By ELISABETH ROSENTHAL

BEIJING, April 9 -- A senior retired military physician said that China's health ministry was lying about the number of people hospitalized in Beijing with severe acute respiratory syndrome, noting that the number in military hospitals alone could be "up to 100."

In a statement released to news organizations and in a subsequent interview, Dr. Jiang Yanyong said he "couldn't believe what I was hearing" as he watched the minister announce last Thursday that there had been only 12 cases and 3 deaths in Beijing.

He said doctors at the military hospitals were "furious" about the statement, noting that on that day the military hospital designated to treat SARS cases, the People's Liberation Army No. 309 Hospital, already had 60 patients and 7 deaths from the disease.

"As a doctor who cares about people's lives and health, I have a responsibility to aid international and local efforts to prevent the spread of the disease," Dr. Jiang wrote in his statement.

Another doctor in the Chinese health system, who spoke on condition of anonymity, said there were also dozens of patients at Youan Hospital, a nonmilitary hospital in Beijing that has been designated as a referral center for the disease, known by its initials as SARS.

While the total number of cases is still not great, the fact that so many have gone unreported in Beijing underscores China's continuing lack of openness in confronting an outbreak that has left 1,279 people ill and killed 53 in this country. Worldwide, 2,750 have been infected and 103 have died.

In China, health statistics are often regarded as state secrets, particularly if they are negative. Chinese leaders are particularly reluctant to release bad news occurring in Beijing, the capital.

In fact, Dr. Jiang said that the first case of SARS in Beijing occurred in March, during the annual meeting of Parliament, the National People's Congress. Ten doctors and nurses at the Army's No. 302 hospital were infected after contact with that patient.

Hospital leaders in Beijing were called to the ministry of health for a meeting. But instead of instructing them to pass on a public health warning, Dr. Jiang said, the ministry told the doctors that they were "forbidden to publicize" that SARS had arrived in Beijing "in order to ensure stability" as Parliament convened.

The first cases appeared in southern China last November and, by January, doctors were aware that they were dealing with a new and potentially lethal disease. But until late March, they refused to share their data or to cooperate with international investigators, insisting that their local outbreak of an "atypical pneumonia" had nothing to do with SARS.

This week, Dr. David Heyman of the World Health Organization told a United States Senate committee that the international epidemic could possibly have been controlled if the Chinese had asked for help earlier.

The World Health Organization has asked all countries for daily updates of cases and deaths from the illness. China, belatedly, agreed to provide them as of April 1.

In Beijing today, a W.H.O. team in China investigating the outbreak praised what it called "extensive" and "reliable" data that has now been provided to them from Guangdong Province, where the outbreak was first spotted.

But they said that data from elsewhere in China seemed far less complete. Noting that the team was "very concerned about rumors we are hearing," the W.H.O country representative for China, Henk Bekedam, said, "We do not really know about Beijing and other provinces, and we have asked specifically about that."

The visiting W.H.O. team met for over an hour with Vice Premier Wu Yi, who promised to look into the rumors of unreported cases in Beijing, team members said. But they said that a possible explanation for the discrepancy was that China was not reporting cases until they were finally and fully confirmed to be SARS, while some of the patients in the wards might still officially be classified as suspected cases.

Officials from the World Health Organization say they have repeatedly pressed the Chinese about their data on the number of cases in Beijing and have been repeatedly told that the data was completely reliable.

Still, in private, team scientists have expressed nagging concerns. When Chinese officials were insisting that there was no SARS in Beijing, scientists wondered how a disease that could spread from Hong Kong to Canada, and from Vietnam to Singapore, could not travel from Guangzhou to Beijing. There are more than 20 flights a day between the two cities.

Since then, Beijing has been filled with rumors about wards full of patients. The W.H.O. team said today that it hoped to be able to conduct its own investigation.

During its weeklong stay in Guangdong Province, the team said it had free access to hospitals, laboratories and patients, affording it great confidence in the data now coming daily from there.

They said that in the last two months Guangdong had developed excellent systems for counting cases and greatly enhanced precautions to prevent the spread of the disease, resulting in a sharp drop in the number of new cases.

"We have been commending the Guangdong experience as a model for China, maybe the rest of the world," Dr. Bekedam said. No doctor has been infected there since March 25 and there have been only 53 new cases this month, giving scientists great hope that the spread of the disease can be controlled.

But the W.H.O. team has not been granted such access in Beijing. "We were given an open book in Guangdong, and hope to get the same for our week here," Dr. Bekedam said.

An unresolved question is whether it is possible to acquire SARS in Beijing: the Chinese health ministry says that all cases in Beijing were acquired elsewhere. Dr. Jiang confirmed that of the patients in the military system, "most of them are people from Beijing who traveled, especially to Guangdong."

In Hong Kong, SARS continued to spread, infecting 42 more people and killing 3, including an American. Malaysia became the first country to ban tourists from Hong Kong and mainland China for health reasons.

A Hong Kong Hospital Authority spokeswoman said tonight that a 51-year-old American man had been brought across the border from Shenzhen in mainland China. He man arrived unconscious at a Hong Kong hospital and was declared dead half an hour later.

The man's 6-year-old son was also hospitalized, and was in stable condition.

The dead man's family name was Salisbury, the spokeswoman said. The Associated Press reported that his first name was James and that he had been an English instructor at a polytechnic institute on the mainland.

The two other SARS patients who died today were an 86-year-old woman and a 35-year-old man. Both had other health problems, said Dr. Liu Shao-haei, a senior executive manager at the hospital authority.

Malaysia today temporarily halted the issuance of visas to tourists from mainland China and suspended its previous policy of allowing Hong Kong residents to enter without a visa for up to 30 days. Malaysia said that people traveling on business trips, or for their governments, would still be allowed in from both places.

The Hong Kong government strongly criticized the measure as unnecessary. Thailand is already requiring arrivals from SARS-affected countries to wear face masks.

Also, South African health officials today gave details of what they called Africa's first "probable" case of the disease.

The patient, officials said, was a 62-year-old man who had recently visited Hong Kong, where the disease is most prevalent. He was admitted to Pretoria Hospital on Monday suffering from respiratory problems. Medical tests have so far come back negative for SARS, officials said. But the results were not conclusive, and officials said they were awaiting more results next week.

Dr. Willi Seiling, who is treating the patient at Pretoria East Hospital, said the man was in critical condition, but progressing well.

"I am happy to say that the patient is doing much better than he was when he was admitted," Dr. Seiling said.

Richard Friedland, a senior official at Network Healthcare Holdings, which runs the hospital, said the patient was known to have had contact with 17 people, including 8 family members. All had tested negative for SARS.

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Posting date: 4/13/2003
Original article date: 4/13/2003
Category: News & Media Reports

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