Newsday - April 25, 2003
Laurie Garrett, Staff Correspondent

The government said those ordered to stay home have had "intimate contact" with others showing SARS symptoms, a Beijing health official said Friday.

The quarantime announcement by Guo Jiyong, deputy director general of the Beijing Health Bureau, came two days after the capital said it was invoking emergency powers to quarantine people exposed to the virus that causes severe acute respiratory syndrome. So far, officials have reported 42 SARS deaths in Beijing and 115 nationwide.

Guo didn't say who the people 4,000 people were or how long they had been ordered to stay home.

The city government has designated six hospitals to handle SARS cases. Guo said it might add more, but he gave no details.

City government spokesman Cai Fuchao, speaking at the same news conference, denied rumors that authorities planned to declare martial law in Beijing or close the city's airports and highways.

He said inspection teams were being sent to 147 city hospitals to ensure that they were following guidelines on handling potential SARS cases.

Cai said the city government was coordinated with China's military to ensure that all cases were reported. Military hospitals earlier had failed to report SARS patients to civilian authorities, leading to complaints that China was not fully disclosing information on the outbreak.

Beijing has reported more than 750 cases of SARS infection.

The closing of People's Hospital, the prestigious teaching facility of Beijing University was the latest attempt to contain the spread of SARS -- severe acute respiratory syndrome -- in a city sent reeling in the past few days as the reality of the mystery disease has set in. The city's official tally continues to grow, reaching almost 775 cases and 39 deaths.

Government signs posted outside the hospital said the people and buildings were under quarantine, and "when the disease situation is effectively controlled the quarantine measure will be cleared." A university official told The Associated Press the hospital was being disinfected and an unknown number of patients and 2,262 employees were moved for observation to another hospital.

The dramatic steps followed the illness last week of a university student who developed pneumonia and was treated at People's Hospital. After a few days, the hospital released the student, according to other students, saying she was cured, and she returned to her dormitory and to classes. A few days later her symptoms returned and she spread SARS to 22 other students, Dr. He Xiong, chief epidemiologist of the Beijing Center for Disease Prevention and Control, acknowledged at a news conference Thursday.

The girl became so ill that she could not move. When ambulance drivers saw her condition, they refused to handle her, and students pooled their resources to hire "floating people" -- migrant workers -- to haul her back to People's Hospital. SARS then quickly spread inside People's Hospital, and the Beijing CDC feared the virus might be spread in the ventilation system.

Now the multistory, city block-sized building is being inspected in an effort to learn how the infection spread, he said.

Normally, People's Hospital houses the bulk of China's AIDS patients. Thursday authorities declined to address whether rapid spread may have been due to the presence of a large population of patients with immune deficiency.

Such closings and other disease prevention policies -- some of dubious benefit -- have been enacted across SARS-impacted regions of Asia. Governments and the public are responding with scrubbing, hygiene campaigns, disinfection, masks, gloves and quarantines. Restrictions have been placed on businesses and travel, and bleaching of surfaces has been promoted in efforts to rid the virus from the environment.

But it is not at all clear that the virus is, in fact, an environmental agent û at least, not one found floating in the air. Nevertheless, many measures appear to reflect the ancient miasma theory of disease, in which pathogens seemed to be part of "bad air" or dirty environs. Last weekend, for example, Hong Kong executed a citywide cleanup day, bleaching every public space. Beijing authorities now require all cabbies to disinfect their taxis four times a day. And Thursday the municipal government shut down the largest library in the city to prevent large numbers of people from congregating in one place.

But Dr. Jeff McFarland, the World Health Organization's Beijing-assigned epidemiologist, said the answers to this outbreak aren't yet understood.

"The role of public health officials is to answer these very important questions and give that data to politicians so they can make rational decisions," he said in an interview. "The difficulty is, not all the answers are in. And in the face of uncertainty, of unknown risk, people seem to become paralyzed, terrified.

"Our public health response has to be to get these answers as fast as possible."

City officials here have been handing out masks and bleach kits to promote cleanliness û a 70-year-old illiterate man died on Wednesday, apparently because he thought he was supposed to drink the bleach to stay free of SARS.

Beijing has become a city rife with rumors: One insists that 10 "floating people" had become infected and passed the virus to 300 others -- and, as a result all of the estimated 750,000 migrant workers -- whom most permanent residents of Beijing consider dirty -- will be rounded up and sent back to their agrarian homes.

Another posits that the military will take control of the city, forcing the populace to remain indoors until the epidemic passes. In response, residents are stocking up from supermarkets in anticipation of a long homebound siege.

The CDC's Dr. Tang Yaowu said Thursday the agency is trying to find and monitor every close associate, family member and neighbor of individuals under quarantine.

Dr. He said there may be other outbreaks across Beijing related to ambulance drivers' refusals to handle potential SARS cases. Authorities have introduced a squad of 30 ambulances to handle only SARS cases, and created a 24-hour hotline for reporting suspected cases. There's also evidence, He said, that the illness has not been contained to large hospitals, that the virus is in "secondary and even lower hospitals. Even the lower hospitals cannot satisfy the demand of so many patients in Beijing."

Given the experience in Hong Kong of the Amoy Gardens apartments, in which more than 300 people became infected after the visit of a single SARS patient, Beijing authorities are hard-pressed to ensure the virus will not spread inside apartment complexes, dormitories and workers' housing facilities in which individual cases have been found.

Given such uncertainties it is perhaps not surprising that Beijing authorities and citizens are nervous, and "nowadays society is a little bit over-reacting," He said. "It's not necessary to wear a mask outdoors, for example. There is little bit of panic out there."

He's team at the CDC is trying to determine exactly what the risks are by studying the virus itself. They have already made one disturbing finding, He said: that it is changing. So far, he said, they have seen a 2 percent to 5 percent genetic drift in the genome of the virus since the earliest cases five months ago.

"The hope is that by getting answers to questions like that it will become clear what are useful prevention measures, and what clearly are not," McFarland said.

Thursday, China delayed the start of its soccer season because of concerns over SARS. The Chinese Football Association said women's league games scheduled for next month have been postponed until June or July. Three men's leagues were scheduled to start playing in mid-May, but the association said matches have been suspended indefinitely.

This story was supplemented by The Associated Press.

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