SARS and the City: Hong Kong Report

SARS and the City: Hong Kong ReportAuthor(s): Julie RoseSource: Log, No. 1 (Fall 2003), pp. 123-140Published by: Anyone CorporationStable URL: http://www.jstor.org/stable/41764959 .

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Julie Rose SARS and the

City:

Hong Kong Report

Now that the last of the SARS patients are climbing out of their pajamas and going home and the SARS toll is counted, perhaps miscounted, it is difficult to recapture the exact pitch the panic pandemic achieved. In the end "officially" only 296 people died, and only 1,755 residents were infected, a fraction of this megalopolis of almost seven million people. Hong Kong is surrendering to that "here today, gone tomorrow" breeziness that blows away natural disasters and calamities, but a trace of spookiness lingers, a reminder that for four months, SARSville was a truly eerie place to be.

One of the two scariest things about the eruption of SARS here was the lack of a proper working definition of the disease. It was new, unknown, and, apparently, lethal. When it first registered on the collective radar it was described, un-

helpfully, as "atypical pneumonia," but there appeared to be

nothing typical to be ¿-typical about. Nor was there anything especially pneumonic about it - as far as you could tell without a chest radiograph picture or high-resolution CT of "infiltrates" and lesions on the lungs. The first reported symptoms included dizziness, shortness of breath, muscular aches and pains, malaise - all of which are typical of a day in the life of Hong Kong, where malaise among the over- crowded millions is a little like angst to 19th-century neuras- thenics, and shortness of breath is an ever-present condition due, unmysteriously, to routinely high levels of air pollution.

But it was soon asserted that "atypical pneumonia" might not present as any of the above, may or may not include fever, cough, diarrhea, headache, or skin rash - in short, may or

may not simply mimic good old-fashioned cold and flu -

though it most likely would, for a couple of days, at least. The word was that some patients might not have all features, and others might present unusually. Quite quickly, doctors were assuming that patients presenting with any respiratory infection at all had to be regarded as potential SARS cases -

guilty until proven otherwise. This was one of the reasons terror took hold so swiftly in the face of any rational assessment of the risks: rational assessment wasn't an option. There was no sure way of knowing if that sniffle you typically came down with at the change of season, and especially this year m



1. South China Morning Post supplement, "The Fighting Begins," March 21, 200?. 2. The germ war even had its own Powell spokesperson (a guy from WHO), who'd occasionally pop up on the nightly tele- vised news before the other one. In Hong Kong the war hierarchy was reversed: SARS came first.

with its unusually unstable weather, was SARS or not; no way of knowing if the dizziness you felt climbing mountains in a

pall of bad air from Guangdong or walking through traffic

gulping diesel exhaust, or putting in 12-hour days in over- air-conditioned offices, might be the onset of a potentially deadly disease for which there was no real precedent and no cure - not even a convincing definition.

The second scary thing was the timing. The broad

symptoms were a match for those attributed to inhalation of anthrax spores, as relayed in the print media here in the inexorable buildup to war in Iraq. As the Hong Kong government stockpiled antibiotics in hospital stores in case of a bioterrorist anthrax attack on the Territory, the leading English-language newspaper defined what you could expect, symptoms already familiar from the anthrax attacks in the U.S.: "An initial phase of flu-like symptoms usually lasts for one to three days, before the patient enters a second phase of

high fever, chest pains, severe breathing problems and shock."1

Though no one seriously speculated that canisters of bacillus anthracis had been released in Kowloon, where the HK of- fensive began, the fact that the emergence of SARS coincided so completely, as far as we then knew, with February's build-up to war in Iraq, followed by the war in March, gave most pause for thought. Was this yet another triumph of bacteria over mankind, or was it germ warfare? Was some other terrorist body using the Iraq war as a cover? The coin- cidence was such that the war in Iraq began in earnest at the

precise moment SARS reached a peak here, five days after the World Health Organization (WHO) issued an anti-HK travel advisory, ensuring a daily media spectacle that was as

compulsory viewing as the situation in Iraq.2 This caused a friend in London, vehemently opposed to the war, to share his fantasy that the "wretched" invasion of Iraq would be

brought to a halt War-of-the-Worlds-stylt by the invading troops all going down with SARS.

If the Iraq war had everything to do, some would say, with the escalating war between the euro and the dollar (in 1999 Saddam Hussein dropped the dollar-for-oil standard that had replaced the gold standard in 1971 by accepting euros from France and Germany), could this local germ war have

something to do with the yuan? The panic and chaos that ensued when SARS took hold showed how quickly and effec- tively a single bioterrorist act could disrupt and strangle a

big city. As residents of Baghdad rushed the canary markets (remember the point of the miner's canary), Hong Kong locals rushed the Chinese medicine shops and stockpiled herbs

124



and vitamins, for whatever war this might turn out to be would require a sturdy immune system.

As news hit that the good doctor from Guangzhou who

brought SARS to HK had inadvertently spread the disease to

strangers staying on the same floor of the Kowloon hotel in which he'd spent only one night - either by sneezing or

coughing on them in the confined space of the hotel lift, or

by touching lift buttons or rails or walls that they then touched* - locals took to surgical masks with a vengeance equaled only by goggle -wearing among the troops or tradi- tional use of the chador. By the time the "Coalition Forces"

began bombing Baghdad, a campaign greeted here with a tremendous burst of boat horns all through Victoria Harbor and down the shipping lanes, most of the hordes in the street had disappeared to the eyeballs behind surgical masks, creat-

ing the effect of a medieval plague - or perhaps a local rep- resentation of life in Iraq. Faces had gone.

