The New Global Threat: Severe Acute Respiratory Syndrome and Its Impacts

356 Pages·2003·9.88 MB·English

by  Tommy Koh

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Published by
World Scientific Publishing Co. Pte. Ltd.
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USA office: Suite 202, 1060 Main Street, River Edge, NJ 07661
UK office: 57 Shelton Street, Covent Garden, London WC2H 9HE
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library.
THE NEW GLOBAL THREAT
Severe Acute Respiratory Syndrome and Its Impacts
Copyright © 2003 by World Scientific Publishing Co. Pte. Ltd.
All rights reserved. This book, or parts thereof, may not be reproduced in any form or by any means,
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For photocopying of material in this volume, please pay a copying fee through the Copyright
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ISBN 981-238-665-3
ISBN 981-238-668-8 (pbk)
Printed in Singapore.
Contents
Editorial by Professor Tommy Koh vii
Editorial by Professor Aileen J. Plant xiii
Editorial by Professor Eng Hin Lee xxv
Section I: WHO: Role and Influence
1. WHO: At the Forefront of Combating SARS 3
Section II: China
2. Fighting Infectious Diseases: One Mission, Many Agents 17
Shiping Tang
3. SARS, Anti-Populism, and Elite Lies: Temporary
Disorders in China 31
Lynn T. White III
4. Baptism by Storm: The SARS Crisis’ Imprint on China’s
New Leadership 69
Christopher A. McNally
Section III: Hong Kong
5. The Impact of SARS on Hong Kong Society and Culture:
Some Personal Reflections 93
Leo Ou-fan Lee
6. SARS and the HKSAR Governing Crisis 107
Ma Ngok
7. The Social Impact of SARS: Sustainable Action for the
Rejuvenation of Society 123
Cecilia L.W. Chan
8. Catching SARS in the HKSAR: Fallout on Economy
and Community 147
Yun-Wing Sung and Fanny M. Cheung
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THE NEW GLOBAL THREAT: SARS AND ITS IMPACTS
9. Will SARS Result in a Financial Crisis? —Differentiating
Real, Transient, and Permanent Economic Effects of a
Health Crisis 165
Frank T. Lorne
10. Facing the Unknowns of SARS in Hong Kong 173
Kwok-yung Yuen and Malik Peiris
Section IV: Singapore
11. Sars, Policy-making and Lesson-drawing 195
Khai Leong Ho
12. SARS: A Psychological Perspective 209
George D. Bishop
13. Cracking the Genome of the SARS Virus 221
Lawrence W. Stanton
14. The Infection Control Response to SARS in Hospitals
and Institutions 243
Paul A. Tambyah
15. SARS — Lessons on the Role of Social Responsibility in
Containing an Epidemic 273
Pheng-Soon Lee
16. Combating SARS with Infrared Fever Screening System (IFss) 283
Yang How Tan
Section V: Taiwan
17. Epidemiology and Control of Severe Acute Respiratory
Syndrome (SARS) Outbreak in Taiwan 301
Chien-Jen Chen, Yin-Chu Chien and Hwai-I Yang
Section VI: Toronto
18. SARS in Canada: The Story of SARS in Canada is Essentially
Toronto’s Tale 317
Pauline Chan
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EDITORIAL
by Professor Tommy Koh
A nation, like an individual, is
tested by crisis. A crisis could break
a nation, revealing all its weaknesses
and negative characteristics. On the
other hand, a nation could emerge
stronger from a crisis. Singapore
emerged stronger from the SARS
crisis. The government made some
mistakes initially. It was, however,
quick to change, in the light of new information and experience. The people
responded very well, with the doctors, nurses and other healthcare workers
showing courage, commitment and grace under enormous stress. The bond
between the government and the people became stronger. It reminded me of
the exemplary manner in which the New Yorkers coped with the tragedy of
11 September 2001. What lessons have I learned from the way in which
Singapore has overcome the SARS crisis?
First, the Singapore Government, unlike some other governments, did
not deny that Singapore had patients suffering from SARS.(cid:1)It is an unfortunate
fact that some governments try to deny bad news.(cid:1)The lesson I have learned is
that is it counter-productive for governments to be in a denial mode.(cid:1)It is
better to face the facts.
Second, it is better to be transparent than to be opaque.(cid:1)Some governments
tried to take refuge by not telling its own people, the WHO and the media
what the facts were.(cid:1)The Singapore government was wise in deciding, from
the start of the crisis, to tell the news, both good and bad, in a calm and
factual way, to the people everyday.(cid:1)The timely delivery of information to the
people helps to instil confidence.(cid:1)The absence of such information prompts a
people to indulge in speculation and to depend on hear-say.(cid:1)Transparency is
a better public policy than opacity.
