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Latest on SARS Situation in China
2003/11/03

The State Council Information Office held a press conference Sunday
afternoon updating SARS latest developments on the Chinese mainland. The
Executive Vice Minister of Health Gao Qiang and Vice Minister Zhu
Qingsheng answered questions from both Chinese and overseas journalists.

Foreign journalist: Officials told us at a press conference a fortnight
ago that Beijing was safe for the Chinese people as well as for
foreigners in China. But the present epidemic situation is becoming more and
more serious. Just now you also explained why there were some
limitations to the data reported some days ago. What on earth are the problems in
Beijing (or in China's health system) that deters you from telling us
the truth?

Gao Qiang: SARS has not been fully understood by mankind and an
entirely effective therapy is still unavailable. What's more, it is very
contagious. So I think if a place claims to be safe, that safety is
relative. Without good preventive measures, a place that doesn't have SARS
today might have it tomorrow.

At our last press conference officials were saying Beijing was safe. I
think their words were based on the situation in Beijing at that time -
when most of the SARS cases were in Guangdong and the epidemic
situation in Beijing was limited to very, very small areas. But there have been
some changes to the situation in Beijing recently, as you can see in
the data I announced just now. SARS cases have been increasing gradually
and this reflects that there are some vulnerable spots in the present
SARS prevention work. The major problem is: medical institutions in
Beijing are subject to the jurisdiction of many departments -- the Beijing
municipal government, the Ministry of Health, the military and so on.
This loose administration system has caused lack of communication among
hospitals: a failure to obtain accurate information on the epidemic and
a failure to take very effective quarantine measures to prevent the
disease from spreading.

CCTV: In view of the situation you just briefed us on, the present
epidemic situation in Beijing is serious. What measures will the central
government and the municipal government of Beijing adopt to curb the
development of the epidemic?

Gao Qiang: First, I think the most urgent and important matter now for
Beijing, as well as for all epidemic areas, is to resort to resolute
measures to prevent the epidemic from spreading. We have employed
rigorous preventive measures on medical agencies to prevent medical workers
from being contaminated. We have adopted rigorous measures on confirmed
SARS patients, suspected SARS cases and those who have had close contact
with SARS patients. We have taken rigorous measures in observation,
surveillance and tracking on airlines, trains, buses and other (public)
vehicles.

We have adopted another important measure: the State Council has
decided to suspend the May Day vacation of seven days and return to the
normal holiday vacation system, to avoid the epidemic from possibly
spreading in the movement of large numbers of travelers. I think this measure
will result in a great loss of income for China's tourist sector.
However, the Chinese government wants to give top priority to the lives and
health of the people.

Second: enforce guidance of epidemic prevention work in different areas
in the country. The Chinese government has dispatched supervision
groups to Guangdong, Beijing, Inner Mongolia, and more recently, to Shanxi,
Henan, and Ningxia Hui Autonomous Region. Why did we send a supervision
team to Ningxia when there was only one SARS case there? Ningxia is in
the west of China where medical conditions are relatively bad and the
income level of the local residents there is relatively low. Protecting
the vast rural area of west China from being caught by the epidemic is
an issue of great concern to the Chinese government.

We want to enhance preventive and surveillance measures in schools,
especially middle schools and primary schools, government offices and the
military where population is dense. We have taken measures to protect
the health of foreigners in China and residents of Hong Kong, Macao, and
Taiwan, too.

Third: integrate national medical research resources to tackle the
issue and improve medical measures to cure more patients and reduce the
mortality rate.

Fourth: set up a medical aid fund for low-solvency patients and
farmers. A document issued by the Ministry of Finance, Ministry of Health and
Ministry of Labor and Social Security said that those who have economic
difficulties in paying the medical bill may receive subsidies from the
government. The budget comes from both local and central government. In
addition, medical workers should receive medical care subsidies from
government revenue as well.

