China claims SARS under control
© BioMed Central Ltd 2003
Published: 17 June 2003
KUALA LUMPUR - At the WHO global conference on severe acute respiratory syndrome (SARS) in Kuala Lumpur today, China claimed that its SARS outbreak, which began in November 2002, is at last under control.
Gao Qiang, China's Vice Minister of Health, told delegates this morning that during the period June 1-16, China had "Five or fewer cases a day for four days, and zero for the other 12." The daily average had fallen from 150 at the start of May to 13 by the end of that month, claimed Gao.
James Mackenzie of the University of Queensland, a member of the first World Health Organization (WHO) team to go into Guandong in South China in March, told us "I think Gao tried to show he knew things a bit earlier than he did. But people who've gone to look are fairly convinced that what he's said is true. But they cut it by luck. They used a shotgun approach and it seems to have worked. They closed schools, hospitals, everything's been quarantined off, without necessarily any good epidemiology attached to it. And apparently it's worked."
David Heymann, Director of Communicable Diseases at WHO, told us WHO believes "China has gained great experience dealing with this outbreak…in a very difficult system where the central and provincial governments were not working together on health matters. They've been able to do that for SARS, and we hope they'll be able to do that in the future. They believe in the next six months they'll have to spend a lot of money and resources in setting up a national network.
"We're also convinced that with a massive involvement of the population they now have controlled this disease," said Heymann.
But Taiwan remains highly sceptical. "We don't believe those figures," Ih-Jen Su, Director-General of Taiwan's Centers for Disease Control, and the man in charge of Taiwan's laboratory diagnosis of SARS, told us. "And we have 400,000 businessmen travelling to China every day. It worries us."
SARS is under control now in Taiwan, claimed Ih-Jen Su. "We can trace all the cases back. We've learned how to contain this epidemic.
"I appealed to Dr Heymann that he should give us even five minutes to stand up at this meeting and say what we'd done. How can you keep Taiwan, who've had so many cases, out of an important SARS meeting? But China said even at the beginning of the epidemic that WHO had to get China's permission for WHO experts to come to Taiwan. They came, but only one or two weeks after the outbreak."
But Gro Harlem Brundtland, outgoing Director-General of WHO, denied there had been a problem. She told us, "Frankly, Taiwan didn't have trouble getting WHO to help. There are many issues of a political and controversial nature in this, but we have seen to it that all areas have been served with the knowledge base and technical support that has been needed. But I am not going to be dragged into this. It's a political matter, a matter for the UN in New York."
"China had a big debate internally, and changed its tack about what was necessary. So they saw for themselves that they needed to respond in a different way. I see it as an important historical phase of development," said Brundtland. "The sharing of data, across an informal network, was a real breakthrough. It's not only China. As we rework the International Health Regulations, countries will come forward to see openness is in everybody's interest.
"One hundred days after the first WHO global warning on SARS, we're lucky to be seeing the outbreaks tapering off in various countries, and there's hope that this round has been contained successfully. It's due to exceptional solidarity and cooperation across national borders… under the guidance of WHO," said Brundtland.
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