The Politics of Disease

Another glitch was timing. The quarantine measures did not go into effect until March 31, three days after they were announced. That lag proved crucial. In the interim, SARS cases at Amoy Gardens soared from seven to 213, and before a lockdown could be implemented there, 113 families living in the complex packed their bags and fled. Instead of separating them from the rest of the city, health officials lost track of them.

A few days later, authorities tightened up, sending remaining Amoy Garden residents to fully fledged quarantine facilities at four local summer camps and resorts. About half of the families who fled the complex had been located by the end of last week. But the Hong Kong Police Department is still tracking down the remaining 45 families. In some cases, they've yet to even learn the names of the missing residents.

Some question why Hong Kong, with its sophisticated medical infrastructure and experience with similar outbreaks—the city effectively contained a deadly avian-flu epidemic in 1997—was caught off guard. Local radio talk-show host Albert Cheng puts it bluntly: "The government wanted to show the foreign press that Hong Kong is not in crisis and that everything is under control."

Medical experts decline to fault the government, pointing out that it was dealing with a disease not seen before and that the situation was fast moving and fluid. Hong Kong's top health official, Secretary of Health, Welfare and Food Dr. Yeoh Eng-kiong, says officials "were as forthcoming as possible with as much information as we honestly had." He adds, "we did try our best."

By failing to keep SARS in check, Hong Kong is now a city full of fearful, surgical-masked citizens—and a city that is an international pariah. On April 2, the WHO issued an unprecedented advisory, warning against travel to Hong Kong and the nearby southern Chinese province of Guangdong because of the risk of contracting SARS. Airlines are slashing flights to the city as travelers stay away. Hong Kong businessmen were even barred from attending a major watch-and-luxury goods trade fair in Basel, Switzerland, unless they submitted to intrusive health checks, sparking a diplomatic row. Says Christine Loh, a former Hong Kong legislator who now runs Civic Exchange, a political think tank: "The importance of getting it right in terms of Hong Kong's image is critical, and this is where we've been messing up."

It's not hard to see why it's crucial to halt the spread of SARS, and not just for health reasons. The economic toll could be devastating. Some economists predict that the hit to Hong Kong's travel and retail sectors will drag the city's 2003 GDP-growth rate down by one-fifth or more, a loss of more than $1 billion. Last week Stephen Roach, chief economist for Morgan Stanley, said SARS is "just another nail in the coffin" for the global economy, which is already stumbling from the Iraq war. He predicts a worldwide recession will begin this year.

Of course, denial and disease often go hand in hand. Other countries have been slow to acknowledge that SARS had penetrated their borders. Hong Kong's response looks positively proactive compared with that of China, where the disease first appeared and which still has the most cases by far, at 1,220. For months, national and provincial authorities kept a lid on publicity surrounding the mystery ailment and refused to share patient information with international health organizations.

Now that SARS has become a global scourge—and the WHO is warning people not to travel to China—Beijing's denial may be ending. In an unusual admission last week, the director of the Chinese Center for Disease Control, Li Liming, apologized for "poor coordination" between medical departments and the mass media. "We weren't able to muster our forces in helping to provide everyone with scientific publicity," he said.

More importantly, after more than a week of waiting, Beijing granted permission for five WHO epidemiologists to travel to Guangdong, the cradle of SARS. They're still not getting all the cooperation they say they need, such as direct access to hospitals and patients. But WHO officials say they are hopeful that by studying the outbreak at its source, they will be able to contribute to the growing body of scientific knowledge about the disease—and perhaps stop it in its tracks, for good.