Fifth: further strengthen the cooperation with WHO. While we are
holding this news conference, officials from the Ministry of Health are
reporting epidemic conditions of both Beijing and other places (in the whole
country) to the WHO expert team, aiming to sort a better way out.
SKY TV: You just mentioned that there will be no long vacation this May
Day. As we know, 74 million people traveled around China during the
last May Day golden week. Does the canceling of the vacation mean,
officially, that the Chinese government declares that China is not a safe
place to travel in now?
Gao Qiang: The canceling of the May Day holiday aims to further prevent
the spread of SARS under the current epidemic situation. We believe
strict measures are necessary. We don't forbid all traveling activities.
We suggest not to travel too far; local travel is advocated.
Reporter from Netherlands: In the cooperation between the Ministry of
Health and WHO, information collection measures are clearly stated, but
why are these measures overridden by the Ministry of Health?
Gao Qiang: Due to insufficient awareness of the SARS situation, the
information collection system was far from perfect at the beginning. As
for Guangdong, they have a better system in terms of reporting and
technology, because Guangdong was involved earlier; things are the opposite
in Beijing. Besides, the Ministry of Health has not undertaken powerful
direction and inspection work in Beijing and this is our problem.
ABC: You just mentioned that the inaccurate figures are due to some
mistakes in your work. But is it possible that the Chinese government
disguised the epidemic deliberately, in particular those cases hidden from
the World Health Organization (WHO) team? It's been reported that some
SARS victims were hidden in ambulances or hotels while the WHO team was
inspecting. Do you believe these reports are true? And is there any
investigation under way to determine whether SARS cases were intentionally
hidden from the public?
Gao Qiang: I think that inaccurate statistics are totally different
from deliberate action to disguise the facts. We asked all regions to
report the actual figures, and release the facts to the public. No delay,
cover-up or missing cases were allowed. Till now, I haven't found any
place which has done so. We've dispatched some supervision teams to some
regions. One of their tasks is to check the actual conditions of the
epidemic. Wherever they are, they will punish those who have covered up
actual SARS cases and will inform you (the public) in time. If any of
you know of such cases, I hope that you will tell me, but the information
you offer must be correct.
Taiwan ETTV: I want to ask Mr. Minister, is there any leading official
or ministry taking responsibility for SARS? What's more, it's said that
a SARS peak will come next week, what do you think of the news? Third,
the large number of migrants in Beijing makes it difficult to curb the
spread of the epidemic. Will Beijing take further measures on
non-natives?
Gao Qiang: The main task currently is to take effective measures to
curb the spread of SARS, and strengthen medical aid in order to make more
patients recover, instead of tracing someone's responsibility. Now, we
are considering strengthening medical work, and perfecting our measures
in order to achieve a better result. Just now, the lady asked if there
will be SARS breakout: I don't know what the breakout refers to? Since
more than 300 SARS cases have been found, I think that it's already
serious. Considering that some patients will be excluded from over 400
suspected SARS cases after diagnosis, and some will be confirmed to be
infected, the number of SARS patients will increase in the next few days.
But it doesn't mean that SARS will spread widely in Beijing. These SARS
patients were mainly hospitalized at the end of March and beginning of
April. Yesterday, I received Beijing's SARS report, which shows 7 more
cases have been found. These cases aren't included in today's report;
we will add them in tomorrow's report.
As an international metropolis, Beijing has a population of over 10
million and daily migrants of 4 million. I think we should take effective
measures to prevent the further spread of SARS, and keep normal order
in people's life and work at the same time. Both of them are wrong if we
ignore the spread of SARS or affect people's life and work by
overestimating the epidemic also. We will adjust our plan according to the
actual SARS condition in Beijing to prevent and control it.
NBC: My question is what are the main symptoms of the suspected cases?
Does China follow consistent standards with WHO in diagnosing suspected
cases? My second question: experts from WHO said a larger number of
patients are under close observation in Beijing who were neither confirmed
to have caught SARS nor proved to be suspected? Do you have figures for
this category?
Zhu Qingsheng: As Executive Vice Minister Gao pointed out just now,
SARS is a new kind of disease which started at the beginning of this
century and still remains unknown to mankind. In the past months, the
Chinese mainland, Hong Kong Special Administrative Region and Taiwan
Province, as well as other countries around the world, have diagnosed and
treated the disease and studied its cases, but we are still at a stage of
exploration. We cannot say all problems relating to SARS are solved. We
have had academic exchanges with WHO; Hong Kong and Taiwan of China and
other countries recently on the diagnosis and treatment of SARS cases,
and suspected cases, through the Internet and other means.
Now in clinical diagnosis we follow three standards: first, the patient
has had some activity relating to the epidemic, for example, contact
with an infected patient or a history of having been to an
epidemic-infected area. Some data is easy to get, for instance, one (team) has been
to an area with many SARS cases; while some is not so obvious (to
follow), such as taking a bus or going to a hospital. It's hard to decide
whether one is infected by a certain person or a certain environment.
Another aspect is the symptoms in clinical diagnosis: a high fever, dry
cough, being short of strength, a shadow on a chest X-ray. To our
satisfaction, WHO has announced the discovery of the cause of SARS as a new
kind of corona virus.
If one or two symptoms occur, we judge it as a suspected case. China
has kept contact with WHO and some other countries and regions where SARS
cases are found. The diagnosis standards adopted by Chinese doctors on
confirmed SARS cases and suspected cases are basically consistent with
those of other countries and regions. We have communicated well and had
friendly cooperation with WHO experts during their inspection tour in
Guangdong and Beijing; whether in clinical diagnosis or treatment. We
reached good consensus on the diagnosis and treatment of the disease. WHO
experts also acclaimed China's contribution in this respect. The
Chinese mainland has the most SARS cases up to now and is the area which has
seen the earliest SARS cases. We should contribute in this respect and
may contribute more in the future. WHO experts have conducted
investigations in Guangdong Province, south China, and the capital city,
Beijing. They have reached a consensus, to a great extent, with the Chinese,
on SARS diagnosis and clinical treatment.
China Radio International: Just now Vice Minister Gao said that the
Chinese government has set up a medical aid system to treat SARS patients
living in poverty or in rural areas. But there are still reports that
some patients were refused at some hospitals because they could not
afford the payment. Could you confirm this situation?
Gao Qiang: I have also taken notice of the situation you mentioned.
This phenomena really exist in some places. But I should think these
hospitals have both subjective and objective reasons for actually doing so.
For example, some hospitals cannot handle epidemics as they may be only
centers for heart disease. If a SARS patient goes there, he might
possibly not receive effective treatment. To solve these problems, we have
taken the following measures.
First, we have designated six special hospitals in Beijing to treat
SARS patients. The publication of the addresses and phone numbers of these
hospitals has enabled SARS infectors not only to receive timely
treatment, but also prevent the further transmission of the disease.
Second, in some well-equipped hospitals, we have set up isolated and
special out-patient service centers for respiratory diseases. The
hospitals should give timely isolation, observation and judgment on patients
who show symptoms of fever and cough, certainly not the normal cough.
Also they (patients) should be reported to relevant public health
department. After receiving a report, the relevant department must send out
experts, medical workers and ambulances immediately to the spot. If the
patients are diagnosed as suspected SARS cases, they should be sent to
designated hospitals.
Third, we also put forward strict requirements for the presidents of
the hospitals and the discipline they should observe. They should not
reject any patients on any excuse, including an economic excuse. If the
hospital really has difficulty in receiving patients, it should find a
place of temporary isolation for the patient and immediately report the
case. The relevant departments will take measures. No hospital is
allowed to reject a patient out of its door. If we find any rejection case,
we will give them severe punishment. Report of such phenomenon is also
welcome by society.
Wang Guoqing: What Gao mentioned just now applies not only to Beijing
but the nationwide regions where SARS cases are found.
UPI: You're promising to be more open with the numbers of the suspected
SARS cases and actual SARS cases; I'm wondering you also mentioned that
there will be a daily report. What is the mechanism for that report?
And also since you're going to be open with the numbers, could you
perhaps be more open with the numbers of the cost, for example, what the
budget is for the Ministry of Health right now, how much money is the
budget for SARS, and how is it going to be divided between the central
government and local government, especially in the west, which doesn't have
enough money?

