Cathay Pacific Asia Miles - Pathetic HK Govt Handling of SARS situation

"Tung targets travel as SARS cases climb "
HK Standard newspaper - another major hit for CX and other airlines using Chep Lap Kok
Since Hong Kong has existed for years as a re-exporter of Chinese goods, the same has happened with the SARS virus.
The disease emanated from Southern China in November 2002. The Chinese authorities tried to first suppress then continued to lie about the extent of the outbreak. Meanwhile this fatal Chinese export continued to cross the Mainland border both ways daily into HKG. It seems quite obvious that if our lame duck HK administration wants to prevent this getting worse in HKG they must institute mandatory health checks on all persons entering from and leaving HKG's borders for China, the source of the SARS problem.
The bug is wrecking HKG's economy so why do they continue to allow unchecked travel to and from the source of reinfection ? The fact that Hong kong will now take the temperature of departing air passengers seems more for 'face' than for practicality and will in no way affect the way the same passengers are treated and examined overseas when they land.
In the Iraq war the troops had to be sure that enemy reinforcements did not return after they contained an area - the same principle applies here with SARS and the source of re-supply by land, sea and air.

Meanwhile - Influenza in USA alone
Number of Cases Reported Annually: 95 million (1996)
Number of Cases per 100 Persons: 36 (1996)
Number of Restricted-Activity Days Due to Flu: 346 million (1996)
Number of Bed Days Due to Flu: 192 million (1996)
Number of Work-Loss Days Due to Flu: 70 million (1996)
Source: Vital and Health Statistics Series 10, No. 200
Number of USA yearly deaths from Influenza and pneumonia - 65,913 persons
http://www.cdc.gov/nchs/fastats/flu.htm
http://www.weforum.org/site/knowledgenavigator.nsf/Content/Health%20as%20a%20Global%20Security%20Risk%3F
- At the beginning of 2001, more than 36 million people lived with HIV/AIDS worldwide -- 50% more than a decade ago. Ninety-five percent of all HIV infections occur in developing countries.
- Two billion people are carriers of the tuberculosis bacillus. Every year 1.7 million die from TB; 99% of all TB sufferers live in developing countries.
- Malaria kills more than 1 million people a year; in 2000 more than 900,000 were children under five years.

http://news.bbc.co.uk/1/hi/health/441076.stm

There are 300 million cases of malaria reported each year
Every second, 10 new cases are reported
This is almost five times as many as of Aids, TB, measles and leprosy combined
One million people die from the disease each year
The cost of the disease in terms of health care and lost productivity is estimated at £1.1bn a year

http://www.who.int/mediacentre/releases/pr70/en/
Influenza can be a deadly disease, not just an inconvenience. During the most recent influenza outbreak in Madagascar which began in early June 2002 and lasted until late August, more than 22,000 people were infected. Six hundred and seventy one people died. The victims were mainly children in the affected area who lacked of access to medical care and had poor nutrition. In the most affected province, Fianarantsoa, there were 18,808 cases and 556 deaths.
http://www.cdc.gov/ncidod/diseases/flu/viruses.htm
Influenza viruses cause epidemics of disease almost every winter. In the United States, these winter influenza epidemics can cause illness in 10% to 20% of people and are associated with an average of 36,000 deaths and 114,000 hospitalizations per year.
Fact
There were 5,200 deaths of bacterial pneumonia and chronic lower respiratory diseases in Hong kong in 2001 (HK Department of Health Stats) or 16.3 % of the total disease death rate - of this number 92.2% were aged 65 or over.

There have been 32 deaths of Sars in Hong kong of which the vast majority were aged or had chronic heart , liver or other diseases.

SARS epidemiology to date

11 April 2003

http://www.who.int/csr/sars/epi2003_04_11/en/

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">
The current cumulative number of cases of SARS is 2781 cases with 111 deaths, officially notified by ministries of health. The global case-fatality rate for probable SARS is 4%.
Most SARS cases to date have occurred in young adults. This transmission pattern largely reflects the age of health care workers, their family members and social contacts, and international travellers. On the basis of present data, children appear to be less likely to present with SARS than adults.
Hong Kong is experiencing the second largest outbreak of SARS with 998 cases and 30 deaths. A significant outbreak at the Amoy Gardens apartment block between 27 March to 1 April resulted in a peak in cases. Stringent public health measures appear to have controlled the Amoy Gardens outbreak. However, cases continue to be reported in health care workers, and Hong Kong health authorities are strengthening their infection control and community-based public health measures accordingly.


</font>

However you are quoting 'official' numbers. The HKG numbers are real. Those from Mainland China are vastly under reported.