The authorities here flipped from denial to warlike hysteria. They spoke suddenly of comprising a War Cabinet, and

immediately fired off (feeble) directives: to incorporate into

toilet-training instructions to flush and wash your hands, to cover your nose and mouth when sneezing or coughing, to use tissues rather than gobbing in the street - all of which, alas, were necessary. They referred to doctors and nurses as

operating at the "front line," redefining the city as a war zone, split into fragments, with pockets of intense fighting in hos-

pitals and certain housing estates flaring against a blurry back-

ground of generalized fear - of an invisible enemy embodied, potentially, in each and every person and perhaps in build-

ings themselves.

Image was all. Tung Chee-Hwa's government was "between Iraq and a hard place," as the joke went. A former

Shanghai shipping "magnate," Tung Chee-Hwa was chosen

by the central government in Beijing to be the CEO of HK, as everybody knows, because he mishandled the family for- tune. His puppet government had sold itself as having no

strings attached and was getting very bad press, partly due to its ungainly attempts to pass an antisubversion act, known as Article 23 legislation, required by Beijing and regarded with alarm by locals concerned with preserving the freedoms of

assembly, worship, and the press that HK still enjoys, even

though the "one country, two systems" mantra has never lulled anyone. The bad press was also part of a general tar-

geting of Hong Kong - as the best place to do business in the

region, as the hub of a booming service industry and trans-

port - in special sections of the western print media, such as

125

5. Dr. Liu Jianlun, a 64-year-old semi- retired doctor from Guangzhou, came to HK for a wedding on February 21, 2003 . Dr. Liu had been treating patients with a strange form of pneumonia in Guangdong province prior to the trip; some of these had died and he himself had fallen ill. But a wedding is a wedding, and he kept his booking at the Metropole Hotel, a spruce modern 487-room hotel in Kow- loon frequented by the fashion trade. He had dinner with his brother-in-law that night in the hotel, where he had a room on the ninth floor - room 911! His brother-in-law and six other people also staying on the ninth floor of the hotel that night subsequently became ill with SARS and some died, but not before spreading it to Hong Kong at large via the Prince of Wales Hospital, where the first SARS patient became "the index patient," as well as overseas to Hanoi, Singapore, Canada, and so on, every route precisely known, every person known and named and counted. The policing aspect of the count is evident. But so, too, the abso- lute importance of each and every person, along the lines of every hair on every head being counted like every grain of sand.



Greater Hong Kong AND THE MANY FERRY ROUTES THAT LINK THE ISLANDS.



4. SARS: Acronym for "Severe Acute Respiratory Syndrome." In April, researchers at the Center for Disease Control proposed the name be changed to "Urbani SARS-associated Coronavirus," in memory of the WHO doctor. Urbani died after treating one of the first SARS patients in Vietnam. 5. Front page, South China Morning Post , June 24, 200}. Cumulative financial toll of SARS in Hong Kong printed on the day the territory was officially declared free of the disease, 104 days after the outbreak began.

the Financial Times , and the International Herald Tribune . And now this city that since 2001 had bravely touted itself as a

truly "international" city, as "The City of Life" no less, was

being targeted by a bug - from that swarming cesspit ... er . . . motherland, mainland China - that was turning it into a

city of pestilence. SARS. Sounds like: SAR . . . Special Administrative Re-

gion (of China), which is what HK is. Though local authorities and the media clung to the term atypical pneumonia for as

long as they credibly could, and one newscaster valiantly persists to this day in pronouncing it zars, the SARS label, first used in Hanoi in late February by Dr. Carlo Urbani, who promptly died of it, stuck, reinforcing the notion that HK was specially targeted - an actual epicenter - no matter the original source.4 The crisis infected and killed more people per capita here - if the figures given by mainland China are credible - than anywhere else. It was not the image of "The City of Life" required to keep the money pouring in, and untold capital evaporated: according to one of the many incantatory tolls published in the South China Morning Post , 4,000 businesses folded, 13,300-plus jobs went, 13,783 flights were cancelled, 3,600,000 fewer travelers crossed the Chinese border at Lo Wu, and 1,000,000 foreign tourists stayed away.5 The bell was tolling, for a time, for the city that "will take

your breath away" (as an ad campaign that ran on unac-

countably throughout the crisis had it). Image, we now know, cost lives. It meant, for instance,

that managers at the Prince of Wales Hospital, where the first cases landed and where the greatest hospital contamination occurred, forced medical staff to remove the "No Visitors"

signs they had put up in Ward 8A on March 10 in a swift bid to isolate the infection after 11 staff working there came down with fever. The managers, answering to a post-SARS Hos-

pital Authority review panel and a panel of experts headed, to general dismay, by Tung Chee-Hwa, say they were concerned with public reaction and the hospital's image. Every- one agrees now that rapid isolation would have been critical to containing SARS. Many more doctors and health workers there got sick. Some died. Portable isolation units loom on the horizon, some, it's been suggested, to consist of converted

shipping containers, in keeping with the image of HK as the (still) busiest commercial port in the world.