Gao Qiang: I'm not the full-time information officer of the Ministry of
Health, so I can't give such a news conference everyday. I think that
information will be released through media organizations. No matter what
kind of form it will take, I hope that every journalist who cares about
SARS prevention and control in China gets related information. As for
the question the gentleman just asked about the capital input in SARS
prevention, that's my special area, because I worked as the vice-minister
of finance for many years.

As for the accurate figure of how much money I have and how much money
is needed for SARS prevention and control, I can only tell you that
it's X. But I pledge that the Chinese government will try to prevent,
control and cure the epidemic through both central and local budgets, no
matter how much money it will spend. The Ministry of Health and Ministry
of Finance have reached a consensus that the Ministry of Finance will
give full financial support as long as the expenditure in their budget
is reasonable.

After over 20 years of reform and opening-up, China has accumulated a
solid economic foundation, and China's fiscal revenue has currently
performed very well. In the first quarter of 2003, fiscal revenue increased
26 percent over the same period last year, so the epidemic prevention
and control will not be influenced by capital shortage.

Voice of America: I have two questions. First, the mortality rate seems
to have gone up a little bit, is it significant to the issue? Secondly,
there are many calls and promises for accountability. Are you aware of
any official, at the provincial, ministerial or central level of the
government, who will be jailed, fired or verbally punished?
Gao Qiang: We are very much concerned with the increase of the
mortality rate. We hope it will be zero. But so far we do not have medicine
which can effectively kill the virus. Guangdong has developed some
effective methods which can cure 80 percent of the patients. The Ministry of
Health is now collecting Guangdong's experience in prevention and
treatment to popularize it in the affected areas.
In terms of accountability, the Chinese government is responsible to
the general public. We'll try our best to correct and rectify the
mistakes and deficiencies in our work. At present, the major task facing the
Ministry of Health is to study, with consorted effort, the methods of
controlling the spread of SARS.

China Daily: China has a large rural population whose income level is
relative low while the medical conditions in the countryside are poor.
This may lead to rapid spread of SARS among the rural population. What
can the Chinese government do to prevent such a trend?
Gao Qiang: So far, we haven't found a large-scale occurrence of SARS
cases in rural areas. But we have been highly vigilant for we know that
the result will be very serious if rural areas are affected since
Chinese peasants earn relatively less than urban people and medical
facilities there are poor and rural people's sense of self protection is less
than the urban population. I think it's very possible for those rural
people who have come to work in the cities to carry the virus back to
their home.

