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China Confronts Problem In Reporting SARS Cases
National Tally of Infections Surges Amid Efforts to Improve Counting
By PETER WONACOTT
Staff Reporter of THE WALL STREET JOURNAL
BEIJING -- China's SARS tally is surging, as the country prepares for a holiday that typically puts a nation in motion -- and this year risks spreading the deadly strain of pneumonia to cities and towns unable to cope with a health crisis.
China's health ministry announced that the number of patients with severe acute respiratory syndrome has climbed to 2,158, including 157 new cases reported Tuesday. Five more victims died Tuesday, pushing the national death toll to 97.
The total number of cases as of Tuesday marked a 19% jump from Friday's total, which was announced on Sunday when Chinese officials pledged at a news conference to begin concerted efforts to report new cases. The most dramatic rise has come in Beijing, which now acknowledges 588 SARS patients, 15 times the number it admitted before Sunday.
The tally, meanwhile, continued to increase in Hong Kong, where 32 new cases were reported Tuesday, bringing the total to 1,434; five people died, taking the death toll to 99.
In Singapore, health authorities said there were just two new cases and no deaths Tuesday. Singapore's total number of cases stands at 186. And in India, home to a billion people, worries began to emerge that the country's medical system might be unable to cope with a SARS outbreak. India reported its first case of the disease last week, and it now has four probable cases.
World-wide, the virus has sickened more than 4,000 people and claimed at least 238 lives.
China's Ministry of Health didn't explain the country's latest figures, and it wasn't clear whether the increase represented new infections or old cases that were being reported for the first time. What's more, China signaled it has an additional 918 cases it classifies as "suspected," with 666 of those being in Beijing. At any rate, the rising number of cases demonstrates how SARS is starting to cut a swath inland, as hospitals in places such as northern Shanxi, Jilin and Inner Mongolia pick up new patients.
The trouble comes at an awkward time for China. One of the country's biggest holidays, May Day, begins next week. The government has attempted to minimize risks by shortening the so-called Golden Week holiday to five days, encouraging people to stay close to home and introducing new screening measures at airports and train stations. But health experts warn large-scale traveling will challenge efforts to contain the outbreak.
The government's reluctance to call off the holiday shows how Beijing is trying to halt a disease without hammering the economy. In the past few years, holiday spending has become part of a government strategy to spur consumption by encouraging travel inside and outside the country.
The government "doesn't want to create a panic and wants people to still take days off," says Dong Tao, chief regional economist in Hong Kong for Credit Suisse First Boston. Mr. Tao worries that if people stay at home for fear of contracting SARS, China's strong economic growth will be undercut. "One can only watch one TV at a time and can eat three meals a day," he says.
Ahead of the holiday, the government is trying to brace the country for the disease. It has issued a national alert, provided hospitals with guidelines for handling infected patients and set aside three billion yuan ($362 million) to beef up medical care in the country's poor interior.
But the quick spread of the disease already is exposing the fragile state of China's health system. As government subsidies have dried up, China's hospitals have struggled to stay afloat financially. Many lack modern equipment, such as respirators, and staff trained to handle outbreaks of infectious disease.
"The risk is that provinces that haven't seen cases like this before could be caught by surprise," said Alan Schnur, head of the World Health Organization's communicable-disease team in Beijing. "No matter how much you prepare, until you see your health workers going down with SARS, the theoretical message just doesn't carry the same weight."
Hospitals are absorbing hard lessons.
In the northern region of Inner Mongolia, SARS patients have filled quarantine wards in the capital of Hohot. The Inner Mongolia Medical College now has 42 SARS patients, including confirmed and suspected cases, according to a hospital. Last Wednesday, nine suspected SARS patients arrived asking for treatment and then departed after being asked to fill out forms. A state media report criticized the hospital for turning away the patients.
A spokeswoman for the Inner Mongolia Medical College said that wasn't the intention, and that its hospital is operating in line with a new health-ministry notice to care for SARS patients. "Our hospital will receive any SARS-suspect patients, no matter whether or not they can afford the medical charges," she said.
Updated April 22, 2003 3:48 p.m.
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