Should I flee China (SARS)

Well, this whole thing has me shaken up a bit, but I’m not really sure what to do. Here’s my situation:

I live in Shenzhen, China. This is a large city in Guangdong, China, bordering Hong Kong. I’m a teacher at a public high school. My job, by necessity, puts me in contact with large numbers of people.

Currently, about 60 people have died from SARS, out of about 1600. About twelve of those deaths are in Hong Kong, about 35 in China. That’s according to the Chinese government anyway, they don’t inspire a lot of trust when it comes to admitting the seriousness of their problems.

So what’s the problem? I live in a city of millions, where a few hundred have a disease that is fatal in only a small percentage of patients. My chances of anything bad seem pretty slim. But . . . :

My employers don’t seem to think there is a problem at all. The local (state-owned) newspapers here say the problem is “under control”. I find it hard to believe that the problem is rampant in HK, (downtown HK is about a 25 minute train trip away) yet inconsequential here. In HK, schools are closed, banks have closed, some factories have closed; here in Shenzhen, business as usual. Yet Guangdong has 3 times as many fatalities and worse medical resources than Hong Kong with which to deal with an outbreak.

I’m afraid if I wait a lot long longer, the disease may spiral out of control and I’d have problems getting into HK because of quarantines at the border. Already, anyone showing symptoms may be quarantined. If things get a lot worse, is it possible they might issue a general quarantine? That really worries me. I honestly don’t trust mainland China’s hospitals, I really don’t want to be sick there.

My contract is up in two months, so I was planning on leaving soon anyway. I’d feel bad about leaving, but I’m angry that my employers and the Education Bureau of the city are acting in a callous manner in order to avoid admitting there might be a problem.

I feel like if I leave, I’m being hysterical. I feel like if I wait and see, I’m passively accepting whatever dangers there might be. What should I do?

You can get some good, accurate information from the CDC.

I’m in Beijing at the moment on business, and I understand your concern – especially given where you are located. But before you make a decision, take some time and do some research online. You’re right, the Chinese publications are not much help but you can find out a lot using the Internet. That way you are making a decision based on facts.

Good luck making your decision.

It’s NOT that serious here in Hong Kong. The measures that are in place are to control and elimate the disease, not save tons of lives that would otherwise certainly be lost. What’s going on is a mix of practical preventative measures and panic, something HK people seem prone to. Of course, it’s easy for me to be care-free since work and school are cancelled and I can ride it out in my apartment, but yes, I do think it would be pretty hysterical to run off when you’ve only got two months left. Just be vigilant and wear a mask if you have to.

However, the advice I’d give also depends on whether or not you have anything to do wherever you came from. Returning to the US would probably be worse overall for me than the odd chance that I’ll get sick and spend some time in the hospital. I’m not leaving befpre I’m ready unless things get seriously Black Plague bad.

The Mainland government’s secretiveness is a worry. At least here in HK we know what the numbers are, we can see that the problem is concentrated in several specific groups of the population, and we can conclude (if we’ve got half a brain, which not everyone here does) that the risk is insignificant. In the Mainland, OTOH, you haven’t a clue.

Still, there are millions of other teachers in China, most of whom are alive and well. All the evidence suggests that SARS is not easy to catch. You might as well stop fretting and get on with life.

You could call the US embassy in Guangzhou or check the websites below. Shenzhen is a lot less densely populated that Hong Kong is.

1.To American Citizens in the Shanghai Consular
District

This is one of an occasional series of messages from
the U.S. Consulate¡¯s American Citizen Services unit
to American Citizens registered with the U.S.
Consulate in Shanghai.

SARS In Asia

This Public Announcement is being issued to alert
Americans that the CDC has issued a travel advisory,
and health alert notices, which are being distributed
at ports
of entry to people returning from the three affected
regions. CDC advises that people planning elective or
nonessential travel to mainland China and Hong Kong;
Singapore; and Hanoi, Vietnam, may wish to postpone
their trips until further notice. This Public
Announcement expires on June 26, 2003.

