FROM BEIJING, CHINA
SARS
With John Pomfret
Washington Post Foreign Service
Wednesday, April 9, 2003; 11 a.m. ET The toll from severe acute respiratory syndrome (SARS) mounted Monday as the number of suspected cases worldwide surpassed 2,600 and the number of deaths reached 100. Seventeen countries have been affected. The number of suspected U.S. cases has climbed to 148 in 30 states but no deaths have been reported. The disease is believed to have originated in southern China in November and the country has come under intense domestic and international criticism for its slow response to the disease and its failure to inform other countries about it. Washington Post foreign correspondent John Pomfret has been covering the story in Asia. He was online Wednesday, April 9 at 11 a.m. ET, to discuss the latest news from China about SARS and the international efforts being undertaken to fight the disease. A transcript follows. Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.
John Pomfret: I am glad to be here today to answer your questions on China and Asia’s response to the SARS issue. I want to emphasize first – to help you frame your questions – that I am not a medical doctor and will be no help with medical advice. Thanks and look forward to an interesting session. John Pomfret
Shanghai, China: What do you think the REAL risk is to people living in China? Are we at risk or is the whole thing being overblown? John Pomfret: The WHO has said that the risk to people is very low. Guangdong has a population of 70-80 million and there are less than 2,000 cases there. The Guangdong authorities seem to have done a good job in controlling the outbreak. But the problem is that we don’t know how fast the disease is spreading in other parts of China. The case of Beijing – where the authorities have clearly downplayed the extent of the infection rate – makes people concerned that the disease could be spreading other places, too.
China: 1. Is it true that SARS oriented from southern China?
2. Why did you think Chinese government hasn't done lot to control it? John Pomfret: Most experts agree that SARS probably originated in southern China and the current theory is that it jumped from an animal to a human. Guangdong is the site where these things have happened on a regular basis in the past – in the 1950s and again in 1968 – most recently.
I think China’s response has been confused and confusing for a variety of reasons. First, China’s government has a natural tendency to cover up anything that could possibly make the regime look bad. That’s why the Communist Party banned news media from reporting about it. Second, local officials don’t want higher officials to know that things are going wrong on the local level. And three a disease like this could affect the two things the Chinese Communist Party cares the most about – foreign investment and domestic consumption. Finally, China’s bureaucracy just doesn’t work as well as it should.
Richmond, Va.: John, I admired your reporting from Bosnia in the early 1990s, as well as your work from China. I'm curious, does the former war correspondent in you twitch to be in Iraq now, or have you had your fill of people shooting near (or at) you? John Pomfret: I begged off the war because I am the father of a new-born. Now we have this strange story here. Anyway, I salute my colleagues in the Middle East, especially the fallen ones. They are heroes.
Washington, D.C.: I see pictures on the news of people in China walking around with masks covering their noses and mouths. Will these masks really help prevent them from contracting SARS? John Pomfret: On the masks, the WHO says that only masks of a certain thickness are useful in preventing the transmission of SARS. But again I am not an expert on this issue.
Washington, D.C.: In your Post article today you quoted a World Health Organization spokesman as saying they were looking for a "magic bullet." He said they did not find one. Was that in just one particular part of China or are other areas being investigated? John Pomfret: The WHO went to Guangdong because that's where the disease is believed to have originated. They were looking for a clear link between animals and humans -- of the disease jumping from one species to another. That was the "magic bullet" but they didn't find it. Currently they are not looking at other areas of China as a potential source for the disease.
Washington, D.C.: Hi Mr. Pomfret: Taiwan is among one of the 17 countries that have SARS cases, yet Taiwan is the only country that does not and will not receive direct assistance from the WHO. Nor can Taiwan directly share its case findings with the WHO because Taiwan is not a member of the WHO. There is only one reason that Taiwan is not a member of the WHO -- China's political agenda. The population of Taiwan is larger than 3/4 of the WHO members. Taiwan has effectively eradicated polio or TB without WHO's help, etc. Do you agree that "health should not be a political weapon" and that Taiwan should be allowed to participate in the upcoming WHO annual meeting, even as an observer which requires no statehood? Thank you. John Pomfret: Both China and Taiwan have used the WHO issue and Taiwan's non-membership in the WHO as a political weapon. The US CDC has given Taiwan support on the SARS issue. And so far it doesn't seem to be affecting Taiwan's handling of the case.
