Comment »Posted on Thursday 23 July 2009 at 11:19 am by Sam Wong
In Health & Medicine

Hong Kong was badly shaken by the outbreak of Severe Acute Respiratory Syndrome (Sars) in 2003. 1,755 people were infected in the city, and 299 died.

The effect that Sars had on public attitudes to hygiene was profound. The restaurant business took months to recover as customers opted to stay at home. When they did return they found that restaurants had begun providing designated serving chopsticks, often a different colour to the others, so that people did not contaminate communal dishes with chopsticks that had been in their mouths.

It became common to see signs in lifts proclaiming that they were disinfected every hour. To be on the safe side, many citizens started pressing buttons with their keys.

Thermal imaging was introduced for monitoring incoming passengers at the international airport, one of the world’s busiest. It’s not uncommon to see people wearing surgical masks, even when the world isn’t gripped by a pandemic.

It is this heightened awareness of basic hygiene in the city that doctors are crediting with the remarkable finding that swine flu is spreading in Hong Kong at half the global rate. The secondary attack rate, a measure of the frequency of new cases of a disease among the contacts of known cases, is estimated at around 29 per cent globally (compared with 5-15 per cent for seasonal flu). According to a study by the University of Hong Kong, the secondary attack rate there is just 14 per cent. This despite the fact that Hong Kong is one of the most densely populated cities in the world.

Hong Kong’s example shows the importance of providing good information on simple measures that can be taken to curb the spread of swine flu. Of course we don’t want to panic anyone unduly. But warning the public of the dangers and informing people about how to minimise their risk of catching flu can make a real difference. Articles like Simon Jenkins’s in the Guardian yesterday are particularly unhelpful. A study published in the BMJ found that believing the outbreak had been exaggerated was associated with a lower likelihood of making the recommended changes in behaviour. Interestingly, people from ethnic minority groups were much more likely to follow advice about how to avoid swine flu.

“Many people might indeed die of flu,” Jenkins writes, “but they might also die of a nuclear attack, an asteroid strike or a dozen other diseases and accidents now receiving lower priority.” Yes, what a scandal it is that resources are being diverted from the NHS Asteroid Strike Service to fight a highly infectious and potentially lethal disease. True, the vast majority of swine flu cases will get better in a few days. But for a virus so infectious, the mortality rate doesn’t have to be high to mean many deaths and an overwhelmed health service. Unqualified columnists should refrain from disputing professional medical advice: misinformation about health can kill.


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