Schools shut to halt the spread of flu

Government's emergency response after the deaths of three children is a grim reminder of the dark days of Sars

Faces in masks; recommendations about bleached water cleanser; TV footage of people being rushed to hospital; newspaper headlines screaming about child deaths - for a brief period last week, it seemed the clock had been wound back five years to when Hong Kong was in the grip of Sars.

Last Wednesday night the government went into full emergency mode and closed all primary schools, kindergartens, care centres and special schools, a reversal of its position earlier in the day, and again reminiscent of the government's reaction in March 2003.

University of Hong Kong's professor of microbiology Yuen Kwok-yung, an iconic figure during Sars, stood in front of the cameras again, telling the public: 'We have to be careful, but not panic.'

A day later, when it was clear that this wasn't a case of Sars II, or indeed anything out of the ordinary in flu season, the recriminations began.Were the school closures and emergency measures a justified response or an overreaction?

And for the government, was it a case of damned if they did and damned if they did not?

The latest flu crisis had its origins on March 1, when three-year-old Ho Po-yi, feverish and coughing, was brought to Tuen Mun Hospital's emergency room.

After a consultation, doctors believed she should be all right and discharged her. Hours later, after taking afternoon tea, the girl became very sleepy before losing consciousness.

Less than 24 hours after developing flu-like symptoms, Po-yi was dead.

More were to follow. Last Tuesday, seven-year-old Law Ho-ming was taken off life-support at Tuen Mun Hospital. He had been admitted semiconscious with a respiratory disease a few days earlier, two days after being discharged from the hospital's emergency room. Around the same time, Prince of Wales Hospital revealed that a 27-month-old boy, Or Ho-yeung, had died hours after being admitted with fever and vomiting on February 26.

The deaths of the three children sparked a chain of events that led to the decision to close schools until March 28 to prevent the spread of flu.

An expert team investigating the three deaths, headed by Professor Yuen, has said that while the two children who died at Tuen Mun Hospital had the flu, other health problems may have contributed.

Last Friday, the Centre for Health Protection said test results from Po-yi and Ho-ming confirmed no new flu virus was involved in their deaths.

Not since Sars have schools closed in response to an outbreak.

Hong Kong is at the height of the flu season but for days last week, Thomas Tsang Ho-fai, controller at the Centre for Health Protection, insisted this year's flu was no more severe than last year's or that in 2006. Yet a series of contingency measures was put in place; steps that were not even contemplated in 2006 and 2007.

The measures, announced on March 6 following the death of Po-yi, included shortened visiting hours in public hospitals, daily announcements of outbreaks and a public-education campaign.

The Secretary for Food and Health, York Chow Yat-ngok, appealed for calm, saying he was aware the public would like correct information on infectious disease outbreaks.

'The announcement [to close schools] was made by the health chief, not by the Education Bureau. It is weird,' said Ida Wong Wan-chu, principal of SKH Ho Chak Wan Primary School.

James Sung Lap-kung, academic co-ordinator at City University of Hong Kong, said the school closure was an example of poor co-ordination between government departments.

'Because of Hong Kong's past experiences with outbreaks of Sars and H5N1 [bird flu], we could certainly understand the heightened sensitivity to any kind of outbreaks and flu-type events,' said World Health Organisation spokesman Gregory Hartl, adding that the school closures were to be welcomed.

The expert panel will take a few more weeks to complete its report on the deaths of the three children.

While the exact causes of death will be up to the coroner's court to decide, the expert panel is expected to shed some light and set out measures on how such deaths can be reduced in future.