Washington, D.C.: Do you think it's OK to travel to parts of Asia that have not been seriously affected thus far, such as Thailand, Cambodia, Laos and Vietnam except for Hanoi? If a traveller were to contract the disease, would he or she be able to get adequate medical care in those countries? John Pomfret: Adequate medical care in some of these countries -- particularly Laos, Cambodia and rural areas of Vietnam and Thailand could be problematic. But the threat of SARS in those regions is a lot lower than the threat of other tropical diseases.
McLean, Va.: What happens to the people in China who have contracted the disease? Are they quarantined? John Pomfret: Yes, people who get SARS in China are quarantined.
The WHO wants the Chinese government to be more vigilant about checking out who these people had contact with as well and to -- if necessary -- also quarantine them.
Fairfax, Va.: We recently have received our referral from China. We are planning to leave for China in 6-8 weeks to adopt our dau, located at the Ankang Children's Welfare Institute in Ankang. Ankang is near the city of Xian, in the Shannxi Province. Following our trip to Ankang, we are expected to go through Gwangzhou for processing and then plan to cut our trip short to return home. Knowing what you know about SARS, would you make the trip or decline travel? Our agency seems to be leaving it up to us to make the decision to travel. We are planning to go unless the U.S. bans travel. P.S. My husband and I are in our 40s and considered to be healthy. Thank you for your response. John Pomfret: That question really depends on your tolerance for risk.
Guangzhou is one of the epicenters of the disease but the WHO today said the government there has made serious strides toward lowering the infection rate and controlling SARS' spread. There have been no reported cases of SARS in Xian in Shaanxi.
Washington, D.C.: Could the further spread of SARS in Asia affect the world economy? John Pomfret: SARS is already affecting Asia's economy -- specifically airlines, hotels, the tourist industry and other services. The worry is that if SARS gets into the factories of China and other Asian countries the affect will be more severe. If this affect increases, SARS will inevitably hurt the global economy. Already Asians believe that SARS will have a more significantly negative affect on Asia's economy than the war in Iraq.
Washington, D.C.: What are "super spreaders?" John Pomfret: "Super spreaders" are people who for some reason or other can infect many other people with SARS.
One shrimp salesman in Guangzhou is believed to have infected 90 people. "Super spreaders" are not just confined to people with SARS. Researchers have identified "super spreaders" among people with the Ebola virus, smallpox and even newborn babies with Staph infections.
Washington, D.C.: Why didn't the United States do more to prevent the spread of SARS when it was first identified as a unknown contagion in November 2002? Our nation was preparing for war then and public health should have been a top priority for the U. S. Government. John Pomfret: I don't think the US government knew about SARS in November 2002. The Chinese government -- specifically the Guangdong provincial government -- didn't realize that SARS was something new and different until December of last year.
Bethesda, Md.: Some reports have said that Asians are more susceptible to SARS than people of other races. Have you heard that? John Pomfret: I have not heard about this.
Washington, D.C.: This is off the subject, but have you been able to gauge what the Chinese reaction is to the war with Iraq? John Pomfret: The Chinese are very interested in the war as a war and their TV is full of reports and pretty detailed and often pretty good straight-up-and-down military analysis on the war. In the beginning, when the US was having problems, there was a sense in the state-run media that Iraqis were heroes. But now that the US appears to be headed for some type of victory, China's media has stopped cheering on the underdogs and is now looking at the war's aftermath and how it will affect China.
Washington, D.C.: Could SARS be bioterrorism? When you answer, please don't say, "there is no evidence of that". As you recall, there was no evidence of terrorism prior to the Sept. 11 attacks.
John Pomfret: The WHO has said they have seen no link between bioterrorism and SARS.
Arlington, Va.: How are the hospitals coping with the disease? John Pomfret: In China, health care varies enormously. Some places are world standard and other places are run-down, dirty dumps. So it really depends. Guangdong province is getting kudos from the WHO because they have stopped some hospitals from dealing with SARS patients because those hospitals can't shield their own health workers from infection. The question now is how well and how quickly will other hospitals in China learn from Guangdong's successes.
Washington, D.C.: What are the current figures as to the number of people infected and the number of people dead from SARS. John Pomfret: About 103 dead and about 3,000 infected.
Vienna, Va.: How is SARS contracted? John Pomfret: Researchers say they still don't know exactly how SARS is contracted. By droplets, for sure -- such as mucous. But also possibly through feces. And maybe through the air in some cases, such as airplanes. So it's still very unclear.
