TCS Daily

Of Cats and Rats

By Jes Randrup Nielsen - January 19, 2004 12:00 AM

When the first patient of the second SARS season was released from a Guangdong hospital in southern China shortly after New Year, journalists were on the scene. In fact, they had been there all along. The medical internment of the initial patient was widely covered in both Chinese and international media. TV crews were allowed to visit the man in the hospital and doctors openly gave interviews. Meanwhile China's central authorities informed World Health Organization experts and requested their assistance. Chinese authorities, it seemed, were finally repairing the flaws of last year's SARS outbreak by acquiring the openness needed to deal with a looming epidemic. Yet in spite of their decisive action to curtail the spread, there is reason to temper one's expectations. A year after the first outbreak of SARS, bureaucratic secrecy, miscommunication and media restrictions still abound.

At first everything seemed in order. On tips from a Hong Kong-based virologist, local officials promptly stepped in to clean up suspect wildlife markets in the province. Provincial top health officials had commanded the Guangdong Forestry Department to roam the meat markets and round up the suspects: an estimated 10,000 masked palm civets which are farmed and eaten in southern China as a winter delicacy for its yang properties which, according to traditional Chinese medicine, are good against the cold.

Some experts were critical about the radical approach to limit the potential of a new outbreak. "The virus is relatively promiscuous. It can infect many different animal species, probably also including rodents, so taking all those things together, the question really is whether the culprit is indeed the civet cat," Dutch virologist Albert Osterhaus told Agence France Presse. He and others pointed out that even though the strain of SARS found in the civet was almost identical to that causing SARS in humans, no direct link of transmission had been established. And neither of the SARS patients had eaten civet cat or visited animal markets. Others were convinced that wiping out the civet population was the right thing to do, among them even WHO virologists working in Guangdong. In either event, Guangdong authorities, eager to shore up any criticism and rebuild their image following last year's disaster, took no chances.

And this is where the difficulties began. Some 10,000 masked palm civet cats were expected to be culled but by the January 10 deadline, only 3,900 had met their fate. In a grotesque publicity stunt launched the same week, authorities called for a "patriotic health campaign to kill rats and cockroaches in order to give the place a thorough cleaning for the Lunar New Year." Restaurants were subsequently forbidden to prepare and serve rats, also farmed in southern China for human consumption.

But issues more troublesome than rash planning and lack of execution soon emerged to irk the officials. To the worry of WHO experts as well as officials in Hong Kong, the official Chinese channels of communication seemed to lack efficiency. Trouble began shortly after the announcement of China's second suspected SARS case, a 20-year-old waitress also from Guangdong. Reports claimed that the woman had been ill with SARS-like symptoms for more than two weeks and isolated for one week before her case was reviewed by a panel of experts. Information simply had not reached the experts.

Still, provincial authorities alone might not be to blame. On January 10 the Hong Kong health authorities announced that Guangdong officials across the border had tipped them verbally about a suspected third case of SARS. Over the next few days, however, Beijing denied reports of any new cases, and WHO experts in China were left with no information, and thus no clue as to what they should investigate. As late as January 11, Guangdong officials denied having any knowledge of a suspected third case. To the waiting press they said they had been in a meeting with WHO representatives and had not heard the latest news.

On January 12 in an almost bizarre move, Guangdong's deputy health chief Wang Zhiqiong defended the handling of the second case, claiming that Beijing had received notification as early as January 9 but that China's Health Ministry wanted samples for their own testing. The results of these tests were only received in Guangdong on January 12. The question remains, of course, why the Guangdong authorities decided not to release the information which they had themselves collected in the first place.

Bureaucratic caution rather than lack of communication might offer an answer. Practices in the past may still restrain Chinese officials from releasing sensitive information to the public. Former director of health in Hong Kong, Margaret Chan, now a director at the WHO, recently told a select committee in Hong Kong's Legislative Council (its parliament) that repeated requests for information in February 2003 were left unanswered by Guangdong health officials. While she abstained from speculating about their reasons, she said she was struck by later comments by a Guangdong official that "there was a legal requirement for infectious diseases at that time, that infectious diseases were classified as state secrets. That is why they cannot share the information."

It is doubtful, however, whether the mere downgrading of SARS from state secret to public domain is improvement enough. In spite of lessons learned during the outbreak last year, Chinese media are not yet free to report on the story. This is of paramount importance because it was a local Chinese newspaper - not the authorities themselves - that first revealed the news about the recurrence of SARS.

Rather, officials seem to have reverted to the old ways and have so far shown little leniency in criticising the paper's editor, Cheng Yizhong, for failing to clear the story with the censorship before publication. To prove their point police hauled him in for eight hours of questioning, and both he and reporter Zeng Wenqiong, who reported the story, are currently under investigation. Journalists now fear a media crackdown

Their worries may be justified. In what the provincial government called "normal promotions," on January 2 it promoted propaganda chief, Cai Dongshi, to deputy provincial head of the Communist Party committee as another hardliner, Zhu Xiaodan, was named as his successor.

Jes Randrup Nielsen is studying for an MPhil in Chinese Studies at Cambridge University.


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