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Press Conference by SARS Experts (2003/04/10)

Chinese Ministry of Health gave a press conference on the progress of SARS control in China April 10. Vice Minister of Health Ma Xiaowei, Director of Guangzhou Respiratory Diseases Institute Zhong Nanshan, Director of the Disease Control Department of Health Ministry Qi Xiaoqiu, and Director of the Chinese Center for Disease Control and Prevention Li Liming met the press. The following is a transcript of the questions and answers translated by

Question: First, about the number of SARS (atypical pneumonia) cases: could you give us a daily report of newly found cases in each province every day? Could you give us names of relevant officials from public health bureaus and tell us who is responsible for the accuracy of the numbers we get? And third question: we have got a different number of SARS cases in Beijing from a PLA hospital compared with the number released by the Ministry of Health – how do you explain the difference?

Ma Xiaowei: We have decided to include the report on China’s SARS situation and treatment measures into the Prevention Law of Epidemics. This means each local government has the legal responsibility in reporting the exact situation about SARS. What I announced today is the number of cases which have been diagnosed as SARS, including the cases in Guangdong, Beijing and Shanxi Province. The number is correct. In some areas, though, there might be imported SARS cases. The Ministry of Health has sent out an expert team to these areas to investigate. Once new areas are verified to be SARS affected, we will release the latest news at that time.

Beijing has now 22 patients diagnosed as SARS cases, of whom four have died. As you know, most cases in Beijing are imported ones. Once a patient is verified to have caught atypical pneumonia, we’ll send him/her to an appointed hospital. To better control the disease, we take corresponding measures to separate patients and medical workers. Practices show the separation is safe for medical workers and effective for SARS control. Some who have had contact with SARS patients but are no longer in need of separation will leave hospital soon.

Question: Mr. Vice Minister, first, could you please introduce in general the epidemic situation of SARS in Beijing? Second, what measures are being taken at present to control the epidemic as well as to guarantee the safety of local citizens and visitors to Beijing from other parts of the country against the disease?

Ma Xiaowei: I have just made a report about the epidemic situation in Beijing to everyone here. Beijing municipal government has been taking many kinds of measures to control extending the epidemic and to protect and guarantee the safety of domestic and foreign visitors to Beijing. The following are measures in brief that we have taken:

Open 24-hour English helpline concerning SARS. Beijing Municipal Health Bureau established special webpage to answer foreigners’ questions about SARS.

Some hospitals with advanced equipment and technology were assigned to offer medical services to foreign SARS patients.

The Foreign Affaires Office of the municipal government has invited foreign embassies and consulates to China, business firms and media to attend often-held press conferences on this issue and distributed to them all related publicity material. The municipal educational authority has organized overseas students in Beijing to attend such meetings where they have been informed of the epidemic and prevention information about SARS.

For foreigners entering China, they are to be given a kind of tour-card on which is printed the prevention information of SARS and telephone numbers for contact with relevant hospitals.

Sterilization for epidemic prevention in airport and transportation facilities has been reinforced. Taxis are to be sterilized daily.

We are going to build up a medical team made up of competent experts to specially offer medical services to foreigners. Meanwhile, manpower of over a thousand people from Beijing will carry out mobile supervision around the country. Once finding the epidemic, they will report it to the public immediately. The Chinese Ministry of Foreign Affairs has sent messages to local foreign affairs offices around the country, ordering them to follow those measures taken in Beijing.

Question: Yesterday, I called the Ministry of Health and they told us they hadn’t got the exact number of SARS cases in military hospital. Now, I’d like to ask if the case number you gave us includes all cases from all hospitals? The second question, are there any primary cases in other places besides Guangdong? Recently we found many new cases in Shanxi. Is it possible they are not imported cases from Guangdong, but were infected in Shanxi? At the beginning it was said that more aged people had been infected with SARS and died. Are there many children infected with SARS because their parents had been infected with SARS?

Ma Xiaowei: The reported number of SARS cases includes all the diagnosed cases from local hospitals, professional hospitals and military hospitals.

In case of Shanxi, the situation we know is that the first SARS case there was imported from somewhere else. Then, some people who had close contact with the patient were infected with SARS, including some doctors. Now there are 32 SARS cases in Shanxi. The Ministry of Health has sent a group of experts to investigate the situation in the province and we will report it as soon as we get the result.

According to death cases in Guangdong, children and old people are not the main death generation. The death cases include people of all age brackets.

Zhong Nanshan: I’d like to clarify something. In Guangdong Province, most SARS infected patients are middle aged and young men. There are some old people infected with SARS and the death rate among them is high. But it does not mean children and the elderly are the main death generation. It is very difficult to say where the contagious disease comes from and if the disease is brought from any other place. For example, the residents in the Amoy Garden in Hong Kong went to Guangdong for fear of SARS in that Garden and infected other people in Guangdong. With the development of the disease there are both primary and imported cases in some areas.