The Centers for Disease Control (CDC) and the World
Health Organization (WHO) are tracking SARS’s origin
and method of transmission as well as determining how
its
spread can be contained. In light of the continually
evolving nature of the geographic spread of SARS,
American citizens should regularly consult the CDC
website
http://www.cdc.gov/ and the WHO website
http://www.who.int/ for updates.

American citizens currently in or planning to travel
to SARS-affected areas of Asia should consult the
Department of State’s Fact Sheet on SARS, Public
Announcements, Travel Warnings, and Consular
Information Sheets for China, Hong Kong, Singapore,
and Vietnam, all of which are available at the
Consular Affairs Internet web site at
http://travel.state.gov. American citizens may also
contact the Department of State toll-free at
1-888-407-4747, or if calling from overseas,
317-472-2328, for SARS
information.

2.To American Citizens in the Shanghai Consular
District

This is one of an occasional series of messages from
the U.S. Consulate¡¯s American Citizen Services unit
to American Citizens registered with the U.S.
Consulate in Shanghai.

The U.S. Department of State encourages American
citizens traveling or residing abroad to familiarize
themselves with the information available from the
Centers for Disease Control and Prevention (CDC) and
the World Health Organization (WHO) about Severe Acute
Respiratory Syndrome (SARS). This Fact Sheet updates
the March 21, 2003, version and reflects changes in
the
geographic spread of SARS cases and includes
additional information. In light of the evolving
nature of the SARS situation, American citizens should
regularly consult the CDC website http://www.cdc.gov/
and the WHO website
http://www.who.int/ for updates.

In Hanoi, Vietnam and Hong Kong, the appearance of
SARS has had an impact on medical facilities, due to
the closing and/or quarantine of hospitals and the
spread of the disease to health care workers. Medical
evacuation
of SARS patients currently is not available by
commercial carrier; additionally, the number of
countries willing to accept SARS patients is very
limited.

  1. Prospective parents of adoptees from mainland China
    and Vietnam should consult the appropriate link on
    adoptions at the CDC website,
    http://www.cdc.gov/ncidod/sars/adoption.htm.

  2. In addition to Vietnam, Hong Kong, mainland China
    and Singapore, the CDC has received reports of
    outbreaks of SARS elsewhere in Asia and in Europe and
    North America, including Canada, the United States,
    Thailand, Germany,
    and Switzerland. Most cases appear to involve
    health-care workers caring for SARS patients and close
    family contacts. CDC is working closely with WHO and
    country partners to define the origin of this
    infection, to track patterns of its transmission, and
    to determine effective strategies for its control and
    prevention.
    Local health authorities should be notified of all
    suspected cases of SARS.

  3. The CDC has identified the following three
    criteria, which must ALL be present, by which a
    potential SARS case may be identified, for those with
    the onset of illness after February 1, 2003:

–Fever greater than 380 C (100.40F), AND

–One or more signs or symptoms of respiratory illness
including cough, shortness of breath, difficulty
breathing, hypoxia (low oxygen in the blood), x-ray
findings of pneumonia, or respiratory distress, AND

– One or more of the following within 2-7 days of the
onset of symptoms: Travel to mainland China, Hong
Kong, Singapore, or Vietnam; and/or close contact*,
with a person who has been infected with SARS (*close
contact
means having cared for, lived with, or having had
direct contact with respiratory secretions (such as
coughs and sneezes) and body fluids of a person with
SARS).

The incubation period between exposure to infection
and the development of symptoms appears to range from
2-7 days. For more specific information regarding case
definition updates and empiric treatment clinicians
should consult and monitor the CDC’s and WHO’s web
sites.

  1. Currently, prevention of new cases is based on
    individuals avoiding close contact with SARS-infected
    persons, as described above. Persons matching the case
    description for SARS should be promptly evaluated by
    medical personnel and, if indicated, admitted to a
    hospital. Persons suspected of having SARS should
    limit their interactions outside hospital settings.