Because of this lazy concern for image, particularly in HK and China, the WHO, if empowered to do so by changes to international law, may well step in where the United Nations has faltered, entering countries where there is a

127



suspected epidemic outbreak. WHO was finally allowed into China in late March, well after the disease had spread from there to HK and on to Vietnam, Singapore, Canada, and many other places, finally affecting 8,4-37 people in ?2 countries: a new map of the globe, based on international routes of transmission that exactly parallel the main air routes of international mercantilism and mass travel, a new twist to globalization. Imagine the peace-keeping forces of the future, virologists and epidemiologists in surgical gear, armed with syringes and respirators instead of guns.

Issues of sovereignty will take yet another turn, for what

happens when a city or country is no longer free to succumb to disease or to tackle it on its own terms on its own turf? Will the health crimes of ordinary citizens replace the depre- dations of, say, the triads? Dirt and hygiene deficiencies have

already been declared the object of an internal "Zero Toler- ance" program here, along the lines of crime fighting in New York City. As a French child I know said on rediscovering foul-smelling Paris after time away in an Australian town, way too provincially clean, "Ah! Les petites saletes des

grandes villes!" There is no reason to fear that all the home-

grown city dirt will be mopped up with any rigor in this sometimes anarchic town. But even as I write, the new HK

Hygiene Squads are hitting the 160 public housing estates, punishing low-rent hygiene offenders with demerit points: 16 points in two years and you're out. Common sense, we are assured, will prevail, though it will take on local color. Take those Taoist door shrines so prevalent outside Chinese

shops and apartments: if the shrine is no bigger than a mooncake box, and if the fruit offerings aren't moldy, it can

stay; if not, it's tossed and you've scored five points.6 Resis- tance is likely to be as stiff among renters as among Parisians in a nonsmoking campaign. But the move underscores the

question of what civic probity might be in times of plague, particularly in a city where Confucian virtue and a sense of

duty vie with the innate anarchy of the impulse, inherent in

any city, to achieve maximum license. For what is a city without unresolved tension between such warring drives? License is what is pulling in the growing millions of mainland tourists, just as "perverted peasants" were once lured to the City of Light that's become HK's model.

Transparency and international interaction are likely to be two cornerstones of this transmuted virtue, even within a

guarded Confucian city-state like Hong Kong, where Sun Tzu's warrior ethics take on an overlay of strongly Christian values. The Germ War, once declared, was fought on several

128

6. The hygiene hit squads of the Team Clean operation are handing out five demerit points to owners of domestic pets living in the 160 or so public housing estates. This is less than the seven demerit points for throwing rubbish out the win- dow, spitting or soiling in public, but punishment for harboring animals does not stop there. Residents have been given two months to get rid of their pets, a gesture of forbearance thought to be humane. As a Chinese friend of mine says, the Chinese generally don't like animals, they just like to eat them.



fronts, well before the creation of the Hygiene Squads or the

tardy imposition of an on-the-spot $1,500 HK fine for litter-

ing, spitting, soiling in public (humans or dogs). Two such fronts crucial in identifying the disease and tracking its victims were established largely in the virtual world.

The first of these, a "multicenter collaboration," was a WHO initiative, set up on March 15, that linked three labora- tories in Hong Kong with labs in Beijing, Guangzhou, Sin-

gapore, Atlanta, Winnipeg, Rotterdam, Frankfurt, Marburg, Paris, Tokyo, and London in a quest to identify the causal

agent and develop a diagnostic test. They connected in real time via a secure website where microscopy pictures, proto- cols for testing, and PCR primer sequences were posted. An account of how this network identified the causal agent as a Coronavirus new to human beings and established its genetic sequence makes for gripping reading. Scientists were engaged in a race against time, in the conviction that "if the causative

agent maintained its pathogenicity and transmissibility, SARS could become the first severe new disease of the 21st century, with global epidemic potential."7 The scientific community breeds as many shock-jocks as journalism, but the prospect seemed real and horrible enough then.

The second project, which has all the obvious potential for abuse of any policing system, put the HK police computer system to work tracking down people who lived at Amoy Gardens, the housing compound that was the most concen- trated geographical locus of SARS in HK. The police Major Incident Investigation and Disaster Support System was also used to monitor the incidence in housing estates generally, as well as public places, and identify possible hotspots. This sur- veillance literally redrew the map of HK as connected or un- connected loci of disease. Data collected was posted on the

Department of Health's website daily, showing which resi- dential buildings had at least one SARS case.

Identifying the enemy was critical to such a schema, but like the troops in Iraq, the authorities were stumbling. As the ancient names of Baghdad, Basra, Al Nasiriyah, and Tikrit

rang out around the world, the recitation of names here linked HK's twin worlds: the British colonial names of front- line hospitals like the Prince of Wales-Ward 8A, Princess Mar-

garet, Queen Mary; and the Canto-Brit amalgams for bleak

high-density towers: Amoy Gardens-Block E, Lower Ngau Tau Kok Estate . . . Eventually lists of no-go areas were published in the papers, and read like abridged versions of the street directory. (In Hong Kong, though street names and numbers exist, addresses are given most familiarly as build-

129

7. "A Multicentre Collaboration to In- vestigate the Cause of Severe Acute Respiratory Syndrome," in The Lancet, Vol. 361, No. 9370 (May 17, 200O-



ings.) This became a negative map, flagging the places, and the people, to be given wide berth.