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THE NEW GLOBAL THREAT: SARS AND ITS IMPACTS
Third, in order to make the right policy one must make a thorough study
of the nature of the crisis.(cid:1)The Singapore government mobilized all available
resources, both domestic and foreign, to understand the nature of the
coronavirus which caused the disease, how it is spread, how it can be contained,
and how to help patients recover from the disease.(cid:1)The Singaporean team of
doctors, virologists, geneticists, public health and communicable diseases
specialists, and other experts was aided in their tasks by experts from the
WHO and the Centers for Disease Control of the United States.
Fourth, the Singapore government decided to designate one hospital, the
Tan Tock Seng Hospital as the SARS hospital.(cid:1)The doctors, nurses and other
healthcare workers of that hospital rose to the challenge.(cid:1)There was no panic
in the hospital.(cid:1)The hospital did not have to lock its doors in order to prevent
its doctors, nurses and other health workers from fleeing from danger.(cid:1)On the
contrary, doctors and nurses from other hospitals volunteered to work at Tan
Tock Seng.(cid:1)The heroism of the doctors, nurses and other healthcare workers
inspired the whole nation.(cid:1)In retrospect, one can say that the designation of
Tan Tock Seng as the SARS hospital was the right decision.
Fifth, the Singapore government decided to trace every person who had
been in contact with a SARS patient.(cid:1)This was no easy task in spite of
Singapore’s small size.(cid:1)The government had to mobilize the human and
technological resources of the police, army, People’s Association, etc. to this
end.(cid:1)Given the manner in which the disease was spread, the decision to trace
every contact, no matter how many and how difficult was clearly a right
decision.
Sixth, the Singapore government decided to impose home quarantine on
persons who had come into contact with a SARS patient who had no symptoms
of the disease.(cid:1)This was necessary because an infected person may develop
symptoms of the disease and become infectious within a ten-day incubation
period.(cid:1)Parliament had to rush through a law to authorize home quarantine
and to punish those who violated it.(cid:1)Public opinion had to be mobilized to
support an action which was both coercive and intrusive.(cid:1)Cameras, linked to
computers, were installed in the homes of persons who were subject to home
quarantine orders.(cid:1)On the whole, Singaporeans accepted the need for such
measures and responded well.(cid:1)There were many examples of neighbors who
went out of their way to help other neighbors who were unable to leave their
homes because they were subject to home quarantine orders.
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EDITORIAL
Seventh, the people of Singapore responded to the crisis in an extraordinary
way.(cid:1)Many citizens came forward as volunteers, to man counters, to measure
temperatures, to set up websites, to man call centers, to deliver food to people
under home quarantine orders, etc.(cid:1)The Singapore Chinese Orchestra went
to the Tan Tock Seng Hospital to perform in order to cheer up the healthcare
workers.
Eighth, new technology, in the form of thermal scanners, were developed
or imported and installed at the airport, the causeway, and many other public
places.(cid:1)The lesson here is that in fighting a crisis such as this, a multi-
disciplinary approach is necessary.(cid:1)There must be no artificial boundary
between medicine and engineering or between medicine and other disciplines.
Ninth, the government, the private sector and civil society joined hands
in waging a campaign to raise the standards of personal and public hygiene, to
take one’s temperature daily, to wash one hands thoroughly, and to avoid
certain bad habits.(cid:1)The campaign was successfully executed.
Tenth, Singapore was conscious of her responsibility not to export the
disease.(cid:1)It therefore implemented measures at our border checkpoints in order
to make sure that we detect incoming passengers and visitors with SARS
symptoms and send them for screening.(cid:1)We also screened our outgoing
passengers in order to prevent the export of the disease.
In conclusion, I would say that of the countries and territories in Asia
which were affected by the SARS crisis, Hanoi probably performed best.
Singapore probably deserves the second prize.(cid:1)The Singapore SARS story is
worth recording because it is a defining moment in Singapore’s history and
because it is a good case study for students of public policy and crisis
management.
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