそなえて、購入しました。こちらの商品のHPをみつけたので一応載せて置きます。<a href="http://www.maja.jp/agmoist/">http://www.maja.jp/agmoist/</a>
---------------------------------------------
A thing called a silver ion spray called AgMoist was put on the market as a measure against Sars by KOUNAN of Kyoto. It offered and purchased there by way of precaution in emergency. Since HP of the goods here was found, it carries once and places.



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月, 3 31, 2003, @ 7:35
SARS update
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月, 3 31, 2003, @ 7:46
SARS update
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水, 4 2, 2003, @ 22:24
SARS update
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Is UN politics getting in the way of best practices?<blockquote>AP<a href="http://boston.com/dailynews/089/world/Taiwanese_accuse_U_N_health_ag:.shtml">Taiwanese accuse U.N. health agency of ignoring them; say it could ag...</blockquote></a> More »

木, 4 3, 2003, @ 10:56
SARS update
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