THREE weeks ago, at the start of the mysterious pneumonia outbreak, an anonymous e-mail was making its rounds in Hong Kong, purportedly from a person with a doctor friend who works at the University of Hong Kong.
The e-mail warned that according to the doctor friend, the mysterious disease that had afflicted scores of medical workers at the Prince of Wales Hospital was dangerous as it was very virulent. It was so infectious that the virus could be transmitted by touching an infected object.
“Be careful what you touch. When someone coughs onto the doorknob and you touch it, you will be infected,” stated the e-mail. “So wash your hands all the time. This is the only way to prevent infection.”
Most people who received the e-mail had a good laugh.
Newspapers in the territory even made fun of the e-mail and one columnist, who drew readers’ attention to the e-mail, suggested the writer had a cleanliness fetish.
But by Thursday, no one was laughing. It turned out that the “wash-your-hand” advice in the e-mail was not only true but its hypothesis about the disease being spread by touch was dead on.
Prof Yuen Kwok Yung, the University of Hong Kong’s Microbiology Department head, when announcing his team’s historic find of a new virus responsible for the deadly disease on Thursday, said: “Your hands are your greatest enemy (in this outbreak).”
Advising the public to wash their hands before touching their eyes, nose, ears and mouth, he said the virus had a lifespan of several hours outside the body and could be picked up by another person who touched the “infected area.”
“A person who has the disease may have sneezed or coughed onto a doorknob, lift button or even a piece of paper. Another person who then touches these items will pick up the virus.
“This person will then infect himself by rubbing his eyes, nose, ears or mouth,” said Prof Yuen at a press conference to announce that a new type of virus from the Coronavirus family was responsible for the disease.
He said many people had a habit of coughing or sneezing into their hands.
“Imagine shaking hands with this person afterwards,” said Prof Yuen, adding that every half an hour, a person will touch his or her face several times. “This is why the disease spreads so easily.”
The advice from his chief virologist Prof Malik Peiris, who was responsible for isolating the pathogen so that it could be identified, sounded eerily familiar to those who read the e-mail.
However, instead of washing your hands with soap and water as suggested by the prophetic e-mail, the two professors advised using alcoholic surgical swabs.
“We know of some brands of detergent that may help but from our clinical study, alcohol is the best,” said Prof Yuen, adding that wearing a respiratory mask alone was not good enough.
Credited by the Hong Kong Government and his colleagues as the single driving force behind the rush to find the mysterious pathogen, Prof Yuen even renamed the disease that had been either called atypical pneumonia or Severe Acute Respiratory Syndrome (SARS).
“You can now call it the Corona Viral Pneumonia. You don’t have to use the name (SARS).”
The Hong Kong authorities had been unhappy with the acronym because it was very close to the abbreviation attached to the territory’s own name – Hong Kong SAR (Special Administrative Region).
WHO had used the acronym SARS when it issued a global alert on Feb 15. It seemed an apt name because Hong Kong is seen as the epicentre of the outbreak that has globally infected over 1,400 people and killed over 50 others.
It is now known that the original outbreak was in southern China some four months ago. The Chinese authorities only reported to the WHO five days ago that 792 people were infected and 31 died of atypical pneumonia in the Guangdong Province on Nov 16.
But this is not the only sore point.
Secretary for Health, Welfare and Food Dr Yeoh Eng Kiong took the WHO to task for coming out with only a general description of the outbreak in its global alert.
He said the description was so wide that researchers and medical investigators would get all sorts of pneumonia reported and would be bogged down with trying to sieve through the quagmire before being able to get to the real thing.
However, most analysts feel that the real bone of contention was the speed at which the WHO sent out the global alert – something it had not done in 15 years.
Although the WHO did not suggest any travel restriction, it gave lengthy advice on how to spot and avoid the infection.
Hong Kong, which is going through its worst recession in decades, had earmarked tourism as one of the main pillars of its re-growth plan. The government expects the economy to grow 3% this year to help balance its deficit with the help of tourism, a sector that contributed to retail sales and exports of services.
According to experts, the killer pneumonia would have a bigger adverse impact on the Hong Kong economy than the war in Iraq.
Standard Chartered Bank Northeast Asia chief economist Kwok Kwok Chuen said the US-led war against Iraq would probably have a short-term impact on Hong Kong and Asia and this would fade away in the second half this year.
The pneumonia, however, might have more serious negative effects.
“If the atypical pneumonia problem lasts longer, it would hit tourism and the already weak domestic demand,” said Kwok.
The Hong Kong Association of Travel Agents, putting on a brave front, said last week tourist numbers from Taiwan and Singapore had dropped 10% from a year ago although some travel agencies reported plunges of 90% in terms of tour groups.
Ironically, the disease was imported into the territory by a mainland Chinese visitor and then re-exported to countries like Singapore, the Philippines, Canada and Vietnam by tourists returning home or continuing their journey.
Surprisingly, there is a lot of information about the first infection here on Feb 21. The core group has already been identified and “ground zero” was at the 9th floor of the Metropole Hotel.
Another irony of the outbreak is that the person who brought in the disease was Dr Liu Jian Lun, a professor in respiratory medicine at Zhongshan University in Guangzhou who had been treating patients with atypical pneumonia during the initial outbreak there.
Medical investigators believe Dr Liu had left a trail of the virus on lift buttons and doors that infected three Singaporeans, two Canadians and an American-Chinese businessman – all staying on the 9th floor.
Also infected was a 26-year-old Hong Kong airport worker who visited some friends on the same floor.
Dr Liu had arrived by bus from Guangdong a day earlier to attend a wedding but was too sick to attend and was taken to hospital on Feb 22.
On being admitted to Kwong Wah Hospital, Dr Liu warned medical staff they should not touch him because he feared he had contracted a “very virulent disease.” He died on March 4.
Over the next few weeks, 70 staff members at the hospital were struck down as well as 17 medical students. Hospital staff also took the virus home to their families.
So far, the number of infections in Hong Kong has risen to almost 400 with 11 deaths.
Kwan Siu Chu, 78, from Toronto, took the disease home and infected five members of her family. She died on March 5 and eight days later her 44-year-old son also succumbed to the disease.
The number of infections in Toronto has risen to 28 with three deaths.
The American-Chinese businessman flew to Hanoi where, two days later, he was hospitalised. He spread the virus to staff at the French Hanoi Hospital before being flown to Hong Kong on March 6. He died seven days later.
There have been over 60 infections in Vietnam and four deaths.
After their four-day stay at the hotel, the three young Singaporean tourists returned home on Feb 25. Within days they were admitted to two hospitals. Over 70 people – mostly medical staff and their family members – had been infected and two persons have died.
As for the 26-year-old local man, he was admitted to the now infamous Ward 8A of the Prince of Wales Hospital in Shatin near the New Territories. He fully recovered and was discharged but not before infecting most of the health workers.
Days later, his sister fell ill and was taken to Princess Margaret Hospital, having already infected no fewer than three of her colleagues. From there, the disease spread at feverish pace.
The hospital finally announced an outbreak on March 10 after over 100 medical workers fell ill at the same time. Within days, the mysterious e-mail began making its rounds. Sadly, its warnings went unheeded.