Such a map is at issue in cases that have subsequently come before the Equal Opportunities Commission, allegedly serving as a discriminatory index to screen potential em-

ployees and tenants who list addresses now branded undesir- able when they apply for work or a flat. Some, including a few of the many Filipina "helpers" the Health Department targeted in one of its hygiene campaigns, lost their jobs because they got sick and there was no safety net. Recovered SARS patients have become the untouchables of a subculture of lingering fear, and they are doomed to continuing immo-

bility and marginalization as that subculture calls for a

lengthy extension of quarantine. While isolating a lethal virus might have been reason-

able, this marginalization was something else, a coiled thing waiting to spring straight out of The Art of War , identifying the problem and its causative agent as foreign. Almost imme-

diately there was talk of "foreign animals," foreign bodies, chickens, ducks; later we heard from the mainland that the

original contaminee, a businessman from Foshan, had been "abroad," with, all the implications of that loaded term. The

press, on the other hand, lamented the one-way flow of disease across the border from China, which was, in fact, about to be opened up to greater flows of people and cargo and, presumably, disease.

When SARS hit, in the middle of the crazy weather, I

got sick. That was foreign enough for me. I don't get sick. This is no idle boast. With an energetic German Shepherd crossbreed and dazzling green mountains behind our apartment block, I ought to be fit. But perhaps those joyful romps with Poppy were the problem. There was a Friday afternoon in early February, for instance, when our otherwise stun-

ning views of Hong Kong were obliterated by the season's usual "white-out," and you could feel the heavy particles coursing down your gullet. We staggered up the hill to the rock pools; the white-out had achieved a "nuclear orange" glow by the time we staggered back home. I then learned from a friend - and checked the Clear the Air HK website to confirm the news - that anyone outside that afternoon was

likely to have permanently damaged their lungs. The epicenter of the pollution was not Mongkok, a narrow conglomer- ation of "rats' nests" in deepest Kowloon that is the most

densely populated place on Earth, not Causeway Bay, with its

choking street-level diesel fumes and endless traffic, but

Tung Chung, a high-rise minicity on our very own Lantau

130



Island. We live on this "outlying island" for the oxygen, but it was now apparently lying out too close to China, where the celebrated Tiger responsible for Southern China's economic miracle was wreaking havoc with the environment. The bor- derless skies were bringing us a pall of toxic air down

through the Pearl River Delta that was worse than the 50 percent diesel concoction HK itself throws up daily.

Ten years ago, the pollution index rose to ?0 or 35 on a bad day; now this passes for low. It usually sits on 50-60. Some

days, though not often, it can shoot up to 150; people with asthma or a heart condition are warned to stay indoors.8 Some 4,000 people die every year of respiratory diseases brought on or exacerbated by the pollution here. This figure gets no

press and got no press during the SARS panic. Around 22,000 people get pneumonia and 3,000 of them die from it, which the South China Morning Post mentioned in a (vain) attempt to put things in perspective.

Lungs in the Chinese system are yin, the female princi- ple. They represent air, breath. On a metaphysical plane, just as the metaphysicists of the West thought, they speak of grief. Could SARS be an expression of collective grief over the bad air? Over all those deaths attributable to it? "It won't be long," Paul Virilio wrote to me from the west coast of France, where the oil tanker, Prestige, had spilled its guts in March, "before we'll need aqualungs to live in big cities!"

Having compromised lungs made you feel very vulnera- ble to a disease that could leap across at you from one dirty sneeze. I did not seek medical help, I infected no one, I recovered. But when my husband came down with very bad flu, not once but twice, he went to the doctor. Employers were beginning to want not mere certification that you were "clean," but a SARS test to "prove" it. Offices, major banks, major businesses, where employees came down with SARS were starting to close. If doctors' rooms were bad and soon came to be deserted, hospitals were the last places you want- ed to be. Yet, to do the test, you had to sit, perhaps for hours, in a public hospital seething with extremely high-risk con- centrations of contaminant. The one diagnostic test then available could only confirm that you had SARS if you had had it for at least 20 days; it could not say you did not have SARS. Our local medical centers were urging patients not to

go near hospitals for love or money.9 Allan returned to work armed with two medical certificates spelling out that the virus he had was not SARS. Since his lungs were unaffected, this did not seem irresponsible.

