Kevin Sinclair's Hong Kong
A veteran SCMP reporter, Kevin examines the good, bad and ugly sides of life in the city. E-mail him at firstname.lastname@example.org
As the immediate threat of Sars faded from our communal memory, headlines were full of the threat of bird flu. Today, there is little in the press about the danger of the pandemic that could wipe out tens of millions of people. Yet the threat remains unchanged.
How come this potential killer disease seems to have faded from the headlines and disappeared from the public consciousness?
In 2004 the University of Hong Kong's head of Community Medicine, Professor Anthony Hedley, warned in a paper to Legco about the dangers of having humans and potentially infected birds together in wet markets.
This could create a killer stew of infection if bird flu jumps from animals to humans, as has happened in Vietnam, China and Indonesia. There's no reason it could not happen here.
Just last week, the American Academy of Paediatrics and the Trust for America's Health issued a joint report warning that US authorities need to improve plans for child protection if super-flu closes schools. Young people are prime causes of concern because they are more likely to pick up and touch birds that have died of the deadly H5N1 virus.
The University of Hong Kong report said the government had accepted the principle of separation of live poultry and people. The key is a central slaughterhouse for poultry so chickens are dead when delivered to markets. But the timetable to which the government is working will not see this system introduced until 2009 at the earliest.
In the meantime, we are at risk.
Dr Hedley points out that a nine-month-old child has already been infected with the H9N2 strain of bird flu because the baby was taken to a market by his grandmother and breathed in chicken faeces in the atmosphere.
Such ignorant irresponsibility is widespread, as anyone who shops in a wet market can see.
'The government will argue that the risk is low but they are adept at discounting risk in all sectors of public health to appease vested interests,' Dr Hedley adds. He gives examples as laxness in taking effective moves against tobacco companies because of pressure from bars and restaurateurs and on a lack of action against air pollution because of business and transport.
The respected expert in community health says bird flu is a very real threat. But the next flu pandemic will almost certainly be a human influenza.
'We are long overdue for a highly pathogenic virus,' he warns bleakly.
Although the public may not have been reading about bird flu, the Food and Health Bureau and Hospital Authority say they are constantly concerned about it.
The bureau remains on an alert response level for human and bird outbreaks outside Hong Kong.
They have stepped up import controls and regulations on keeping poultry in Hong Kong.
Doctors and scientists are running regular exercises; the latest was 'Operation Chestnut' on September 21. This showed a stockpile of 20 million doses of antiviral on hand to deal with any emergency. The government is also working on closer collaboration with mainland and international health authorities.
The FHB belatedly in February last year (after backing down to rural interests) banned backyard poultry. This is vital. We are now in the middle of the massive autumn migration when millions of birds fly over and stop in Hong Kong. A pair of ducks in a farmhouse backyard is an almost irresistible invitation to make a call; migrating birds are known carriers of the virus.
Shane Solomon, Hospital Authority chief executive, stresses there is no question of relaxing precautions. The authority's manager for corporate communication, Elinda Luk, says patients admitted to hospital with possible bird flu symptoms are questioned closely about where they have been and with whom they have mixed. If they have recently been in a known danger spot, tests become automatically more intensive.
In the past year, the Hospital Authority has run 40 hospital checks to test contingency plans and two city-wide drills involving many departments.
If the long-expected disaster should hit, there are 1,400 isolation beds ready in public hospitals.
From next month, the peak of seasonal flu outbreaks, the authority will start vaccinating those most likely to be vulnerable.
So despite my fears that we are overlooking bird flu, the government seems prepared as it can be for an outbreak. When the first human case appears in southern China I can assure you that bird flu will be back in the headlines. And in very large print.