SCMP 12 April
Suspected Sars cases left off the official list
Hitting back at critics, a mainland health chief says doctors have to be careful not to misdiagnose patients ALLEN T. CHENG

Mainland officials yesterday admitted, for the first time, that they did not include all cases or suspected cases of severe acute respiratory syndrome (Sars) patients in their official statistics.
At a press conference held primarily for journalists from Hong Kong and Taiwan, Qi Xiaoqiu, the head of the Centre for Disease Control at the Ministry of Health, said officials did not include suspected or "observation" cases of Sars.

"Taiwan, for instance, has four definitions of classifying Sars," said Dr Qi. "Possible, highly likely, Sars infected, and severely Sars infected.
"We on the mainland have only three definitions, suspect or observation required, Sars infected, and severely Sars infected. We do not include suspect or observation required in our official statistics."
When asked why the government did not include suspected cases, Dr Qi said Sars was such a new disease that doctors should be careful not to misdiagnose patients.
The ministry has come under attack this week for not revealing the full extent of the disease in Beijing. Dr Jiang Yanhong, 72, a retired director of general surgery from People's Liberation Army Hospital 301, alleged that Health Minister Zhang Wenkang had downplayed the extent of the virus in the capital.
Official statistics list 1,290 Sars patients on the mainland, with 55 deaths. The ministry says there have been 22 cases and four deaths in the capital. But according to Dr Jiang, there have been 146 cases of infections and 10 deaths in three major PLA hospitals alone in Beijing.
In the capital, there are 300 hospitals, including 15 run by the PLA. Rumours have been spreading like wildfire that most of Beijing's hospitals now have Sars cases.

Dr Jiang's allegations of under-reporting was one of the reasons why a team from the World Health Organisation (WHO) decided to begin a five-day inspection tour of Beijing-area hospitals yesterday.
"I'm willing to meet the minister of health face to face and settle this issue," said Dr Jiang. "If I am wrong, I am willing to apologise to the world."
Dr Jiang said he was well aware that health officials did not include all Sars cases in their official statistics.
"I'm glad the WHO is investigating Beijing," said the doctor, a member of the Communist Party for nearly 50 years, and someone who apparently has strong enough backing within PLA medical circles to dare to challenge the Ministry of Heath.
Dr Jiang is not the only critic who claims that the outbreak in Beijing is far more severe than the public has been led to believe. A senior sales executive for a western pharmaceutical company said nearly all of Beijing's 300 hospitals have had at least one Sars-related cases.
"The government has issued an edict: if it's Sars, don't label it as Sars," said the woman executive, surnamed Wang.
"Label it as a flu, but isolate the person and treat him or her quickly. The government doesn't want the public to know that the outbreak is quite severe. It's concerned that such news would cause panic and instability."
A Beijing-based political analyst said the Communist Party has traditionally tried to keep issues secret and resolve them internally.
"Though the party for a long time eschewed traditional Chinese values, it is highly traditional when it comes to practice," said the analyst.
"Just like a Chinese family, the party never likes to air dirty laundry in public."

As far as I know, the WHO has not given uniform instructions/criteria to report SARS cases. If you look at the daily updates on the WHO site, you will notice that the WHO started reporting 'probable' cases of SARS (those with symptoms and x-ray exhibit indication of respiratory illness) just only a few days ago.

And the WHO is not still requiring that 'suspect' cases be reported in that country-specific list.

I am sure if China reports even suspect cases, the total tally would balloon. I am not sure if HKG data includes suspect cases. Or are you saying HKG data includes suspect cases as well?

Only the U.S., I think, has been reporting 'suspect' cases, which are under investigation. See a note below the table.

Since they don't know conclusively the cause of this illness, even some probable cases have been withdrawn, i.e., they turned out not to have SARS! Check Taiwan data. You will see a note to that effect.

The WHO also says these changes can happen.

Japan also figured for the first time in the list as of April 11, because the health ministry says the WHO started demanding probable cases be reported. Before that, it was up to the discretion of each country. (Blame the WHO, not China, maybe?) Japan had a policy of reporting only confirmed cases.

In Japan (but not to the WHO), the Japanese government has long been reporting suspect cases and probable cases, not more than 10, I think. All but four of them have been withdrawn. We now have four as of today and they are 'probable' cases. Not confirmed. And quite fortunately, no deaths yet here.

[This message has been edited by Chiangi (edited 04-12-2003).]

Most SARS cases are occurring in younger people because, as the WHO says, they are the health workers and younger family members caring for the people who get really sick. It is old to very old people who are dying of SARS. Very few young ones who weren't already chronically ill with something else.