His colleagues were horrified when Allan went back

m

8. Statistics concerning air pollution in HK, and the effects of morbidity and pre- mature death from particulate exposure, can be obtained from the Clear the Air (HK) website [www.cleartheair.org.hk]. In Mongkok, for example, the level of "Respirable Suspended Particulates" is twice as high as the worst U.S. case study; on-grade air pollution in Cause- way Bay reaches levels of more than 200 percent above the annual limits, according to the Environmental Protection Department, HK. 9. The reason hospitals were so badly hit had partly to do with the concentration of contagious droplets, sometimes via "super-spreaders" carrying high viral loads, in infectious disease wards and to initial medical procedures such as the use of nebulizers, which had the effect of aerosolizing the disease. Inadequate ventilation and other factors still being investigated may have played a signifi- cant role.



without a mask, though no one was wearing a mask inside the office. One of his secretaries was hacking all over the place, others looked pale and wan. But the masking business was

tricky. For the Chinese, wearing a mask showed you had

something to hide. It was a loss of face, literally and figura- tively. If you were sick, you most likely would try to hide it, since employers typically did not offer sick pay in the case of

pandemics. You could not afford to take time off without

pay and if you did, you might lose your job. If you got sick

you might lose your job. So inside the office, no masks. Out- side, where it was safe to do so, you declared yourself a re-

sponsible citizen by always and everywhere wearing a mask. When the first masks appeared, they covered Chinese

faces. Masking grew to point up a racial divide, with gweilos (the idiom for Westerners meaning "ghost faces" being iron- ic enough in the circumstances) putting up a stiff resistance to what was perceived as mounting hysteria. I don't mean to

suggest anything as un- Chinese as strident racial tension, merely the friction that happens when parallel universes not so much collide as rub each other the wrong way. It happens in minor ways all the time, much as you'd expect in a former

colony where most of the population chugs along happily without reference to the administrative elite. Now such friction sometimes flared into shouting matches in the street between unmasked gweilos and Chinese incensed at such civic misbehavior. Gweilos abhorred the irrationality, since the masks, particularly the flimsy paper squares that were

cheaper and so most popular, were not much protection or none at all.

But it was a shield of sorts, a prophylactic in a city that would soon swathe itself in prophylactic plastic. We stopped buying sushi and sashimi from the outlet in the Wellcome store tucked away in the Landmark Building basement, even

though the excellent staff had always worn masks and surgical gloves to prepare the food. Eating out was anathema, anything anyone had handled was suspect. Restaurants were deserted, though there were people brave enough - locals would call them reckless - to have a ball, grabbing the best seats at quiet movie theaters, lapping up the attention of the staff at hotels and bars all over the center of town. Then

again, there were people who did not open their doors and lived in fear in tiny confined spaces for weeks on end.

I did not wear a mask. It took a holiday by the sea in Australia for my lungs to really heal, but if it was SARS that I had had, it was a mild gweilo version of what seemed, for a time, to be a Chinese disease. So much so that a Japanese m



researcher in Tokyo was able to publish, in a medical journal as serious as The Lancety her argument that the Chinese lan-

guage, when spoken, was likely to transmit the disease by droplet production far more efficiently than other languages due to heavy aspiration - a requirement of the argument presumably being that the Chinese spoke Chinese only to each other.10

Language is also a shield. Even in Discovery Bay, a place as close to social harmony as HK can get, the locals seemed to hear a different set of signals, ones you couldn't pick up if

you didn't speak the lingo. One day, for instance, a Cantonese friend who'd been a stockbroker in New York and prided himself on western cool, turned up in a square three-ply, then backed off perceptibly as I approached. He explained that the Chinese papers had announced three confirmed SARS cases in our Bay. The English-language papers never broke the story and it seems to have been untrue. But the next

day, a great number of Cantonese appeared in masks, scurry- ing heads down to the ferry or making lightning raids on

Park'n'Shop, our one supermarket, where high-speed shop- ping was reaching comic dimensions. The usually friendly cleaning woman in our apartment block was suddenly masked and wouldn't look you in the eye. My lovely next- door neighbor, who for years was a nurse, appeared masked in the lobby with her, issuing instructions on correct clean-

ing procedures. She turned away, ashamed for me (for not

wearing a mask?), for herself (Tor wearing one?), for what was happening to neighborly relations in this town; who can say? She wasn't about to tell me. Talking seemed sudden-

ly to be too risky. Even looking at people seemed to be out, with eyes darting to the side over the mask or cast down to avoid ocular contact of any kind. (The official hygiene cam-

paign stressed not to touch your eyes without first washing your hands; was this translated to mean that vision itself could be a source of contamination?)

In greater HK, a mask culture was massing. When hun- dreds of people were infected at the Amoy Gardens in late March, a public meeting was called at which one of the healthworkers addressing the frightened crowd said, "Wear-

ing masks has not been part of Hong Kong culture up to now. This must change."11 Masks became so much a part of HK culture that by mid-May business leaders were vehemently campaigning against mask- wearing as detrimental to HK's international image and, therefore, business. Hong Kong, they said, should show its face. Even with HK officially declared to be free of SARS as of June 24, a few diehards in

m

10. "SARS Transmission: Language and Droplet Production," The Lancet , Vol. 362, No. 9378 (July 12, 200?)- 11. Financial Times , March 31, 2003: 15-



town are clinging to them: perhaps masks have become, for them, like sunglasses. But back in March, this being a "one in, all in" kind of town, two top officials, Yeoh Eng-Kiong, Secretary for Health, Welfare and Food, and Dr. Margaret Chan, Director of Health, were popularly castigated for

appearing sans mask when talking with the media. Presum-

ably they did not wish to appear to have something to hide; both have since lost their jobs, though Chan was kicked up- stairs, so to speak, to a post at WHO.

By late March, a number of non-Chinese faces began to

appear masked. Mask- spotting was added to the daily routine of coffee and croissants. One day, the Spanish fashion-plate spilled out of a hire car with her three glamorous kids, all

sporting the new sea-foam green three-ply with elasticized sides. A few young Manchester mums followed suit. The odd older woman now wore one inside the supermarket, then whipped it off outside to sit down with the girls for a coffee or beer.

