Did only Hong Kong learn lessons from Sars?

Hong Kong is fortunate to have contained swine flu more than a month after the outbreak in Mexico and the US. So far, all cases identified in Hong Kong - and on the mainland - were imported from North America, with no community outbreak.

With memories of severe acute respiratory syndrome still fresh, Hong Kong acted decisively after identifying the first case of swine flu on May 1. The patient, a 25-year-old tourist from Mexico, was kept in isolation in hospital for a week. And 286 guests and workers in the Metropark Hotel, where the man had stayed, were also quarantined.

On May 13, Hong Kong identified its second case, this time, a local man who had returned from San Francisco. By this time, the first case on the mainland had also been identified, a student who returned from St Louis. The disease was being spread by travellers from North America.

Secretary for Food and Health York Chow Yat-ngok wrote to his US counterpart, Kathleen Sebelius, the secretary for health and human services, asking Washington to screen outgoing air passengers to avoid exporting swine flu cases.

He pressed his case again when he saw the American official in Geneva at the World Health Assembly meeting and told her what Hong Kong had done in managing departing travellers during the Sars outbreak in 2003, including requiring a health declaration and thermal screening.

Apparently, he was unsuccessful. The US side said it had adopted measures such as a public education campaign and advising people not to travel if they were sick.

The international attitude towards the current swine flu epidemic is starkly different from when Hong Kong and southern China were hit by Sars. At the time, many voices were raised, calling for the isolation of Hong Kong and the mainland, as well as the exit screening of departing passengers not only from Hong Kong and the mainland but also from Toronto, Vietnam and Singapore.

Hong Kong traders were barred from participating in a jewellery and watch fair in Switzerland, and Malaysia imposed entry restrictions on Hong Kong residents.

The World Health Organisation's position on swine flu seems to be that the horse has already bolted and there is little point now in locking the stable door. So why didn't the WHO act earlier? Even now, the only reported cases in Asia - with the very notable exception of Japan - are imported ones.

Certainly, where Hong Kong, the mainland and Taiwan are concerned, all cases identified as of last weekend arose from travellers from North America, except for a mother and daughter in Taiwan who apparently got the virus in the Philippines.

But this time around, there are no demands for restricting travellers from North America. Guan Yi, a professor of virology at the University of Hong Kong, has been quoted as saying that there was a chance for containing the swine flu virus in its early phase, but that the WHO did not take action, possibly for political reasons.

The danger for the countries of Asia is not only the current strain of swine flu, which has taken relatively few lives outside of Mexico, but the possibility that the virus may mutate when it comes into contact with the much more deadly avian flu virus. Besides, Asian countries are not as well prepared as the US to cope with any outbreak.

So far, it appears, only Hong Kong has raised its voice calling for exit screening from the US. After Dr Chow's letter to his US counterpart, the Foreign Ministry was asked if it, too, had made such a request. The Chinese spokesman sidestepped the question, saying only that the mainland hopes 'to contain the spread of the disease through international co-operation'.

We can only hope that swine flu does not become a global pandemic. In any event, Hong Kong has done its best to prevent the spread of the virus.

Frank Ching is a Hong Kong-based writer and commentator. frank.ching@scmp.com