Palatine, Ill.: A boy in my son's grade returned from Asia Saturday. His parents were oblivious to others concerns and have sent him to school. The school also has said he can return without any stipulation. Not a medical release, waiting period or even to require him to wear protective mask. Although the chances are remote, I am concerned and have now kept my child home for two days. I have read the incubation is 2-16 days according to Doctors in Hong Kong treating the patients. I am afraid it will have to spread in the U.S. before more caution is exercised. -- Concerned Parent without a legal leg to stand on. John Pomfret: It depends on where the boy had traveled to in Asia.
There are a lot of places in Asia where there have been no or only one or two SARS cases.
SARS: What is the risk of a virus like SARS being used by terrorist organizations? Is this virus easy to control in a lab? Can it be easily disbursed? John Pomfret: WHO researchers have themselves yet to isolate the virus or the agent that causes SARS. So I don't think anyone knows.
Somewhere, USA: Could there be a world backlash at China for not acting earlier in the detection of the disease? John Pomfret: That is a good question. People here have compared China's handling of the SARS issue with the Soviet Union's handling of the Chernobyl nuclear accident. The whole issue raises important questions for the Chinese government about the interests of the state versus the interests of the public. There is no doubt a debate within China's leadership circles over what to do about this problem.
Airborne diseases throughout history: Does SARS have the potential to fall into the same category as the black plague, small pox, and other population eliminating diseases? Thanks for your info on the matter. John Pomfret: Some researchers in the United States worry that if SARS is not checked it could become a significant health threat and have significant damage on the economy. If you can get it in an airplane, will people want to fly? It's mortality rate is low, however, so it's not another plague.
Madison, Wis.: Is the "very high fever" described in news about SARS really only 100.4? I believe in early reports that the fever was said to be 104 or 105, but has lately been consistently reported to be 100.4 from all sources. I don't think anyone considers 100.4 a high fever, rather that is a low fever and I am confused about it. Can you clarify this for us? Thank you. John Pomfret: It is a fever of 100.4 and above. Sustained. With a cough.
Beijing, China: If an ordinary Chinese citizen flies to the United States from Beijing now, what will happen to him? -Sleepless in Beijing John Pomfret: Currently, the US does not have airports manned with health officials waiting to put you in quarantine. In some cases, however, that could happen -- but your citizenship would generally not be an issue.
Washington, D.C.: If someone has SARS and you travel on the same plane as that person, can you contract it that way? Is it airborne? Or does someone have to sneeze on you and get mucous on your skin? John Pomfret: That's a good question. I don't think researchers know exactly how it's transmitted. Generally they say that you need some type of direct contact -- through droplets or via touch -- with the virus.
Baltimore, Md.: Hi!
Do you have any indication as to which countries are currently trying to develop vaccines and how they're going about it? The risk of fatality from SARS appears to be greater today than the risk of fatality from AIDS -- is this accurate? How has the UN responded? Is the Congress about to take SARS in consideration as they work on bailing out the airline industry? Thanks. John Pomfret: Right now the focus of the science is on identifying what kind of agent causes SARS. Once that is done, work on a vaccine can begin. But a vaccine is probably going to be years away.
London, U.K.: Jopes,
Great reporting. How dangerous do you feel it is for you, as a reporter, to work in villages hit by SARS? I'm concerned for you, but more concerned for Mei and Dali.
P. Fu
London John Pomfret: I caught a nasty cold in Guangdong province last week but luckily it was not SARS. China's villages are no longer rural idylls. They are polluted factory towns. The biggest danger there, I felt, wasn't the SARS, it was the smoke coming out of all the chimneys.
Adelphi, Md.: Are people in Asia who have contracted SARS stigmatized by others? John Pomfret: That stigmatization process is starting. Today Malaysia announced that it would not allow Chinese tourists to come to Malaysia. (500,000 went there last year.) Thailand requires all Chinese to wear a mask while in Thailand and threatens stiff fines if they take the mask off.
Virginia: So it is still safe to travel in Asia then? John Pomfret: The WHO issued its first travel advisory in 55-year for southern China and Hong Kong. It did not issue this advisory for other parts of Asia -- Japan, South Korea, Indonesia, Thailand, Australia, etc.
Washington, D.C.: Is there a test to determine whether a person has SARS versus pneumonia or a severe cold? John Pomfret: There still is not cut-and-dried test to determine SARS.
John Pomfret: I'm signing off. It's 'round midnight in Beijing. Many thanks for your questions and good night -- and have a nice lunch.
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