Then mask-spotting gave way to spotting who was left, mask or no. Discovery Bay is a haven for kids; a place where the worst that can happen when the Plaza fills to its brim is to be rammed by a dinkey or a skateboard. But now the women and children were being sent away in droves. Some have not yet returned, others never will. Lone men went loping along the streets or huddled together in the Plaza, drinking. Occasionally whole families fled and the sound that rent the air was the screech of the drill so characteristic of HK, as vacant apartments and houses were gutted for the next ten- ant, should there be one. Rents and property values plum- meted and residents began a reshuffle from current abode to much cheaper abode that has not yet stopped.

The more Dr. Chan denied rumors that HK would soon be closed as an infected port, the more convincing they became. So many were leaving while they still could that you felt a stab of pleasure on passing someone you knew who'd

stayed, a typical greeting becoming an exclamation of sur-

prised delight that the person was still there, particularly if

they were women with children. For some, the fear of flying and catching SARS in the confined space of an aircraft cabin, with its lousy recycled air, left them no choice but to stay.

By the end of March, panic was setting in. If those who could were getting out, no one was coming in, especially not since the WHO travel advisory of March 15 warning the world to stay away from HK, Hanoi, Singapore, and the entire province of Guangdong - what the French termed, flatly, la zone

géographique asiatique surveillée. The Hong Kong Sevens

m



match went ahead on the final weekend in March, but it did so without the French, Italian, or Argentinian teams. All concerts, conferences, and trade fairs were cancelled. Even those tough old geezers the Rolling Stones bailed, dipping out not only on two high-earning concerts but also a celebri-

ty bash hosted by Shanghai Tang's David Chan at the China Club. The Stones gave a sum just shy of $400,000 HK of

party-ticket money for the purchase of masks, which were now being consumed at the rate of three million a week by hospitals alone. In a state that has always relied on charity, it was similarly up to the South China Morning Post to organize donations to buy special coats for the medical heroes at the front line, where those who were gowned, masked, and

gloved had a far greater chance of not succumbing than those

wearing only masks. Masks were running out; they were being recycled and

not disposed of properly. Dead masks appeared on the im-

ported Australian sands of Tai Pak beach, down among the

polystyrene and plastic debris, becoming flotsam and jetsam like any other banal consumer item. But in a cheerier aside, plenty of people were beginning to rip their masks off in

Discovery Bay, even as the panic grew. When the good- humored women in the local Chinese medicine shop tossed theirs, they instantly resumed the lovable personas that the masks had somehow trapped.

Masks weren't the only things running out. Shelves all over town were cleared of vinegar, which the Chinese boil as an antimicrobial to clean the air. Westerners had their own remedies. On any given day at the supermarket comfort foods and delicacies like smoked salmon and fine French cheeses

passed through the checkout in great quantities. But nothing anticipated the pandemonium that broke loose on April Fool's Day. When I descended on the supermarket, there were no

trolleys to be had; inside, crazed shoppers were frantically snatching up fresh and frozen goods for fear that the shop would close the following day. We didn't know that near- riots had broken out at supermarkets all over town, thanks to a rumor posted on the Web by a schoolboy hacker that HK was about to shut its gates. I took one look at the people flinging frozen chicken wings into their trolleys, backed out of the shop, and headed straight across the square to Watson's Wine Cellar.

In the antiseptic chill of the pristine new shop (surely no germ could survive at this temperature), I was the only customer until another woman stormed in on Prada- shod feet. I knew at a glance that she, too, was Australian. I studied

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labels on the Australian shelves; she joined me. I looked at her, she looked at me. I said, "More alcohol!" She laughed. "It's the only way!" I left with a champagne and a solid red; she collected an armful of whites. A well-known western folk remedy complementing the Chinese vinegar remedy; vinegar, after all, is vin aigre : sour wine.12

With rumors of shutting the gates to the city, parts of the

city were being shut down. Block E of Amoy Gardens was

quarantined, though only after most households had fled, fearing the treatment they were in for. Those left were round- ed up and sent to government holiday camps in Sai Kung and Chai Wan, now known as "isolation camps," where conditions were appalling. In one camp, there were only two toilets for

every three rooms, not good considering the prevalence of diarrhea in the Amoy Gardens cluster. Many escaped and took to the hills like frightened feral creatures.

The compulsory medical treatment protocol alone was

frightening. When in late March the government spoke of

using its powers under the Quarantine and Prevention of Disease Ordinance, we began to be truly scared, for it seemed if the disease didn't get you, the doctors would. Powers were invoked to nab suspected SARS carriers in their homes. Images of denunciation by neighbors or passersby flashed before us. I still had a dry cough; Allan had a grayish post-flu pallor: we were distinctly potential candidates for nabbing. Those nabbed, and anyone presenting to a doctor with respiratory symptoms of any kind, were thrown into the hospital where treatment was compulsory. This consisted of a cocktail of the antiviral drug, ribavirin, and steroids, both administered in-

travenously in heavy doses. Without wishing in any way to undermine doctors willing to risk their lives in the service of public health, some of whom have just completed four months' unstinting labor to the detriment of their own lives, and four of whom died doing so, peers in the medical profes- sion considered the protocol highly questionable.1* Steroids

suppress the immune system; their use on patients whose immune systems were seriously depleted by a lethal virus was risky even if it did allow the inflammation to subside. Ribavirin, used mostly against hepatitis C, can cause arrhyth- mia and hemolytic anemia, as well as birth defects when taken during pregnancy.14 Ribavirin pills nonetheless became a general prophylactic, handed out to any healthy person exposed to SARS victims.

