SARS in a wilderness of mirrors
May 2003
It used to be thought that in China, the only way of confirming if a story was true was if the state-owned press had already emphatically and categorically denied it. The belief persists.
THERE IS an old Chinese folk tale in which a fool deposits 300 pieces of silver in a hole. In order to conceal his largesse, he puts up a sign nearby to announce that "300 pieces of silver do not lie here." The moral of the tale was that the more you try to cover something up, the more obvious it is that something is being concealed.
The Chinese government, fiercely vigilant when it comes to any manifestation of press freedom, are learning this lesson the hard way with regard to the mystery viral condition known as SARS, or Severe Acute Respiratory Syndrome. It used to be thought that in China, the only way of confirming if a story was true was if the state-owned press had already emphatically and categorically denied it. The belief persists.
When there is a sort of institutional wall of silence on every possible issue, information of some description still squeezes itself out somehow. The thirst for news must be slaked, even when there is no news. During the brouhaha of the APEC conference, held in Shanghai in Autumn 2001, the city pricked up its ears amid rumours about unexploded bombs in airports and a terrorist assault on a hotel on the city's main thoroughfare, Nanjing Road.
Similarly, one could hear whispers in local bars following the outrage of 9-11, with stories concerning Shanghai-based Muslim terrorists being rounded up by the authorities, and several of them going underground or fleeing to the remote West, where, according to another rumour, a fierce military campaign against insurrectionaries was being conducted by a joint Chinese-Kazakh army.
Which of these stories was true? None of them were mentioned in the People's Daily, the organ of the Communist Party, and even if they were, most readers would have remained suspicious. In the West, where the press is considered to be relatively free, such a "wilderness of mirrors" approach to the honesty of the media is quite commonplace in conspiracy theory circles. In China, with the press compelled to "follow Xinhua", the state-run news agency, scepticism is obligatory.
The internet has offered a valuable outlet for a nation starved of debate. But with the internet, any cock-eyed rumour one cares to invent very quickly rolls out of control. Indeed, one of the main scares about SARS in Hong Kong was caused by a fourteen-year old boy who faked a story saying that the region had been declared an "infected city", prompting a wave of panic buying throughout the former colony and a volley of denials from the authorities.
No one, of course, trusts the local Chinese media. Not even the local Chinese media. Couple that with an insidious network of chat roomers and e-mailers, most of whom have heard talk of SARS victims being dragged away in the dead of night to secret military hospitals, or of snifflers being dragged off aeroplanes just before take-off, and at the very least you have an atmosphere of panic. And by the beginning of April, there was a crisis of confidence. Conferences were being cancelled from Beijing to Jakarta, and before long, everyone would surely be wearing tin-foil hats and gas masks and joining the queue for rations. Most of us were running through the list of symptoms, checking our temperatures and pulses and wondering whether the malaise, myalgia and dry coughing that had been an inevitable part of everyday life over the past several years could still be attributed merely to the drinking, smoking and late-night parties.
The lonely fight for facts, it seemed, would be left to the foreign press stationed here in China. Meanwhile, the authorities finally decided to make their move.
“A RESPONSIBLE GOVERNMENT”
At the beginning of April, the municipal government in Shanghai finally acknowledged that the virus had hit the city. Most of the foreign journalists stationed in Shanghai had arrived at a small conference room in the International Hotel. The place hissed with gossip, and there was a pervasive sense that something momentous was about to be disclosed, that somehow, the big SARS balloon that had been blowing up for weeks was about to burst.
Although the Health Bureau official announced that there was only one SARS case in Shanghai, the assumption was, naturally enough, that he was lying. At best, a turning point had been reached. This seemed to be a compromise, face-saving revelation that would allow more frankness further down the line. After all, the government had responded with blanket denials up to then, and to shift suddenly from total disavowal to the announcement of a dozen deaths would have been too great a volte face. As I write, the official figure in Shanghai has risen, but only to two - the victim's father had also succumbed to the illness - and there were also a number of suspected cases.
The reporters at that first press conference were, of course, spitting feathers. "The Shanghai government are a responsible government," the spokesman said, to a chorus of groans..
The natural assumption was, and remains, that behind all the reassuring smiles, the city's hospitals actually resembled scenes from Night of the Living Dead. The government had denied the issue for so long that it came as no surprise that no one believed them when they began to make noises.
And so, sensitive observers were suddenly noticing the ambulances nipping through the traffic, presumably rushing to deal with the latest sighting of SARS. Late at night, cleaners were seen to emerge, spraying the streets with gallons of Dettol. Minor coughs and colds, common at this time of year, were thought to be the beginning of a viral cataclysm.
It seemed at one point as if the scourge of SARS was about to bring (a) economic growth, and (b) civilization to an end. It was probably unfair to conclude that, finally, after years covering Communist Party puppet shows and international business junkets, the hacks at last had something to get really indignant about: after all, the panic was palpable, and the statistics ?particularly from Hong Kong ?were thoroughly disturbing. And it was undeniable that the Chinese government, despite 20 years of economic reform, remain culturally disinclined towards the sort of openness and transparency that might have curtailed the spread.