In other words, it's much the same as a flu epidemic, but on a much, much smaller scale.

Useful reference sites:
http://www.info.gov.hk/dh/ap.htm
(Click on latest information)
http://www.cdc.gov/ncidod/sars/
http://www.who.int/csr/sars/en/

HK Cumulative Figures on Atypical Pneumonia Cases
(as at 1 pm, 11 April 2003)
Cumulative Number
(The numbers in brackets are those with pneumonia symptoms)
Total No. of Discharged Patients

Health care workers of Hospitals/Clinics and medical students 264 (264) 78
Patients, family members & visitors 795 (795) 91
Total 1059 (1059) 169

Total No. of Deaths * 32
* Most of the deaths occurred in individuals who have a history of chronic diseases, or were patients who sought treatment at a relatively late stage of infection.

Perhaps to support Marco Polo's claim about the HKG gov't., the TIME magazine also features SARS in the latest issue with Saddam on the cover.

In one of the articles, it compares how Hong Kong and Singapore reacted to the virus. Hong Kong definitely acted slower, the magazine claims.

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by christep:
It is old to very old people who are dying of SARS. Very few young ones who weren't already chronically ill with something else.</font>

Bad form to quote myself I know - sorry. But today's figures (updated at http://home.so-net.com.hk/~pns/ ) show two things:

- good news: lots of patients discharged (though still not quite as many as new ones)

- bad news: two deaths of 30-somethings with no reported prior chronic illness http://www.flyertalk.com/forum/frown.gif

[This message has been edited by christep (edited 04-12-2003).]

[This message has been edited by christep (edited 04-12-2003).]

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by christep:
In other words, it's much the same as a flu epidemic, but on a much, much smaller scale.</font>

Well said. It's just much scarier because they gave it a fancy sounding, albeit meaningless name, reminiscent of another other four-letter acronym, AIDS.

A comparison between the flu and SARS (such as the one at the top of this thread) completely misses the point:
There is protection against flu -- flu shots -- that has been shown to reduce both the incidence and severity of flu. Until and unless the specific cause of SARS can be identified, no such preventative measure is available.
The severity of SARS is far greater than flu. Based on the figures that Marco Polo provided, someone getting the flu averaged spending 2 days in bed plus another 1.8 days of restricted activity. All reports indicate that SARS has a far greater impact.
Since you (Marco Polo) seem to like statistics, here's one for you to chase down: how many SARS patients (that is, people who are being treated for active SARS) were there in mid-February, how many in mid-March, and how many in mid-April? Generate a curve (or set of curves) based on those data points, and how many SARS patients would you expect in June? In September? In Feb, 2005? (ok, I know, but it's to make the point that the problem is not the current number infected, but the potential number, given the amount unknown about SARS and how it spreads.)

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by wideman:

how many SARS patients (that is, people who are being treated for active SARS) were there in mid-February, how many in mid-March, and how many in mid-April? Generate a curve (or set of curves) based on those data points, </font>

I see you are trying to justify exponential growth but 3 data sets are way too premature to arrive at any conclusion. You must take into account the preventive measures people are now taking, compared to mid Feb. Also, you can't neglect the possiblity of slow down in the summer season, or even a vaccine!

Let us not be so pessimistic.

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by wideman:
how many SARS patients would you expect in June? In September? In Feb, 2005? </font>

A simple linear extrapolation of trend line makes no sense - with your logic the enter world population will be infected by 2006 http://www.flyertalk.com/forum/wink.gif

OK - this is enough - I am moving a cave in West Virgina as soon as I find one with internet access.

Let me make it clear that I do not believe that everyone on earth will have had SARS by next March 13.

My comment was intended to show that using statistics to compare flu to SARS (for example, reported cases of flu vs reported cases of SARS) misses the whole point. The threat of SARS is not based on the number of people currently infected, but rather the potential for infection. Because at this moment on April 12, the medical science/public health community does not know how SARS is spread from one person to another, they do not know when an infected person is contagious, and they especially do not know how a few people seem to be able to infect enormous numbers of other people.

The travel warnings serve not so much to protect a single traveller from getting SARS -- the likelihood of someone visiting HK and getting SARS is in fact extremely low -- but to limit the extent to which SARS gets spread around the globe, at least until an effective treatment and/or prevention has been developed.

They do know how it is spread
Close proximity droplets from a sneeze (1 meter)
Touching infected secretions with the hand (the virus stays viable for 2-3 hours) then touching your eyes, nose , face or mouth with that hand
Via fecal matter in blocked drains (the Amoy Gardens case)

What is severe acute respiratory syndrome (atypical pneumonia)?