Contact Information for the CDC:

Public Inquiries:
English (888) 246-2675
Spanish (888) 246-2857
TTY (866) 874-2646
Mon-Fri 8am-11pm EST
Sat-Sun 10am-8pm EST

=====
American Citizen Services
U. S. Consulate General
Shanghai, China 200031
ADD: 1469 Huai Hai Zhong Lu, Shanghai
Tel: 86-21-64336880
Fax: 86-21-64711148

If I were you, I’d leave… the Chinese government is legendary for denying a problem exists till it reaches disastrous proportions.

Living in Singapore, I’ve also heard stories of how a few of our SARS victims went to China hospitals for treatment, and the hospitals just gave a placebo and still let the person walk out onto the streets after that. You really don’t want to be in a place where this is going on.

I wouldn’t be too concerned, it isn’t a major outbreak, but if it would make you feel better relocation, at least temporarily, wouldn’t be too bad a thing. Maybe an extended vacation.

Hmm… now they’re saying it’s airborne. I’m really not worried about dying from this right now. I’m a pretty healthy 25 year old, even if I’m infected, the disease has a low fatality rate (3.5%, roughly).

But China is really keeping tight raps on this. What happens if this really becomes an epidemic, infecting hundreds of thousands, overwhelming hospitals?

Is there any precedence for a nationwide quarantine? Might America say, “no more flights from Asia until we get this under control”, or could Hong Kong close it’s border checkpoint with China?

<sigh> This is mostly just extra stress I don’t want to have to handle. Now everytime one of my students sneezes, I stare at him for the rest of class, mentally assessing his conditoin. Chinese students virtually never stay home from class (It’s not uncommon for me to go a whole week without a single one of 440 students being absent), and although they’ve been told to stay home if they’re sick, we’re about a week away from midterms, so that advice is mostly ignored. Oh well…

I know a doctor here in HK who is bailing out of town: she says she is in the front line, and thinks things will get worse before they get better.

As for me, I’m already sick of wearing a face mask. My wife and daughter are overseas right now, and I’m not having them come home here until things settle down.

The recent outbreak in Amoy Mansions is a cause for concern - one of my colleagues lives there, and was quarantined from work today.

Another colleague is heading back to her home in Vermont for an extended holiday.

Despite all this, Space Vampire makes an accurate point that people here are a little panicked. Its a bit scary seeing so many people wearing face masks.

(Having now realised how many people here are in HK, is it currently not a good idea to arrange a lunch? I promise not to sneeze on your food.)

http://boards.straightdope.com/sdmb/showthread.php?s=&threadid=169482

Ah, many thanks for that. I will contribute further there.

A New Zealand friend of mine noted that the NZPM referred to the disease as being the next Spanish flu - immediately causing alarm amongst Kiwis in HK.

I’m moving to China in August and have natural concerns about this as well. I’m going to be living in Tianjin, which is quite near Bejing.

To me, this is just one of those things I’m going to have to accept. Yes, there is a small chance that I could catch a disease, but IMHO, I’m more likely to catch something else that is more common in China than I am SARS.

Anyway, I’m concerned too. I may be buying a surgical mask when I get there anyway, since pollution is quite intense. Don’t know if it will help, but worth a shot.

Captain Tripps

You could of course travel somewhere further into China rather than into Hong Kong to fly out. Train it to Kunming, then fly to Bangkok from there, for example.

Looks like an American Airlines flight was quarantined in San Jose, Calif. today:

The flight originated in Tokyo.

No!

Stay where you are!

I don’t want you bringing any nasty SRS germs to where I might come in contact with them!

Yeesh!

(Just thought I’d provide the selfish, NIMBY, paranoid perspective … )

Based on [url=http://news.bbc.co.uk/2/hi/health/2908435.stm]this**, I’d say put a mask on, and make plans to leave. Just my opinion.

Damn. Link.

Apparently the World Health Organisation have now advised people not to travel to Hong Kong.

Too bad if you are already here…

Who? Certainly not the WHO.