The situation was bad enough, but all hell broke loose as the case count rose at Amoy Gardens: seven on March 26, then 85 by March 29, and 237 by April 1, with 52 new cases

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12. Folk remedies of all kinds were abounding. The best entailed smoking: "SARS doesn't like clean lungs, so if you smoke, you won't get SARS." In other words, SARS was a way of excusing any preexisting unhealthy behaviors, preju- dices, lunatic notions. 1}. The Center for Disease Control and Prevention in the U.S. did not endorse the HK protocol, and none of the 211 people there with suspected or probable cases of SARS died. There was no control group here for comparative analysis, no more proof that the method saved lives than it curtailed them. 14-. See "SARS Treatments Make Progress," The Asian Wall Street Journal , April 3, 200?.



recorded overnight; 250 by April 4; 278 by April 7; 289 by April 10, and a total of 321 cases by April 15, well after Block E was quarantined, cleaned, and evacuated. Was there now a more virulent strain of SARS, or were people just getting sicker faster? Had it become airborne? It was evidently no

longer spreading through face-to-face contact alone, but some other way from which masks were no shield. Was it spreading through the air-conditioning? Had it been introduced by a delivery boy, plumber, rats, cockroaches, pets? "Environ- mental factors" were under suspicion. At one point, contam- inated blasting dust from a building site downwind was

thought to be the culprit. It didn't seem related to neighborly contact. Pictures revealed tiny apartments, not squalid but sad, often housing old people living alone, so-called "isolates" within the hyperdensity of some 2,000 people.

After much investigation, the culprit turned out to be a

systematically faulty sewage system that disseminated the virus once it was introduced by a visitor to one of the apartments, a man with chronic kidney disease who'd slipped through the hospital net when he was discharged, supposedly SARS-free, leaving him free to "shed." The bits of information that came out, one pellet at a time, did nothing to allay panic. Not only might the virus be mutating within the human body and passing out through excrement, there were

super-spreaders able to pass through the hospital system un- detected. Now buildings themselves were bad; the disease could get you within the sanctuary of your own home. A

building in which it was possible for other people's excrement to come hurtling down pipes inside your kitchen (traces were found in kitchen sinks as well as backed-up bathroom floor drains) was already inherently bad.

With buildings and every surface now in question, the bleach blitzkrieg began in earnest. When the new "Team Clean" cordoned off Block E and threw bleach at it, the cor- don sanitaire tightened around HK, a ring of panic as palpa- ble as the ring of steel concurrently tightening around

Baghdad. The public health campaign that had begun so

mildly as the attempt to complete basic toilet training now became a massive domestic and public clean-up campaign, with the formula "one part bleach to 99 parts water" ring- ing like a mantra in the minds of all dutiful domestics, which HK households were assumed to contain. (Employers were asked to clean their offices and public spaces.) A mother-

daughter dynamic duo was depicted in action in a new ad

campaign, intensely scrubbing their home. The message was to clean with bleach every day, "then wash your hands and

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change your clothes." Westerners gasped in disbelief and

began to recite the formula for fun. But a more insidiously effective campaign was one aimed at breaking down social interaction. Its mantra, "Say 'HIP then wave goodbye," was not funny.

The way the town was sealing itself off by sealing people off from each other was already clear in the use of plastic as a prophylactic, suddenly appearing as Glad-wrapped lift and door buttons in our apartment block and proliferating all over town, swathing interfaces of human touch: intercom buttons, ATM buttons, all the buttons and knobs of modern living, all the railings and handrails and banisters that might be con- taminated by droplet-coated human fingers.

The effect the campaign could have was brought home most forcefully one morning in early April, when, out walk-

ing my dog, I encountered a young Chinese woman out

walking her dog down by the harbor foreshore among the cool palm groves. We chatted - at a safe distance; I patted her

dog, she patted mine. Then she introduced herself and held out her hand. It was only a quarter of a second but I did find

myself checking her for signs of incipient illness. Not that I would have rejected her graceful, slim hand, but I was pleased to note how radiant she was, and I grabbed her hand and shook it - while making a mental note not to touch my face or pat Poppy until Fd had a chance to wash my hands.

We went home to Sydney a week or so later at Easter and had the instructive experience of being foreign in our own land, pariahs from SARSville. April 17 was the first day outgoing passengers at Chep Lap Kok airport were screened

by a temperature test. Mine was almost too low; Allan's was normal. Being frisked reminded me that terrorism was still on the agenda and it felt almost nostalgic, like a dim signal from a lost world. Half the airport shops were closed, those open, deserted. We bought an HK sweatshirt at the Canton Market that was never worn; back home in Sydney, it did not do, we found, to advertise where we had come from.