Severe acute respiratory syndrome is an acute respiratory infection that has been reported in a number of places, including Hong Kong. It is a form of atypical pneumonia caused by a new agent.
Hong Kong's health authorities are working closely together to control the spread of the disease. They are also working very closely with the World Health Organisation.
The disease can be transmitted by respiratory droplets over a short distance of one metre or through contact with a patient's secretions.
Symptoms of severe acute respiratory syndrome include: fever (over 38 degrees Celsius) and chills, coughing, shortness of breath, headache, aching body and general malaise.
Any person with respiratory illness symptoms should seek immediate medical attention and wear a face mask.
Most patients diagnosed early are responding to treatment and showing signs of improvement. Some have been discharged from hospital.
What preventive measures can be taken?
Maintain good personal hygiene
Wash hands regularly with liquid soap.
Cover the nose and mouth with a tissue paper when sneezing or coughing. Properly dispose of the tissue paper immediately.
Wash hands immediately after coughing, sneezing or wiping the nose.
Wash hands before touching the eyes, nose and mouth.
Wash hands after going to the toilet, after touching public installations or equipment and when you get home. Dry hands with a disposable paper towel or a hand dryer.
Avoid shaking hands.
Do not share towels.
Do not share eating utensils-use serving spoons and chopsticks.
Build up good body immunity. Eat a balanced diet, exercise regularly, get adequate rest, avoid stress. Do not smoke.
Avoid crowded places.
Maintain good hygiene at home and work
Clean the home and office at least once a day using disinfectant or a solution of diluted household bleach. For general cleaning, use a diluted bleach solution (1 part bleach : 99 parts water). Rewipe with a towel soaked in clean water. For areas, equipment, or facilities contaminated by vomitus, or that have come into contact with an infected person, use a stronger bleach solution (1 part bleach : 49 parts water). Rewipe with a towel soaked in clean water, or rinse with clean water, and dry.
Maintain good indoor ventilation by opening windows from time to time. Keep air-conditioners well maintained and wash air filters frequently.
Make sure toilets are clean and work properly. Provide liquid soap, paper towels and hand dryers.
What should be done if a family member, colleague or friend gets infected?
Patients with severe acute respiratory syndrome must be hospitalised.
Those living in the same household, or those who have cared for an infected person, must attend a designated medical centre for daily medical surveillance for 10 days.
The Department of Health will issue specific guidelines to those under medical surveillance. During the surveillance period they must stay off work and rest at home. They should not leave home unless it is absolutely necessary. If they have to leave home, they must wear a face mask and observe good personal hygiene.
Asymptomatic social contacts (e.g. friends, colleagues) of an infected person will be provided with specific information and a hotline number. Should they develop respiratory illness symptoms, they will be advised to attend a designated medical centre.
General Guidelines
At home
Keep the household clean and maintain good indoor ventilation.
Wash hands when you arrive home.
If caring for a family member with any respiratory illness :
-Promptly consult a doctor if you begin to feel unwell.
-Follow instructions given by doctors, including the use of prescribed drugs.
-Get adequate rest.
-Adhere to good personal hygiene practices.
-Wear a face mask to reduce the chance of infection.
At schools
Sick children must not be taken to school or child care centres.
If a child becomes sick while at school :
-Inform parents/guardians immediately and advise them to take the child to see a doctor.
-Separate the sick child from others. Ask the child to wear a face mask if displaying signs of a respiratory illness, or fever.
-Wear a face mask if in contact with a child displaying respiratory illness symptoms.
Schools should keep good sick leave records of staff and children. When there is an increase in the number of absentees:
-Contain the staff or parents/guardians of absentees to ascertain the reasons for their absence.
-Inform the Department of Health when there is a large number of absentees with similar symptoms.
-Clean and disinfect toilet facilities at least twice a day.
-Clean school furniture and equipment and maintain good indoor ventilation.
At work
Consult a doctor promptly and take sick leave if there are symptoms of respiratory illness.
If a staff member is diagnosed with severe acute respiratory syndrome, company management must immediately inform health authorities, as well as all other staff members.
Keep the workplace clean and maintain good indoor ventilation.
In public places, e.g. restaurants, cinemas, markets
Wear a face mask if suffering from any respiratory illness symptoms.
Wear a face mask if involved in the preparation or serving of food.
Wash hands regularly with liquid soap.
Dispose of used tissue paper in a covered litter bin. Then wash your hands.
Do not spit.
Ensure toilet facilities are clean and work properly. Provide liquid soap and disposable paper towels or a hand dryer.
In apartment blocks and common areas
Clean and disinfect common areas at least twice a day using a stronger bleach solution (1 part bleach : 49 parts water).
Pay special attention to :
-Intercom facilities.
-Mailboxes.
-Escalator railings, lift lobbies and elevator buttons.
-Doors and door handles at entrance lobbies.
-Common facilities such as corridors, rest chairs, playgrounds.
-Club facilities.
-Security guard booths and enquiry counters.
-Refuse collection chambers and facilities.
-Toilets.
Wearing masks
Wearing a face mask properly offers protection against respiratory tract infections. People with respiratory illness symptoms, or those who have had close contact with confirmed cases of atypical pneumonia, should wear a face mask to reduce the chance of spreading infection. Their carers, or those visiting sick people in hospitals, should also wear a face mask. Members of the public may wear a face mask for self protection.
Wash hands before wearing a face mask and after taking one off. Follow the manufacturer's instructions. Ensure the face mask fits snugly on the face and is attached firmly by using the ties or rubber bands provided.
The coloured side of the face mask should face outside. The mask should fully cover the nose, mouth and chin. A metallic strip on the mask should be fixed securely over the bridge of the nose to prevent leakage.
Surgical face masks should be changed at least daily under general circumstances. Put used masks into a plastic bag and tie closed before dropping into a closed rubbish bin. Replace a mask immediately if it becomes worn or damaged.