Question: Is there a concrete number to show the suspect cases of SARS in China? What are the conditions of the case distribution in every province and area? Moreover, compared with many countries that continually released relevant news, it seems China gave out little information. According to the Chinese Center for Diseases Control and Prevention, there is a diagnostic criteria for suspect cases in medical circles. World Health Organization (WHO) experts working in Guangdong Province also told us that despite great effort to collect information for the cases, they have not yet released any information so far. My question is that why can’t you give out this information and what is the content?

Qi Xiaoqiu: To date, the concrete pathogeny of SARS is not yet clear. Although China and WHO both have set up diagnostic criteria for SARS, there are still many things that need to be understood in the course of diagnosis. So in line with the requirements of the Ministry of Health, the SARS diagnosis is categorized into three parts: diagnosis case, suspect case and object for medical observation. The number we offered to WHO and released to the public should incorporate diagnosis cases and suspect cases. For example, the number of cases in Hunan Province is cut down by two now as they are treated as suspect patients before and were found to be all right later. Therefore we make continuous updating to our numbers.

In order to further prevent SARS from spreading, varied local health departments made medical observations which have expanded to many closely concerned people. It is unreasonable to count up the number of these people.

Question: How reliable do you think the information collected in the epidemic areas is? Did local officials accurately report the number of infected people? Generally speaking, they could have hidden the truth and made a false report with data for fear of losing face or their job. Do you think China should further enhance the transparency of the health authorities? The Ministry of Health should provide the public and media with some free information. Do you think China should take some measures to make information more accessible?

Ma Xiaowei: We are adhering to the principle of early found and early reported. The accuracy of the number is very important to the judgment of the epidemic situation and also important to what measures we should take. The State Council has taken effective measures. The atypical pneumonia has been put into the category of a national epidemic disease. Local governments are required by law to report the epidemic situation. Once there are new epidemic disease outbreaks or new suspected cases, the Ministry of Health will send experts to investigate the situation within 24 hours and provide assistance in epidemiology and aetiology.

In addition, we will further perfect the information report system and establish an information report center to handle emergences. This work is under discussion by concerning departments and will start up soon. Meanwhile, the Ministry of Health will conduct investigation on those who failed to report the data of epidemic disease accurately.

According to current feedback from expert groups, the local governments of various levels are taking active measures to deploy the prevention work of the atypical pneumonia. The disease control departments of all parts of the country are trying their best to do some prevention work and report the epidemic situation timely, accurately and scientifically.

There is one thing I think you may have noticed that China is such a vast country with huge population that it is an enormous task to conduct broad investigations on some unidentified disease. I believe the work of reporting epidemic situations will be improved after we take the measures.

Question: Many people have no doubt about the doctors’ words on the number of SARS cases but they are suspicious of data from government sources. For instance, if a doctor from a Beijing hospital says that SARS cases in Beijing are over 60, people tend to believe his words. How do you reconcile the disparity of the data?

Ma Xiaowei: Beijing has received 22 patients confirmed contaminating SARS. The majority of the 22 persons came from outside the city to seek medical help here. They were received in a number of hospitals and got transferred to hospitals appointed by the Beijing municipal government as SARS treating bases after they were confirmed to have SARS. Staff members coming into contact with SARS patients from those hospitals are quarantined to receive medical observation for the sake of their health as well as disease prevention. It’s true that some of these quarantined people include medical workers have some suspicious symptoms but none of them have been confirmed to have SARS yet. Now many of the quarantined people have proved to be healthy and will be allowed to leave hospital soon.

If we found a person among these people under clinical observation to have symptoms of SARS, we’ll treat him/her in those appointed hospitals and report the case to WHO in time.

Zhong Nanshan: I’d like to answer this lady’s inquiry as a supplement to Mr. Ma’s answer. If one is not a doctor in this field, he’ll take it for granted that any symptom means the disease. Take my institute as an instance: we have 13 colleagues suffering from SARS after they were in contact with SARS patients. But some people thought the figure should be over 20 or even 30 because they equate symptoms with the disease. Such discrepancies are common and I am never surprised at that.

Question: Could you introduce the situation of hospitals in Beijing and do military hospitals give their case report to the Ministry of Health as other hospitals?

Ma Xiaowei: A military hospital in Beijing received a SARS patient from Shanxi Province in March. Seven of the total 12 people in contact with the patient during treatment were infected. Among them, five have recovered and two have died. They are all included in the Beijing’s statistics of 22 infected and 4 deaths.

Question: I interviewed Vice Primer Wu Yi and attended a press conference yesterday. The experts from WHO praised the Chinese government’s cooperation. Could you introduce the government’s further cooperation with WHO?

Ma Xiaowei: The experts from WHO discussed the situation of SARS and gave us advice on how to prevent and control the disease. Chinese government will cooperate with WHO to look for the cause of SARS and the disease’s clinical diagnosis and treatment. We’ll also cooperate with respect of the epidemic germ.

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