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The following is the transcript of the Secretary for Health Welfare and Food, Dr Yeoh Eng-kiong, at the press briefing on atypical pneumonia this afternoon (March 21):
We now have 197 patients with pneumonia so this is an increase of 32 from yesterday. We also have another six individuals who are under observation. Of the 197, we've included some individuals whom we highly suspect [have pneumonia] but this needs to be confirmed. So there is some caveat in the figures but the experts think these are likely to be, but the Department of Health will still have to do some investigation. The difficulty now is the clinical syndrome, which is based on the best experts' views of what these cases are.
Most of the increases have been related to the Prince of Wales cluster. We are seeing now among the health care personnel another eight individuals with pneumonia. All the other increases have been in the secondary contacts. So these are health care workers who have then gone home or the relatives of visitors of the hospital who have gone home.
We also have another 19 cases of pneumonia among the relatives, patients and visitors. All these have been predominantly related to the Prince of Wales. The only exception is that two were related to the contacts of the Pamela Youde Nethersole Eastern Hospital. The primary cases are the ones that had direct contact, the numbers are now increasing. So most of these are the secondary contacts, so the contacts of the contacts. The number of the medical students is the same.
Today we have one suspected new cluster. This is in a private hospital. We have three individuals, three health care staff with pneumonia, and they were in contact with a patient suspected of carrying this putative new virus. So we have one new cluster from the Baptist Hospital. So we now have nine clusters.
I think the difficulty with this outbreak is that you are trying to distinguish a new phenomenon, which we are learning more and more about towards the background of all and each of the pneumonia, so even for ourselves it is quite difficult. And imagine that in China where it is such a vast country and the provinces are very large as well, and the county hospitals and city hospitals where the information flow is quite difficult. But I can assure you that the health authorities in China, particularly in the Beijing Ministry, are very forthcoming. They have never tried to hide anything. They have been more than helpful.
Obviously, I think the information that they have may not be the type of information that we have because we have a much more sophisticated system in Hong Kong and we also have the benefits of having one system.
One of the great things about Hong Kong is that we have one big public system and the information flow is much more co-ordinated. If you went to any other place in the world, even in America, it would be very difficult to get the same type of information because you are dealing with different hospitals, different organisations with different information systems. So people don't realise how lucky we are in Hong Kong to have this system where you are able to derive information very quickly. So I guess one has to understand the background of the state of development of the health system in China and not to blame the health officials there. I can assure you that they are very co-operative, certainly with the Ministry of Health, we have many years of liaison with them and we do hold policy meetings. In fact we had a policy meeting last year in which the Minister himself, myself and the Secretary from Macau, we had a three-day policy discussion where we discussed a whole range of issues and one of them was communicable disease control. So I can assure you that there are these forums. But I guess there are sometimes difficulties that they may not be able to find the same type of information that is expected from a system like Hong Kong. Now you are pushing us and demanding more and more information. We're trying to provide as much information as possible because we know that the more information and the most updated and accurate information is the only way to deal with uncertainty.
One of the reasons why in Hong Kong we are able to give such a lot of information is because we have a very good public (health) system where 97 per cent is subsidised. So the public only bears three per cent of the hospital costs, 97 per cent is from general revenues, from public taxes, that support the public hospitals. There are very few places in the world where you have that - where it is practically free, and yet we are able to provide a reasonably comprehensive service, which I believe the quality is acceptable to the citizens in Hong Kong. Obviously with that system, you are able to generate much more information because you do tests. The hospitals tend to do very vigorous investigations, because there is no cost to the patient when you do a certain test. So the hospitals would tend to do a more comprehensive diagnostic workup.
But in market systems, where the patients have to bear the cost, obviously the extend of investigations is not likely to be as extensive and complete because the patients will have to bear some of the cost and you will have to be mindful about the affordability of doing the test. So you cannot expect the same type of information. In market systems where you have all these issues, the surveillance system and information systems cannot be generated from the overall operational system. In Hong Kong, we generate a lot of our information from our operational system, so I was just trying to show the contrast between the systems here and in Mainland China, not only because the county is very vast, they do not have the same information system as we have in Hong Kong. Of course, they also need to be mindful because the patients got to bear some of the costs. So, by the very nature of the way that they operate, they cannot provide as extensive information as we can in so short a time. If they needed to investigate an outbreak they would have to consciously put in efforts and have a system. They have disease control centres and they then have to use these centres to investigate an outbreak like you do in CDC. In Hong Kong, certainly we don't have the same equivalent because we have a very good public system where information systems will allow us to deride the information and supplement outbreak investigation.
(Please also refer to the Chinese portion)
End/Friday, March 21, 2003
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