World health inspectors visit Beijing hospital

Team seeks to resolve questions about SARS


BEIJING - A team of World Health Organization investigators made its first visit to a Beijing hospital yesterday, hoping to clear up a swirl of questions and rumors about the prevalence in this city of a dangerous new respiratory disease.

The Chinese government agreed late last week to the outside monitoring of Beijing's medical facilities after international experts complained about officials dragging their feet, some local doctors said the caseload was higher than officially reported, and tourist and business visits to the capital began to dry up.

As of Thursday, according to the last public report by authorities here, Beijing had recorded only 22 cases of severe acute respiratory syndrome, including four deaths. But the figures for Beijing and several other Chinese cities have been widely questioned, and senior WHO officials in Geneva have described uncertainty about the course of SARS in China as a major global worry.

The investigation should clarify the situation at least in Beijing, said one of the team leaders, Dr. James Maguire of the U.S. Centers for Disease Control and Prevention. Yesterday afternoon, after extensive discussions with local health officers whom Maguire described as cooperative, the team visited Chaoyang Hospital, a large general facility that has seen patients with the new ailment.

"If there had been hundreds of SARS patients, it would have been very difficult to hide them," Maguire said in an interview last night. He said the initial inquiry had not turned up huge holes in the official reporting system in this district.

"But we know there are a lot of doubts out there, and we're going to dig," he said. In coming days the team will visit numerous hospitals of its choosing and pore over local health records.

By all accounts, the main burden of SARS has fallen in the southern province of Guangdong, where the first case is believed to have appeared in November, and in nearby Hong Kong. This month, after the Chinese government was criticized for a slow and secretive early response to SARS, it granted a WHO team full access to hospitals, patients and records in Guangdong.

The international experts confirmed the official assertion that new cases in Guangdong were declining and praised the province for its aggressive efforts to contain the disease, which is believed to be caused by a new member of the coronavirus family. But they said they had little confidence in reporting and prevention measures elsewhere in China, including in Beijing, the capital.

On Thursday, after WHO officials appealed to Health Minister Zhang Wenkang and Deputy Prime Minister Wu Yi, the Beijing city government agreed to an outside investigation. Chinese doctors have described as many as 50 SARS cases at individual civilian hospitals, while a respected military surgeon said he knew of at least 100 patients, including seven who died, in local military hospitals.

Even if the higher claims prove true, the disease would still be rare in this city of 14 million people, and life has mostly carried on as normal. But the low credibility of official accounts and fears of the possible spread of SARS have led to the departure of foreign residents and the cancellation of conferences and tours.

In a news conference Thursday, senior health officials insisted that Beijing's announced total of 22 cases was correct, but they did not explain why several local doctors had declared otherwise. Some experts have speculated that the city had treated but not reported many suspected cases.

Last week, Beijing strengthened its disease control measures, pledging to isolate relatives, health workers and others who had close contact with SARS patients and to track down people who were probably exposed to the virus.

International officials say the claims of some Chinese leaders that SARS has been "controlled" in the country are premature. Just yesterday, cases were reported in two previously unaffected provinces, Inner Mongolia and Fujian. Experts worry that many Chinese cities may not be able to muster the countermeasures seen in the relatively developed regions of Guangdong and Beijing.

In Hong Kong, the government announced late last night that Malaysia would drop its ban on the entry of virtually all visitors from Hong Kong and China, replacing it with close medical screening.

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