Press Releases

Transcript of Secretary for Health, Welfare and Food

Following is the transcript of a stand-up session by the Secretary for Health, Welfare and Food, Dr. Yeoh Eng-kiong, after a radio programme this morning (May 3):


Secretary for Health, Welfare and Food: I said that we had a very long and good discussion with the Executive Director of the World Health Organisation who is in charge of the infectious disease centre, Dr. David Heymann. We had more than an hour discussion and the first part of the discussion I presented to him the work we were doing to control this endemic in Hong Kong for Severe Acute Respiratory Syndrome (SARS). I briefed him on the measures that we are taking in terms of doing online surveillance because you know we designed a system as soon as patients admitted to hospital and suspected of suffering from SARS. The information will be put automatically to the computer systems transmitted to the Department of Health (DH). The DH colleagues can then immediately act on the suspected case. We are now using the Police system for contact tracing because it is a very helpful information system. The Police system is able to tell us where the addresses are, whether there are certain buildings that are affected so that the DH colleagues can do immediate investigations. As I said before, if there are two families in the same building are infected, then we have a multi-disciplinary team close by immediately to do the investigation. The Police system also permits us to get in touch with the people or contacts even with their addresses and names, and sometimes their stops. So this system will enable us to identify hot spots, so-called hot spots in the community, where we can do immediate investigation to prevent any outbreak as the case in Amoy Gardens. The computer system also enables us to get in touch with people who have close contact with suspected SARS patients so that we can do more efficiently on the contact place, more promptly so that we can then get the affected individual under early surveillance, to prevent infections to other people and to treatment. So in fact we have designed now a more online and real time system. So I have explained all these to him.

I also explained how we try to control the infection outbreaks in hospitals, so reducing the burdens. And in the last week or so, our numbers of new patients have come down. So I was able to present all these to them. Of course, he was very pleased in our work and the way that the epidemic was being controlled. So we did discuss the criteria for lifting the travel advice to Hong Kong. We talked about basically four principles. One of course is that they wanted to know all our situation, the size of disease going in Hong Kong. Second, they wanted to understand more about the mode of transmission because when this outbreak first occurred, traditional or the expert view was that it was droplets. And the Amoy Gardens outbreak was the first time that there was a large outbreak in the community setting. There's all the other outbreaks have been in the hospital or health care setting. So, obviously the WHO was really very concerned about the possible mode of transmission in the community because there have been indications of the spread of the disease in other places of the world. So they really wanted to understand more the mode of transmission. They thought that the investigation work began investigating the outbreak in the Amoy Gardens was a very good one. It did not provide completely the answers because most of the studies is very very difficult to reconstruct the whole event. But the investigations we have done are very thorough. They now have a team working that will see whether there are any further insights. So obviously they need to understand more the mode of transmission. The third is of course the need to look at the number of our control, how good we are controlling the virus in terms of the number of new cases and active cases, we discussed in terms of what they would be for Hong Kong. Fourth, there was no exportation of new cases of SARS to other places in the world. So I guess we are at that stage. In fact we are arranging another videoconference next week. I'll be discussing further with Dr Heymann at the end of next week at the videoconference the exact requirements of this and to take through this discussion so that we are able to meet the criteria that the WHO sets up. He said that he would be going back and discussing it with Dr Brundtland and to see how we can take this forward and for us to continue the discussion on the criteria for lifting the travel ban.

Reporter: The significance of the survey showing that 80 per cent of the people infected with SARS in that particular hospital?

Secretary for Health, Welfare and Food: As you know, SARS is complex. It's not a specific disease entity, it's a group of symptoms that individuals have respiratory illnesses and that we're watching this fever. It's a very, very broad symptom and complex that includes a lot of other pneumonias, other bacterial and viral pneumonias. So, it's not a precise disease entity. It's symptom of a complex of symptoms. So, it's very, very broad. By this definition, it's very difficult to distinguish a disease entity because the definition will include many disease entities that will fit into our categories. So when we look at our cases of SARS, so that's why the definition talks about probable and suspected cases. In Hong Kong, we have in a way over-diagnosed because we included everything that is confirmed. So, our index patients are much lower. So we've included a lot of cases where we needed to go back and look at the case definitions to see how many of them are really coronavirus related, as in SARS. Because SARS is symptom complex which can be caused by other viruses and bacteria if we are not careful, then that's not going to work out. When we look at our cases, the Department of Health has looked at over 1,600 cases, the history of contact - people who have contacts with other patients in SARS outbreak - accounted for about 80 per cent of all the cases. So now we have about 1,600 cases and 80 per cent of them fitted into the criteria of the World Health Organisation because there must be straight contacts either with SARS or SARS patients. Obviously we cannot use the second criteria in Hong Kong because everyone in Hong Kong has lived in a place with SARS which would fit the second criteria. But if we take the second criteria out and just contacts with the SARS, 80 per cent of our cases had contacts with the SARS, 20 per cent of the SARS patients that we had do not have history of contacts. So we are in the process of trying to see whether these 20 per cent of cases are coronavirus-related. What we are doing now is we are looking at the laboratory investigations because we now have a test for coronavirus, which at 21 days, you show it to the person who has contact with SARS, the blood test will show you a nil response. We are now doing all the tests to see how many of these 20 per cent of individuals have had laboratory evidence of SARS. What we are also looking at is that in the process of investigations, we also do tests for other viruses and to see how many of these 20 per cent of individuals have other viruses or infections that could account for the symptoms and that they are not coronavirus-related. So we need to have it distinguished. When ultimately we will have discussions with WHO on the number of new cases, we need to be very specific that we are not including all the cases that are coronavirus-related. So when you ask for the numbers, I think you need to clarify what the numbers actually mean. Mr Tung mentioned about single digit. Obviously we really want to have zero. I mean we can but whether we can or not depends the epidemicity of the disease in Hong Kong. We certify to get this from hospitals but we need to distinguish between the coronavirus-related SARS which we all are concerned about in terms of preventing and the other background causes of SARS which could be some of other viruses.

(Please also refer to the Chinese portion of the transcript.)

End/Saturday, May 3, 2003
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