To curb the occurrence of such cases, we have adopted the following
four measures: First, all transportation tools are required to take strict
monitoring and isolation measures. Any persons found having symptoms
will be sent to the floating inspection station in the locality. Second,
we will give the same treatment to migrant workers in the cities as to
its urban residents. Whenever there are cases appearing among them,
they'll receive immediate rescuing and medical treatment. Third, we have
urged the rural population to watch out for the epidemic, immediately
reporting any suspected cases for timely isolated treatment. Fourth, any
peasant who is affected by the epidemic should be sent to hospital for
timely treatment. Those people who have financial problems will receive
subsidies from local government. If a local government has financial
problems, the central government will subsidize the local government.
Far Eastern Economic Review: I have three questions. The first is would
you like to give us more information about the cause of the epidemic in
Beijing? You just now gave us very large numbers for cases in the city.
Can you tell us when the numbers of the cases started to rise
dramatically? Can you tell us whether the numbers of the cases each day has
began to level off or is still arising and how does the seven yesterday
compare to the cases in the last ten days? Could you give us more
information about these? And also could you explain why there are so few
medical workers affected among the Beijing cases? When in other outbreaks, it
seems medical workers have been a much greater proportion of patients.
My second question is that you have taken extraordinary measures to get
accurate numbers in the city of Beijing. How confident do you feel
about the numbers in other parts of the country? Do you feel perhaps the
situation in places other than Beijing and Guangdong could be as bad as
in Beijing and Guangdong? My third question is: Are you still
encouraging the foreign community to come to China as you did during the past few
weeks?

Gao Qiang: I don't think the phrase "to rise dramatically" is accurate.
Just now, I have said that the increased numbers were collected by tens
and hundreds of personnel sent by us, taking one week to check out
patients scattered in various hospitals. The truth is that the number of
SARS cases we have found and reported now has increased.
Five days before, the number was 37, now it is 339, increased by 302.
But it doesn't mean the 302 people were infected within the last five
days. It could have been ten or twenty days ago and they could be
unregistered patients in some hospitals. To check them out is a good sign of
our statistic work, but it doesn't mean the situation in the city of
Beijing is deteriorating dramatically. As for few infected medical workers
in Beijing, I think we should thank the better medical conditions,
public awareness, and protection and prevention measures in the city. Just
now the lady had some doubts about the accuracy of numbers in local
areas; I can tell you that we have sent inspection teams to deal with any
cover-ups.

As for whether we are still encouraging international exchange: aren't
you staying in China? Monitoring is necessary, but maintaining normal
international activity is necessary too. I am not in favor of saying
China is the safest country in the world, or that we can promise for you
not to be infected by SARS, and I don't agree with any judgment that
China is a dangerous country and you are likely to be infected very much
here neither. This plague is not exclusive to China. It has broken out
in more than twenty countries. We hope that more measures may be taken
to protect foreigners and fellow Chinese from Hong Kong, Macao and
Taiwan, among whom, five were under medical care in hospitals of Beijing. So
far, one Canadian has left the hospital, two Taiwanese are about to be
discharged after recovery. Whether Beijing is safe or not, you may
judge for yourself.

CNN: First I want you to understand why foreign journalists in China
have been suspicious of the Chinese authorities. Over the past weeks we
have received distorted information once and then again and the
information has misled us and stirred confusion amongst us. For instance, two
weeks ago Minister Zhang said the epidemic had been put under control; a
week ago, it was said that Beijing had 37 SARS cases, and when we asked
whether the 37 cases include cases in military hospitals, you said yes.
Why is it so hard to squeeze accurate information from you? President
Hu has said that any cover-up, delay or discounted reporting is
intolerable. But the data you announced just now is yesterday's information and
you also mentioned that there are seven new cases. Why don't you report
all the cases at one time? Is this because you have not attached enough
importance to this issue?

Gao Qiang: I think that I have given enough of an explanation to
similar questions but if you still don't understand, I'd like to say more.
Beijing is the capital of China and there are work units of central
government, local government and the military. These units are
respectively in charge of some hospitals. These hospitals have received different
patients. This is an issue then about the Chinese medical system. With
the present system it is pretty difficult for the municipal authorities
of Beijing to collect accurate and timely epidemic information in a
hospital run by the military. President Hu Jintao and Premier Wen Jiabao
have sharply noticed the problem and decided to put the epidemic
prevention work of all the Party; government and military organizations,
public instructions and enterprises under the leadership of the Beijing
municipal government. I think with the leadership of this unified system
the situation of the previous days will not be repeated.

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