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Speech by Permanent Secretary for Health, Welfare and Food


Following is the speech by the Permanent Secretary for Health, Welfare and Food, Mrs Carrie Yau Tsang Ka-lai, at the China-ASEAN Entry-Exit Quarantine Management Meeting on severe acute respiratory syndrome (SARS) in Beijing today (June 1):

Vice Premier Wu, Minister Li, honourable guests, ladies and gentlemen,

I am pleased to be here, and grateful for the opportunity to share with you Hong Kong's experience in quarantine management and the fight against SARS.

Just a few months ago, who could have imagined that we'd be gathered here today for this meeting? These are indeed extraordinary times. And the fact that we're all here today is evidence that the governments of this region have risen to this unprecedented challenge.

I want to talk today about how Hong Kong has dealt with SARS, and what we've learned from it. But there remains much to be done, and that's also part of my message.

As we see it, there are three keys to success. First is the government's commitment and resolve to tackle the SARS problem, and we've demonstrated that. The second key is our unrelenting vigilance. The WHO may have lifted the travel advisory against Hong Kong, but we will not let down our guard. The third key is the need for ongoing public education and promotion of civic-mindedness among the residents of Hong Kong.

When this brand-new disease erupted, Hong Kong was at the vanguard of the learning curve. There was no SARS manual. SARS was completely new to us. The critics will argue that in some areas we acted too slowly, in others too quickly. But I think that by and large, we got it right.

To bring the outbreak of SARS under control, the Hong Kong Government has set in place a comprehensive series of control measures. They include an effective and legally-empowered surveillance system for early detection, isolation and treatment of SARS patients, contact tracing, border control measures, stringent infection control measures at health care setting and public health education.

One of the first tasks involved our frontline healthcare workers -providing them with adequate protective gear, training them and maintaining a healthy environment in hospitals. At the same time, resources were redeployed and non-urgent services were stepped down by more than 30 per cent to cope with SARS.

We developed a powerful computer system that lets us trace the contacts of confirmed and suspected SARS patients quickly. It also helps us identify hot spots or buildings needing investigation. We have also set up telephone hotlines so hotel guests and air passengers can get medical advice when a SARS patient is confirmed to have stayed in the same hotel or travelled on the same flight.

We also required household contacts of both suspected and confirmed SARS patients to undergo home quarantine for a maximum of 10 days. As of May 29, 1234 persons from 484 households of suspected and confirmed SARS patients had been quarantined. Our home quarantine system has been effective. There have been 88 referrals to medical institutions, 33 of whom were confirmed to have contracted SARS.

I must say that although SARS has had a devastating impact on some of our families and businesses, our infrastructure and our community have withstood the crisis. Our public healthcare system has shown resilience. Our frontline healthcare workers have served the community diligently, professionally and above all courageously. We are studying ways to permanently commemorate the sacrifices of these dedicated workers and the unselfish spirit they embody.

Our research scientists have been working with their counterparts around the globe to decode the virus's genetic makeup, to find its source and its modes of transmission, and to seek out a vaccine.

For the international community, the most crucial element of any containment plan is comprehensive quarantine measures implemented without delay at border control points. Hong Kong has accomplished this, with assistance from abroad and from our colleagues in the Mainland. I would like to mention at this point that we are most thankful to the support given to us by the Central Government in the timely provision of protective gears and border screening equipment. The work of AQSIQ in coordinating all the quarantine measures among the provinces and cities of the Mainland has also contributed to containing the spread of SARS.

Soon after the SARS outbreak began, the Hong Kong government took steps to prevent the virus from being 'exported' out of or 'imported' into Hong Kong. We set up medical posts at the airport and sea and land boundary control points to watch for travellers displaying symptoms.

All incoming travellers have been, and will continue to be, required to complete a health declaration. On top of that, health alert cards containing advice are given to arriving passengers. The objectives of this paperwork are to heighten public awareness, to encourage reporting of illness for early treatment, and of course to prevent the spread of SARS. Those suspected of having SARS are referred to hospitals for further management.

Some have questioned the efficacy of these health declarations. They assume that travellers will hide any symptoms they have, so that they won't be inconvenienced. This is far from true. In fact, between March 29 and May 29, more than 1,590 travellers reported on their declarations that they were sick. Of these, 57 were sent to hospitals, and 16 were admitted as suspected SARS cases. Two of them were confirmed to have SARS.

