'Have you seen the Hollywood movie Outbreak?' Renowned surgeon Sydney Chung Sheung-chee threw the question at me and paused. He was breathing heavily behind a white face mask, peering through his steamed-up glasses with tearful eyes. It was the first time I had seen him weep. The tough man in front of me, the Dean of Medicine at Chinese University, was overcome with emotion and the stress of recent weeks. His voice trembled as he told how the atypical pneumonia outbreak, which has infected 286 people in Hong Kong - including 115 medical staff - and spread across the world, had devastated him and his colleagues. 'It is a holocaust. It is a war with an unknown enemy. My hands have shaken for two nights. It is the worst medical disaster I have ever seen,' he said. The conversation took place last Saturday afternoon. The Prince of Wales Hospital in Sha Tin, where the outbreak started early this month, was so quiet it felt eerie. There was a sense of unease. Most administrative staff have been evacuated. Everyone wears a white face mask, prompting those that are left to label the outbreak 'white terror'. Taking medical advice, I put on a mask as a precaution before entering the hospital. My colleague, a South China Morning Post photographer, did not have one. 'Where is your mask?' Professor Chung asked bluntly, like a headmaster admonishing a disobedient student. He took a mask out from a paper box and handed it to him. The message was clear. A face mask is something one cannot do without at the hospital. It is as important as an oxygen cylinder is to a deep-sea diver. Professor Chung's blunt tone can easily be forgiven. You only have to think about how the disease has picked off his staff one by one, and brought chaos to the hospital. The virus, transmitted through droplets, has spread like wildfire, starting in the hospital's wards 8A and 8B. So far, about 70 medical staff at the hospital have succumbed. Several are now at the intensive care unit (ICU), with some on ventilators to help them breathe. Professor Chung recalled how Hollywood star Dustin Hoffman, played an infectious disease expert in the film Outbreak, fighting the Ebola virus, which had originated in a monkey. In the film, US authorities failed to control the epidemic and at one point planned to bomb the small town where patients had been segregated. For days, flashbacks to the film have occupied Professor Chung's mind. 'I feel terrible seeing my colleagues struck down one after another,' he said. 'I have visited a medical officer [receiving treatment] in the intensive care unit. In the first two or three days, the doctor could not breathe at all. We gave him oxygen, but still he could not breathe, his lung function was totally damaged. 'We put him on ventilator. At one stage we thought we were losing him. Then he recovered and just few days ago, he was able to wave to me. I was thrilled.' Professor Chung is known not only for his medical achievements but also for his outspoken style. When Secretary for Health, Welfare and Food Yeoh Eng-kiong said last week that the disease had not spread to society at large, Professor Chung was quick to contradict him, telling reporters more than 10 patients had been infected in the community. 'Yes, I have a different opinion. It is a fine line between causing panic and taking enough precautions. In a situation like this, I put myself on the safe side,' Professor Chung said. Educated at Hong Kong's Wah Yan College, he received medical training in Ireland and topped his class when he graduated from the Royal College of Surgeons in 1980. After receiving surgical training in Hong Kong, he worked at Kwong Wah Hospital and then joined the Department of Surgery at the Chinese University of Hong Kong. Professor Chung has experienced crises before. He was involved in treating victims of the Pat Sin Leng tragedy in 1996, when two teachers and three students died in a hill fire. But that was nothing compared to the pneumonia outbreak, he said. As one of the doctors treating the pneumonia patients daily, Professor Chung has avoided close contact with his Norweigan wife, a doctor in hospice care, and his two daughters. With so many medical staff succumbing to the disease, the hospital has introduced a number of contingency measures. For the first time, it shut down its accident and emergency ward and cancelled all elective operations. The virus responsible for the chaos still remains largely a mystery, even to top microbiologists. It has been given the name Severe Acute Respiratory Syndrome. One of the problems, say doctors, is that it is very difficult to diagnose in the early stages, when the symptoms are similar to common flu, such as a running nose and high fever. But the condition of patients then deteriorates sharply and by the time the serious nature of their illness is evident, their lungs have already been severely infected. Between 10 and 20 per cent of victims so far have suffered respiratory failure and have only been able to breathe with the help of ventilators. To avoid cross infection, the Prince of Wales Hospital has designated a special team of medical staff to take care of infected colleagues and patients. They call it the 'Dirty Team'. Professor Chung, a member of this team, said what worried him most was the potential spread of the virus to the community at large. The team has worked day and night to trace the source of infection. A nurse earlier identified a 26-year-old man as the source among medical staff. The man, who had stayed on Ward 8A, was used as a case for clinical examination. Medical students from Chinese University had contact with him and at least 17 of them fell victims to the disease. Health officials later confirmed that the man, who has recovered, was among the six people infected by a Guangzhou medical professor. The Department of Health said the professor, and six other people who had contracted atypical pneumonia, had stayed in or visited the Metropole Hotel in Waterloo Road, Mongkok, between February 12 and March 2. The 26-year-old man visited his friend who was staying in the hotel from February 15 to 23. Health officials have confirmed that the Guangzhou professor was the index patient of the Hong Kong outbreak. His brother-in-law died after contracting the disease. Professor Chung said that after the hospital's index case was found, doctors and nurses who had attended to that 26-year-old man fell sick one after another. 'We put down the names of these medical staff on a board. Then we estimated the incubation period and knew in advance exactly who would be sick and when. It was like a call from the devil.' He said his colleagues had been under enormous pressure. Apart from risking their own lives in taking care of the patients carrying the highly infectious virus, medical staff also had to worry about taking the virus home. So far, eight children of infected medical staff have contracted the disease. Twins girls, aged 15, were last week in serious condition. Some medical staff have avoided contact with their families and have not left their hospital for many days and nights. Professor Chung said it was not only a challenge, but a time for doctors and nurses to show their professionalism. While they might be frightened, doctors believed that had to abide by the Hippocratic Oath, and not desert their patients, he said. A medical team from the surgical department has volunteered to work at ward 8A and 8B, where the outbreak started. And as the number of victims keeps rising, the hospital's intensive care unit has been forced to send patients to other hospitals. The hospital is ready to open an extra, temporary, seven-bed intensive care unit in case the situation worsens. Nurses from the endoscopic surgery team have volunteered to work for the new ICU. Some nurses burst into tears after making the decision. 'It is not tears borne out of fear, it is a result of mixed emotion, something very difficult to describe,' Professor Chung said. 'There are staff who have applied for sick leave during this difficult time. We cannot blame them. They have families to worry about. As a dean, I feel I have to ask them to work in a place of danger. I cannot tell them it will be 100 per cent safe.' Support from the public for medical staff fighting against the virus is overwhelming. A fund-raising campaign organised by Albert Cheng King-hon, host of Commercial Radio's talk show Teacup in a Storm, received more than $3 million in donations from 15,000 people for the purchase of facial masks for medical staff. Mr Cheng launched the campaign after medical workers complained there was a shortage of masks at hospitals. Flowers and cards, some sent by primary school students, have flooded in to the hospitals and fill the corridors. 'We feel the public is behind us, it is an appreciation of the sacrifice that the medical staff are making,' Professor Chung said before leaving to Ward 8A for another daily round.
