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.
f
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.
(China.org.cn April 21, 2003)