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Hong Kong braced for inquiry
An inquiry into what went wrong with SARS follows another that cost some scientific jobs | By Katherine Schlatter

HONG KONG—For infectious diseases researchers in Hong Kong, the SARS outbreaks of recent times have meant record numbers of publications and significant funding boosts. But for many, those windfalls have been overshadowed by high-profile resignations linked to a legislative inquiry that sought to apportion blame for the disasters.

Another inquiry started last week and given the repercussions of the earlier investigations, scientists would have good reason for concern. This time, a judicial panel is investigating whether any severe acute respiratory syndrome (SARS) deaths were related to hospital mismanagement, mistreatment, or other inappropriate actions.

"There's no doubt SARS is an emotionally charged issue for Hong Kong," said Joseph Sung, a clinician at the Prince of Wales Hospital and chair of the Chinese University of Hong Kong's Department of Medicine.

There's a lingering sense of public outrage over SARS, Sung told The Scientist. His department and research came under daily scrutiny by the press and later by the legislative panel that dissected decisions about patient treatment and hospital infection control.

Sung worked closely with the virologist John Tam who, early in the SARS outbreak, wrongly identified the virus as a paramyxovirus. Tam and Sung—along with others—made the decision to give SARS patients ribavirin and steroids.

But Tam has since resigned. He quit just before the legislative inquiry released its final evaluation in July. He now works for drug firm Wyeth, but the timing of his departure raised eyebrows.

At the same university, Sydney Chung also resigned abruptly from his post as dean of medicine, in February this year. During the SARS outbreak, Chung had expressed dismay at the high number of his medical students and staff who caught SARS.

During the legislature's inquiry, Chung said health officials didn't take hospital infection control seriously enough. He's now working in as a professor of surgery at the University of Papua, New Guinea. Neither Chung nor Tam was available for comment.

Also as a result of the legislative inquiry, a number of health officials originally held up as heroes have been pushed out in recent months. Yeoh Eng-Kiong, former health minister, and Leong Che-hung, former hospital chief, resigned within 24 hours of the report's release.

The former Health Director of Hong Kong, Margaret Chan, resigned to take a job with the World Health Organization, only weeks after the new disease stopped spreading—but long before the inquiry started.

"The public wanted some accountability," said Lo Wing Lok, a former legislator representing Hong Kong's medical sector.

Lo, like many of his colleagues in medicine, was not surprised that Yeoh and Leong were given the all-clear during health department internal audits, only to be seized upon by local legislators as incompetent. He's saddened by the resignations but does not believe any individual was to blame for the SARS crisis. He does, however, think that better sharing of research could have helped.

"What's happening now is healthy," Lo said. He also believes there is better dialogue now between the city's public health specialists and the hospitals.

But Lo concedes the city's newly formed Center for Health Protection is not exactly made up of fresh faces. The center, which was formed in June, will take over the task of health crisis management. It will also train epidemiologists, handle the government diagnostic lab, and direct risk communication.

The center's scientific committees are staffed by many of the same people who handled SARS. Lo, who himself sits on one the center's scientific committee, admits Hong Kong has too small a pool of expertise, a lament echoed by many academics here.

Hong Kong University's Malik Peiris says hiring new blood is tricky in Hong Kong. "It's easy to find excellent people here… but matching them [with what you need] is not." Looking to the future, Peiris says mainland China will be a great source of skilled people, but adds that ideally the right candidates will have spent some time in the Untied States.

Hong Kong, a former British colony of seven million people, reverted to Chinese sovereignty in 1997. However, the territory still maintains a separate government and legal and public healthcare systems. Visitors from mainland China must qualify for a temporary visa to cross the border to Hong Kong, and skilled workers often have a tougher time securing work permits than many of their counterparts from the United States, Europe, and Australia.

Hong Kong's biggest weakness is that it hasn't invested enough in the sciences in the past, Peiris said. "Although we've shown we can deliver, we've hardly been given the chance [to excel]."
Links for this article
R. Walgate, "Hunt for SARS agent intensifies," The Scientist, March 18, 2003.
http://www.biomedcentral.com/news/20030318/05/

D. Ng, "Hospital officials urged to stay on," The Standard, August 28, 2004.
http://www.thestandard.com.hk/news_deta ... rticleid=5 0388&intcatid=42

R. Walgate, "Guangdong doctor linked to SARS outbreak," The Scientist, March 20, 2003.
http://www.biomedcentral.com/news/20030320/09/

K. Schlatter, "Hong Kong CHP officially open," The Scientist, October 27, 2004.
http://www.biomedcentral.com/news/20041027/02


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