To the casual observer, two cases out of millions of travellers may not seem tremendously significant. But as we all know, when it comes to a highly infectious disease like SARS, two cases would already be too many.

Health declarations are just the first line of defence. On April 17 we instituted body temperature checks for all departing passengers at the Hong Kong International Airport. A week later the Airport became one of the first places to extend temperature readings to all arriving and transit passengers as well.

Over 700,000 passengers and crew have been checked so far at the airport. Five were referred to hospital and two were admitted. Since the institution of these measures, no air passengers have been confirmed with SARS.

In fact, no one gets into or out of Hong Kong without being subjected to a temperature check. At our seaports, all arriving and departing passengers are also checked. And at our land boundary checkpoints, over 300,000 people cross between Hong Kong and Shenzhen on a typical day. To avoid duplication of efforts, the governments of the Hong Kong SAR and Shenzhen agreed that both parties would implement temperature checks for arriving passengers - including drivers of container trucks - at their respective immigration control points. A total of 192 infra-red devices have been installed at various control points. It's part of a comprehensive co-operation scheme with our colleagues in the Mainland to implement an effective system to screen potential SARS patients.

Overall, as of May 29, over 6 million passengers had had their temperatures taken; 73 were referred to hospital; 15 were admitted, and five were still under observation.

The result, I wish to highlight, is that Hong Kong has kept the SARS virus from getting in or out, even in this age of massive movements of people. As remarkable as this achievement thus far is, I want to stress again that we must remain vigilant. As evidence that we are, we're acquiring more new infra-red scans. And we've announced that traveller temperature checks will remain in place at border control points for at least another year.

What are the lessons we've learned? Well, they have been numerous, but here are three. Be open and transparent, and provide people with the facts they need. We need citizens' goodwill and civic-mindedness to win this war. Keep the disease in perspective; take extra precautionary measures but avoid knee-jerk responses. And face the fact that change may be necessary. While SARS has been contained in Hong Kong, it has forced us to closely examine a whole range of issues related to personal, family and community hygiene. Frankly, we need to do more.

And so we are. For example, our new Team Clean task force, headed by the Chief Secretary for Administration, has been set up to establish and promote a sustainable cross-sectoral approach to improving environmental hygiene in Hong Kong. Part of its job will be educational - to inculcate a sense of personal and shared responsibility towards the cleanliness of Hong Kong. This education process will involve some 'tough love', in the form of heavy penalties. There will be zero tolerance of littering, spitting and other unhygienic behaviour. Team Clean's task is no less than to create a new paradigm of cleanliness for our city and its 6.8 million citizens.

Meanwhile, the Financial Secretary is leading efforts to revitalise Hong Kong's economy. And we will also look into how best to incorporate a new centre focusing on communicable diseases into our public health care system to better fight and prevent such diseases in Hong Kong.

But our immediate goals are to achieve a zero-infection rate and to get Hong Kong off the WHO's list of SARS-affected areas. Then we must improve our public health structure so we can do a better job of fighting future epidemics. We have formed an international committee of experts to conduct a comprehensive review of the handling of the SARS outbreak, including the organisational framework, implementation of control measures, lessons learnt and improvements to better our system for any future outbreak.

Thanks to air travel and global trade, we are all closer to each other today than we've ever been. This new interconnectivity creates jobs and prosperity, but it also throws up unprecedented challenges. Nowadays, we know that what happens in a kitchen in Hong Kong or Guangzhou can have an effect that ripples around the world.

After the WHO lifted its travel advisory against the Hong Kong Special Administrative Region on May 23, many countries followed suit by lifting their own advisories. We are grateful for these responses, which we consider a strong recognition of our work in containing SARS. Yet, the WHO's action signals not the end of the SARS war, but the beginning of a long-term campaign. There is still a great deal of work to do.

There's no getting around it - SARS is an international issue. To overcome this virus, we need a collaborative effort. We need cross-border co-operation, as demonstrated by this very meeting, as represented by the spirit of ASEAN. This crisis has been damaging and frightening. But it has also reminded us of the virtues of being neighbourly, of taking responsibility, and of learning to live together in peace, harmony and good health.

Thank you very much.

End/Sunday, June 1, 2003


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