FULL DISCLOSURE
Last weekend, following the revelation that there were as many as 339 diagnosed cases in the capital, almost ten times the previously acknowledged figure, a couple of scapegoats were identified, with the mayor of Beijing and the head of the Ministry of Health both dismissed. The government are now promising full disclosure, but the e-mails continue to flow, the rumours keep on rumbling. Who the hell believes them now?
And so, the panic grows. Staff at the US consulate here in Shanghai were heard on Friday April 11 to be suffering from SARS-related symptoms, and Reuters breathlessly issued a report. "The US consulate in Shanghai said in an email seem by Reuters that two Americans were among nine being treated at the Shanghai Pulmonary Disease Hospital with symptoms of SARS." That night, an ominous air seemed to pervade the clubs and bars scattered throughout Shanghai.
But it turned out to be untrue. The victims were released from hospital shortly after having been shown to be suffering from nothing more than severe colds.
Meanwhile, the Australian government have now put SARS in the same category as the Plague, Cholera and Yellow Fever. This follows comments by the New Zealand prime minister, Helen Clark, warning that the problem could be even worse than the 1918 flu epidemic.
Many of the news agencies based in China have imposed emergency measures. Among the foreign community, rumours spread very quickly, and an otherwise luxurious existence has been laced with danger.
Even sceptics are hedging their bets, citing the belated reaction of the Chinese government as well as the traditional sources at the World Health Organization. Public occasions are marked with a curious sense of esprit de corps in a climate of pre-storm calm, almost as if we are amazed that we have found the courage to leave our homes. The vocabulary of foreign residents is now larded with the jargon of virology, and their tales - hushed and weary - resonate with all the old fears. We listen to third-hand hearsay about the woman in the flat below or some friend of a friend currently manning the hospital barricades.
It is better to be safe than sorry, say some. Hong Kong - which has already seen its confidence battered in recent years - has been shaken to its boots by the SARS crisis. Receipts at Hong Kong's restaurants are reportedly down 50-80%, and its cinemas are empty. Housing sales are down 65%. There are 70% fewer tourists. One estimate suggests monthly economic losses of HK$ 8 billion.
“WE’RE ALL GOING TO DIE”
Analysing the current figures is a difficult business, not least because they are rising every day. It is worth noting, however, that even if the accumulated total number of cases in Beijing reaches 1,000 in the coming days or weeks, it still represents only 0.0075% of the total population, and that of all the cases, there seems to be a survival rate of well over 90%. The rate is much more worrying in Hong Kong, with an infection rate of about 0.02% and a fatality rate currently at 6.7%.
But is the figure worrying enough to justify the recent claim made by the the popular local e-newsletter and website, Chinabiz, unerring advocates of the "we're all going to die" school of journalism? Citing the Hong Kong Standard, the newsletter claimed that preventative measures had come too late, and that the virus was now "threatening virtually all the country's 1.3 billion people".
There are other things happening throughout China, of course, none of which are covered by the domestic media. There are mass lay-offs at state-owned companies leading to strikes and police crackdowns. There is the endemic corruption and gangsterism throughout the provincial-level cities. There is the ongoing scandal of the Falungong, a tawdry, superstitious little cult that was transfigured by the excesses of the State into a pious order of martyrs, to which, Western pilgrims regularly pay homage on Tiananmen Square before being unceremoniously expelled.
The spread of HIV/AIDS in China has also become a subject of concern, with the official number of sufferers currently standing at 850,000 and thought to underestimate the real total. According to the darkest predictions cited by Kofi Annan in his visit to China last year, that figure threatens to multiply to as many as 10 million by 2010. Meanwhile, a recent report revealed that tuberculosis still kills 2 million people worldwide every year, 98% in developing countries, and that a third of the world's population is infected with the TB bacillus.
There is something about infectious diseases that brings out the worst in us. On April 20, the International Herald and Tribune, reporting from Hong Kong, told of yet another side effect of SARS. Victims, the report said, were being ostracised. In accordance with government regulations, buildings in which infections have taken place are marked clearly with a sign. Hong Kong officials were initially reluctant to impose harsh restrictions in the fear that victims would be "driven underground".
Amid the mayhem, I look for rational voices. I am consoled by the words of Christine McNab, a spokesman for the WHO speaking to The Guardian, who said that most of the cases were in a hospital setting. "The rest seem to be people in very close contact with affected people. That narrows the risk to the general population. The pattern of how this is moving does not indicate at this point that there is a widespread risk to the general population."
I listen carefully to the words of John Oxford, professor of virology at the Queen Mary School of Medicine in London, who said that more attention should be paid to the potentially greater threat posed by new strains of influenza. "SARS does not look like it is explosively infectious," he said, "Most of the cases seem to have come out of hospitals, among doctors and nurses, all of whom have been in very close contact with ill people. It is causing problems in certain environments, but it's not zipping around the globe."
And yet, by now the panic is more infectious than the virus itself, and even the sturdiest of observers are struck regularly by the thought that infection is just a stray droplet or contaminated elevator button away. As is the case in most health scares, the very act of paying attention - of isolating, analysing and comparing statistics - creates a potent symbolic space, one which draws on all our fears about mutating bacteria, outfought immune systems, and mass pandemics, and leaves very little room for a sense of proportion.
