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Following is the transcript of a press conference to announce new measures in tackling atypical pneumonia held today (March 27):
Reporter: I'm with the Washington Post. I have two questions. First, I'm not quite clear, are you compelling people to stay home, or are you highly suggesting that they stay home? The second question: how many people are we generally talking about here who have had contact with infected people. And the third question is, sir, this is your first public statement about this. You've made many statements through your spokesmen about this issue. Do you think you should have made an earlier statement about this issue?
Chief Executive: Well, I'll answer the third question and let E K [Yeoh] answer the other questions. Firstly, actually, from the very beginning, every day I have been in close touch with Dr Yeoh. Secondly, on March 15 I actually went to visit the Prince of Wales Hospital to try to understand what it's all about. So this is an ongoing effort. What I think important is for you to recognise what we have done from March 10 to March 27, in 17 days. We were able to identify the source, we were able to identify the virus, we were able to successfully develop a quick diagnostic test, and we were able to provide specific medicines to start treating those who are sick. And these are very, very important breakthroughs. And the fact that today I am able to stand here and talk to you like this is because of all this progress that we have made. That is why we are taking all these measures. It's time to take these measures for us to move forward.
Secretary for Health, Welfare and Food: Just a supplement. When you look at the cause, the first instance when we figured that something was unusual was on March 10 and today is March 27. I think when you compare it to all the outbreaks that you have - since you're from the Washington Post - in terms of your bioterrorism, the HIV Aids outbreaks, the West Nile [virus] outbreak in New York, I think you can compare those things. And I think you can also compare the involvement of your own leaders in those instances as compared with Mr Tung's involvement right from the very early onset.
I just want to explain about the Quarantine Ordinance - the Quarantine Ordinance does provide very draconian powers to the Director of Health, but what we are using is trying to encourage people to come to our designated medical centres, to report every day so that we check them to make sure that they are well, and also to make sure that they are at home during that period as far as possible, so if they are infected to reduce any possible risk of their coming into contact with other individuals and spreading the infection. So these are the provisions in the ordinance. If they comply with the instructions of the Director of Health, they can continue to stay at home and come back to the clinic every day just to be checked. And this is to their benefit because, as Mr Tung was saying, we now have effective treatment and the earlier we give the treatment, the better is the outcome because we found that you get far fewer complications. The initial experience at the Prince of Wales is that before we gave treatment, about half of the patients who had pneumonia had insufficient oxygen in their blood, because the lung damage was so severe. But now with the new treatment, if given early, very few patients are going to that state. So it is to the advantage of people who have been in contact and are at risk to come for medical surveillance so that we can institute treatment early. Really we are facilitating their treatment and we want them to take responsibility and stay at home. But if they do not follow the instructions, then we have the powers to either fine them - the maximum fine is up to $5,000 - remove them to a place for quarantine or they can be imprisoned for up to six months if they are found guilty. I think these are more draconian measures which we will not use, or use very sparingly, and we hope that we can encourage people to come forward for treatment and surveillance.
The total number of people we are talking about: we have about 1,080 individuals who are close family contacts, we have another 600-odd who are more social contacts. These will be put under a different degree of surveillance, because these are fairly casual and do not need to follow the same instructions. The biggest risks are individuals who are family contacts because they are in day-to-day contact, and all the experience has been that the highest risks are family contacts. And we have another 300-odd who have been off surveillance because they have gotten well.
Secretary for Education and Manpower: May I just put this into perspective. When the Aids epidemic first struck globally, it took laboratories worldwide, in America as well as in France, three years before they found the virus. Our two medical schools, in 17 days, have now identified the possible virus. So let's put this into perspective. Our medical schools, our medical care in Hong Kong is extremely good.
Reporter: There were reports today that your granddaughter was not going to school. Would you care to comment on that? Did you withdraw her? And I'd like a clarification on the number of students that are affected by this.
Chief Executive: My granddaughter's ... what to do is the decision of her father and mother.
Secretary for Education and Manpower: Up to now, 14 students have been affected with this disease.
Reporter: It will affect how many students ?
Secretary for Education and Manpower: Well, Mr Tung has already said we will close all the schools. He just announced it. In fact, I will be giving details a bit later on.
Reporter: How many students are there in Hong Kong ?
Secretary for Education and Manpower: How many students are there in Hong Kong ? Over a million.
