Burdened in Hong Kong

Outbreak: Hospitals struggle with SARS cases as residents find their lives disrupted.

April 08, 2003|By Gady A. Epstein | Gady A. Epstein,SUN FOREIGN STAFF

HONG KONG - It was the sort of heart-rending tale that defines the heavy burden the SARS outbreak has carried here, for both the patients and the health system that must take care of them.

A local man stuck in an isolation camp called a local radio station yesterday desperately requesting information about his wife, who was suffering from severe acute respiratory syndrome. Her health had been declining precipitously after she underwent a caesarian section last week, nearly two months before her baby was due. He had been temporarily freed from isolation only to be nearly barred at Princess Margaret Hospital from visiting her.

"I could only see her for five minutes, through the glass window," the man, who wanted to be identified only as Kwok, told the radio station RTHK. He has yet to see his newborn boy.

"I'm not asking too much," Kwok said on the radio. "What I want is for the hospital to give me a call every day and let me know how my wife is getting on."

The hospital has since contacted Kwok and apologized, but the incident demonstrated the pressures on the overtaxed health system in Hong Kong, where so many resources are being diverted to stemming the nearly month-old outbreak.

With 883 suspected cases of the pneumonia-like illness in the former British colony - including 122 new cases in the past three days - regional hospitals are turning away non-SARS patients, doctors and nurses are continuing to fall ill, and hospitals are trying to add to their staffs. Nearly a quarter of those infected are health care workers.

A spokeswoman for the Hospital Authority, which oversees 44 public hospitals here, said everyone in the organization was so busy contending with SARS that no one would have time yesterday to comment on how busy they were.

"These patients are putting the hospitals under a lot of stress. For example, at some hospitals, care of patients of traffic accidents, cardiology patients, are being jeopardized," said Lo Wing-lok, president of the Hong Kong Medical Association. "If this becomes the same in every regional hospital, then our hospital system will be in trouble."

The almost single-minded focus on the virus has paid off for SARS patients, doctors here say. By using an old anti-viral agent, ribavarin, and administering weekly steroid injections, doctors say they are winning the battle - at a cost of less than $150 a day, including antibiotics to fight secondary infections.

For the 10 percent to 20 percent of patients who are extremely ill and don't respond after three weeks of that treatment, an antibody-laden blood serum taken from recovered SARS patients has proven successful, a doctor at Prince of Wales Hospital said yesterday.

"It's worked in every case. ... It's a miraculous supplement," said the doctor, Leung Ping-chung, who is also a professor at the Chinese University of Hong Kong. He said recent experiences in treating patients should be reassuring, even though six have died in the past three days, raising Hong Kong's total to 23 deaths. Most of those who died were elderly or suffered from chronic diseases.

"The mortalities really gave a lot of worry, but those will be exceptional, I believe, " Leung said. "There shouldn't be any panic about the ability to cure the disease."

But residents are fearful because the outbreak shows no signs of burning itself out. The rate of new cases has risen drastically over the past three days, with new clusters of infections found among medical staff at two hospitals in the past week. In all, 208 health care workers have been sickened here since the epidemic began.

Yesterday, citing concerns that the treatment for SARS may have side effects for women early in pregnancy, the Hospital Authority announced that staffers in their first 13 weeks of pregnancy could take paid "special leave."

Last week's new cases included the chief executive of Prince of Wales Hospital, Fung Hong, whose hospital became an early hot spot for the virus, infecting roughly 70 health care workers. Fung previously had been admitted with flu-like symptoms and was discharged upon testing negative for a coronavirus identified as a cause of SARS - only to be readmitted soon thereafter.

Fung's case highlights concerns about the ability to correctly identify and isolate SARS patients. At United Christian Hospital, where more than 160 SARS patients are being treated, about 20 employees became infected after an undiagnosed SARS patient was admitted to a general ward.

"The problem we face is that there is insufficient segregation of [patients]," said Lo, an expert on infectious diseases.

He suggested that "the level of alertness" for doctors and nurses in non-SARS wards may be lower. "If a patient with SARS is accidentally admitted into a general ward, then the other patients and nursing staff in the rest of the ward will have a higher risk of infection."

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