For more information:
Call the Department of Health's pre-recorded health education hotline on 2833 0111, or the Department of Health hotline on 2961 8968 during office hours, or visit the Department's website at : www.info.gov.hk/dh/. (http://www.info.gov.hk/dh/.)

<font face="Verdana, Arial, Helvetica, sans-serif" size="2">Originally posted by wideman:
My comment was intended to show that using statistics to compare flu to SARS (for example, reported cases of flu vs reported cases of SARS) misses the whole point. The threat of SARS is not based on the number of people currently infected, but rather the potential for infection. Because at this moment on April 12, the medical science/public health community does not know how SARS is spread from one person to another, they do not know when an infected person is contagious, and they especially do not know how a few people seem to be able to infect enormous numbers of other people. The travel warnings serve not so much to protect a single traveller from getting SARS -- the likelihood of someone visiting HK and getting SARS is in fact extremely low -- but to limit the extent to which SARS gets spread around the globe, at least until an effective treatment and/or prevention has been developed. </font>

It's this way of thinking that is screwing up our travel and it just plan bad math. If you want to present mathematics, I'll present math to you.

First curves, whether in T-form or exponential form based on statistics contain **STATISTICAL ERROR** and use an incorrect alpha percentage to tilt the number "their way" and with additionally wrong sample information (i.e.: 20 cases when the actual number is 10). Then, most statisticians, end there and give their results at that point. They don't continue to the upper form to prove these results under probability.

So your concept is entirely disproven. What if SARS ends up being the swine flu and disappears?

The fact remains, if your temperature is taken against your will entering or leaving "x" country, a majority of travellers will stay home and there will be no airplane to fly even you.

Think a differnent math. How about the probability that the information you receive comes only from the news media? Let me guess, is it 99.4%??

SHADO

This time last year there were 98,600 pacx through Chep Lap Kok daily - three days ago there were 31,700 IN and OUT. 195 flights were cancelled yesterday. The HK Govt intend to use Auxiliary Medical services and airline staff to take the temperatures of DEPARTING pax only. Meantime the land borders with China see (reinfection) movements of 400,000 a day.

'Virus Checks for Travellers' SCMP Letters to the Editor - today
"Chief Executive Tung Chee-hwa has introduced measures to allay the fears of the international community, including testing all outbound passengers for symptoms of severe acute respiratory syndrome (Sars). Will this solve Hong Kong's problems, at the core of which is the origin of Sars?
With the influx of mainland tourists over Labour Day expected to be down from 400,000 visitors to just 200,000, should we be concerned about the drop in revenue or with the mainland's failure to accurately disclose the full picture? Someone in Guangzhou, who had no vested interest in saying otherwise, told me that according to the media there was no Sars in China.

But would Mr Tung risk upsetting Beijing with a requirement for all inbound mainland tourists to be tested for Sars? I think not.
Hong Kong will just sit and suffer misinformation, more widespread infection, and more uncertainty.
With modern mediums of communication, there is little need for travel to the mainland or vice-versa. Close the border between Hong Kong and China, and test all inbound and outbound passengers at the airport and ferry terminals.
Or if the Hong Kong-China border is not to be closed, then test all incoming and outgoing passengers.
Do not pretend this is a Hong Kong- based phenomenon. For the sake of Hong Kong, this is not an issue of face but of our future, Mr Tung. "