Reporter: First of all, congratulations on all the great developments over the last 17 days. In a situation like this, I'd like some comments on whether or not it would make a lot of difference if China had been more open to this situation, given that we're good neighbours ... sharing information, this is my first question. The second question is, as we know, with diseases looking for cures, it's a long long process. Can we know what the next step is now that we know two viruses are high candidates. We have now diagnostics, and all of that.
Chief Executive: On the first question, let me say this in English. The Central Government has agreed with us to establish a mechanism for us to work very closely on this. And the details of which will be announced very shortly. I will ask E K to answer the second question.
Secretary for Health, Welfare and Food: Well, in terms of the two candidate viruses, we are now doing the cross-tabulation of the various specimens, because we have the virus unit from the Department of Health. So the virology Department of Health is looking at two viruses and testing, because the Chinese University virus was grown in the specimens of the patients in the Chinese University and there was consistency in the diagnosis and detection. The Hong Kong University virus was cultured from the brother-in-law of the professor who died in Kwong Wah, so it was also tested positive in the panel of tests provided by the virus unit of patients in the other hospitals. So what you need to do is to cross-test it, so using the Chinese University tests to test it in all the other samples outside of Chinese University, and using the Hong Kong University test to test it in all the patients in the Chinese University. So if you find that all the specimens show both viruses, the evidence is that both viruses were present and have a possible role. We still need to affirm, just because you have two viruses present, it means that all the individuals who are infected by two viruses, which might lead one to think that both viruses have a role to play in the infection. The laboratory then needs to confirm this by looking at more detailed studies in the laboratory whether these individual viruses kill human cells. And afterwards you establish a cause, then obviously you want to understand more about the behaviour - why is this virus infecting so rapidly? Professor Yuen was saying that now that we have these diagnostic tests, we can test people much earlier and then we also need to test to see whether we can test the virus even before the individual becomes sick. Then this will help in defining so that people will not be isolated so long, and our quarantine measures don't need to apply to so many people and you can start treatment early. So if you can detect the virus even before the patient becomes sick, then you can start treatment early, you can distinguish who is a carrier, who has been in contact but has not been infected. Then you also need to look at using tests for treatments. He [Professor Yuen] is already experimenting, I'm sure Professor Tam is also doing it, once you grow the virus, then you test various antivirals with the virus to see how effective which ones are. Then you can also look for vaccines; because you can grow the virus, now we can find that there is protective antibody, so we can start looking at the various types of responses of the individuals and whether you can look at... vaccine. So it is a very, very exciting area of work. So there's plenty of work to be done.
Professor K Y Yuen, HKU: I think the excitement about this virus is that now because you have the virus, the most important thing for us to do in the next one to two weeks is to have a complete genomic sequencing of the virus. The virus has 30 kilobase of ATTC. We are now doing all the gene content to decide what are the gene targets of which we can decipher a vaccine. That is very important, because once you know where is the protective part then you can start using that particular target to do the vaccine. Now how much time does it take? If you just talk about getting the gene fragment cloned into the ..., which is a bacteria, it takes around six to nine months to finish the whole thing and start doing animal experiments. But from the animal experiments to the clinical, it is usually around five years. So I must say that for the acute control of the outbreak, the vaccine has not much place at the moment. I'm sure that it will have a lot of place, because we don't know if this virus will continue to mutate and cause other epidemics.
Chief Executive: Let me just emphasise by saying that the vaccine work is a long-term work, but for the control and the cure for the time being, we are managing fine, we are making great progress.
Professor John Tam Siu-lun, CUHK: I think at the moment, our most important task is a united front to fight against this disease, working together with the Department of Health, the two universities, work towards several topics. One is, how does the virus transmit from one person to another? At the moment it is strangely transmitted, only to those who are in very, very close contact. But then, a lot of people get infected and then a lot of people get sick very quickly. This is one very major thing that we have to resolve at the moment because that is immediate. Second, we will have to know exactly what the virus is causing, what is the reason why patients are getting so sick? Thirdly, of course, many years down the road you will have trying out in a systematic way all the different methods of treatment. At the moment, the way we are treating patients, certainly they get well, but how do they get well. If the virus is going to mutate, are we going to be able to handle them with this kind of drugs? So this is going to come on from many years of research, and hopefully Hong Kong in this particular area will be able to contribute something.
Chief Executive: In the case of avian flu, Hong Kong really excelled in the research work, and I am quite confident that my colleagues will do just as well in this area of research.
(Please also refer to the Chinese portion)
End/Thursday, March 27, 2003
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