The big question onboard was: to mask or not to mask? None of the staff was wearing them. All of the Chinese passengers were, and some of the non-Chinese too. The plane was half empty - a small plane, a far cry from the usual jam-packed jumbo. Allan pulled out a packet of masks. I tried one on. They were the crummy pleated gauze squares with ribbons that tie at the back of your head. Mine kept slipping. I pulled it up, it got in my eyes; I lowered it, it

slipped off. I pulled it back up. My reading glasses fogged up. My eyes watered. It was hard to breathe. A little cloud of

1*8



claustrophobia wafted up from my mouth. The cloth already- felt wet and we hadn't yet left the tarmac. I ripped it off. My first and last tussle with a mask ended before takeoff.15

Soon after takeoff I began to sneeze - and sneeze and sneeze; Allan's eyes went red around the rims. They used to wait until you landed on Australian soil before spraying the

space above your head with germicide from canisters held by smiling flight attendants who walked expertly down the aisle as you sat, bleary-eyed and baffled, waiting to disembark. Now Qantas was pumping germicide through the system. No one would admit this, but I know allergic rhinitis and this was bad. I spent the night coiled with my head under the airline blanket so no one could see me pinching my nostrils closed for fear of sneezing and being nabbed as a SARS suspect. In the morning, I almost passed out trying not to sneeze or look too lousy going through customs, where pairs of hygiene officials gazed abstractedly at arrivals.

If we had been concerned about being thrown into

quarantine in HK, we were even more concerned about what could happen in Australia. There were no cases of SARS there

yet - only one case ever was confirmed, months later - but

powers to seize and quarantine were already in place. The official stance was nothing compared to a media frenzy that seemed to grow daily as we watched from our self-imposed semi-quarantine by the sea. "WORSE THAN AIDS," screamed one tabloid headline. This "expert's devastating warning to Australia" claimed that one billion people could be infected worldwide within a year. A week after Easter, worried

Sydney residents were said to be snapping up masks and herbal remedies.

Wherever we went it seemed a suspected SARS case had just been declared and the headlines kept shouting impend- ing doom. Trade was dropping, the lucrative student intake from Asia was under threat, shop assistants were handling our HSBC credit cards with a certain tense respect. I found

myself blurting out that yes, we were from Hong Kong. "But it's OK, we don't have SARS." The hysteria mounted and achieved panic levels familiar not so much from our experience in HK as from the rabid xenophobia whipped up in the

past few years by the conservative government of Australia over "boat people" and "queue -jumpers," and focussed now with manufactured alarm on the approach of yet another boat of asylum-seekers seen heading to our shores from Asia, which had collapsed into one disease-ridden mass.

These boat people were the old-fashioned kind from Viet- nam, not seen much in the midst of all the desperate Afghanis 1*9

15. The flight to Sydney is eight and a half hours. Qantas day flights had been cancelled; Cathay was losing $24 million HKD a day and planned to ground most of its staff; pilots we knew were already on forced leave without pay. We were lucky to be on the Qantas night flight, because the international web was being undone by a Coronavirus faster than it was by 9/11.



and Iraqis fleeing persecution to reach a promised land they would not be allowed to enter. Though Vietnam, unlike Hong Kong, had capped its SARS outbreak successfully with hon- est, efficient application, suddenly these boat people were, it was suggested, SARS -addled queue-jumpers bringing Aus- tralia doom. They were not allowed to land, but were turned around in international waters.16

Back in HK, it looks as though a germ actually cleaned

up the system a little, flushing out politicians and bureau- crats unable to read the symptoms of unease in the body po- litic. In China, some of the authorities who kept SARS quiet, and so allowed it to spread, are gone; a new "transparency" has been hailed - once the central government stopped in-

voking the "state secret" in relation to information about SARS. It may not last but it is some relief. In Hong Kong the

government seriously misread the levels of discontent over its handling of the crisis, and particularly its initial muzzling of the Chinese press, which only exacerbated fears about Article 21 legislation, those fears intensifying with what was seen as contempt for people's suffering because Beijing- appointed Mandarins lamely followed mainland directives. The woman most closely associated with the legislation has

gone, the finance minister who did so little for the poor has

gone, and others have been shunted aside to other portfolios. On July 1, in the middle of the hottest summer on record since the 1967 anticommunist riots, 500,000 people took to the streets to manifest how they feel about Article 2? and the "one country, two systems" line. The protest was peaceful, almost jubilant, as blue skies and bright sun restored to

Hong Kong all its sweetness and gravity and grace. When SARS was declared over, I made a special trip to

the Wellcome store in the basement of the Landmark Build-

ing for sushi and salmon šashimi. Not only was the store closed; there was no trace of it, no hint that it had ever exist- ed. The basement was gone, the escalator leading down to it, between Gucci and the Fook Ming Tong Tea Shop, gone, the

opening cemented over and seamlessly retiled to match the rest of the gleaming floor. That's Hong Kong for you.

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Julie Rose is an Australian living in Hong Kong, where she trans- lates THE WORK OF FRENCH AUTHORS, INCLUDING PAUL VIRILIO and Chantal Thomas. Her most RECENT TRANSLATION IS OF Alexandre Dumas' s The Knight of Maison-Rouqe.

16. See David Marr and Marian Wilkinson, Dark Victory (Sydney: Allen & Unwin, 200?)-



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