SARS Updates

From AITECE 2003-05-19
Dear AITECE Teacher,
I hope you have been well and in good spirits since I wrote last. Here in Hong Kong the news continues to be up-beat and the authorities claim they are now in control of sars. However, there were four new cases yesterday and two deaths. It is interesting that the report from China yesterday said there were only 28 new cases and two deaths in the whole county. That is similar to what Hong Kong alone was reporting about a month ago.
These figures are encouraging since these days the WHO is scrutinizing reports from China and accepts them. If the threat is indeed receding we can expect travel restrictions etc to relax soon.
One of the greatest inconveniences for everyone in China these days must be the clampdown on movement not  just outside the city but often outside the campus or local area. It is one example of the stringent steps the authorities are taking to restrict spread of the disease.
Beijing is the hardest hit areas but later this week schools will start reopening though many restrictions will remain for the next few weeks. Guangdong, where it all started, now reports that it has no new cases and whether this is a result of the temperature having risen to summer levels, or something else, it is welcomed news. 
Many airlines are cutting down on domestic flights, again because of the shortage of people traveling. Quarantines are very much in vogue. One teacher is still waiting to be allowed to leave her room after her return from England. It is another sign that things are returning to normal when the authorities suspect the threat now is more likely to come from outside the country than from inside. 
Finally, here in Hong Kong they say more are suffering from food disorders as a result of sars anxiety than from the disease itself. So if you can't sleep, eat or concentrate you have somewhere new to look for the cause! I am sure you are keeping up the precautions even as the news improves and hopefully it will be getting better and better each week.

 May 18, 2003  Worst over, says WHO

THE majority of the SARS outbreaks around the world are coming to an end, the World Health Organisation (WHO) said today.

Difficult struggles remain in mainland China, but the epidemic there is no more complex than it is in other countries and the government is making great strides, WHO's coordinator of the global effort to stop the severe acute respiratory syndrome virus, Mike Ryan, said.

Scientists from 16 SARS-struck locations concluded a one-and-a-half day conference today at the WHO's Geneva headquarters, where they discussed the key factors that allow the virus to spread, how well control measures are working and what remaining questions still require answers.

"The message coming out of this meeting is certainly one of great hope. It's one of celebration that the measures are working, but also a call to action because we've got a lot more to do yet before we end this problem," Ryan said in a conference call with reporters.

"The experience across the range of countries involved has been that the control measures that we designed at the beginning of the epidemic have worked. In country after country, we have managed to break the cycle of transmission through the simple implementation of good case finding, contact tracing and isolation practices in hospitals," Ryan said.

"We have seen the number of secondary cases per case dropping systematically in all of the countries to a point now where we believe, in the majority of cases, we are now seeing the epidemics coming to an end," he said.

The main lesson of SARS, which has made more than 7,800 people ill and killed 625 since it first emerged in the Chinese province of Guangdong in November, is to be prepared and organised, Ryan added.

"Managing an outbreak as serious as SARS requires very good collaboration between all services. The lesson for any future epidemics is really how we organise ourselves. We probably need to do that better in future," Ryan said.

"It's about having in place good preparedness measures, good communication systems between the different sectors of government, early decision-making and systematic implementation of what's been decided."

Dr Margaret Chan, director of Hong Kong's Department of Health, said epidemiologists at the meeting concluded that the pattern of the SARS outbreaks is similar in different places.

The belief that SARS is spread almost exclusively by droplets from coughing and sneezing emerged clearly from the discussions, Chan said.

It is possible that the virus could be contracted through faeces if it becomes so fine that it can be inhaled, the scientists concluded.

But there is scant evidence that it can be spread by faeces-contaminated hands touching mouths.

"There is not a lot of evidence to suggest that the faecal-oral route is playing a part in driving this epidemic. We have to look at this issue because we have seen that the virus can be excreted in faeces, but this is not driving the epidemic as we understand it at the present time," Ryan said.

Questions remaining include whether there are people who have caught the virus but did not get sick enough to be noticed and whether people can spread the bug before they develop symptoms.

Ryan said there is some evidence that there are mild cases, but that there is no sign that those sufferers have spread the virus.

The same is true for those who have been quarantined and later developed SARS.

"We are reiterating that there is no sign of infection coming from people before they start developing symptoms," said Angus Nicoll, from Britain's Health Protection Agency.

"There are one or two circumstances that need further investigation, but nobody was reporting that as a phenomenon."

The Associated Press

May 16  From British Consulate-General, Guangzhou

As of 16 May, on the basis of data available from the Guangdong Health Department, there were 2 new confirmed cases of SARS in Guangdong, with both new cases found in Guangzhou. 11 patients were discharged from hospital and no new SARS death occurred. Cumulative totals for Guangdong are 1515 confirmed SARS cases, 1353 patients discharged and 56 deaths. In addition there are now 320 suspected SARS cases in Guangdong. 
Daily SARS figures released by the Guangdong Health Department - 21 April - 16 May 2003.

May 15  From British Consulate-General, Guangzhou
As of 15 May, on the basis of data available from the Guangdong Health Department, there were 3 new confirmed cases of SARS in Guangdong, with all 3 new cases found in Guangzhou. 15 patients were discharged from hospital and no new SARS death occurred. Cumulative totals for Guangdong are 1513 confirmed SARS cases, 1342 patients discharged and 56 deaths. In addition there are now 367 suspected SARS cases in Guangdong.

May 13 - From British Consulate-General, Guangzhou

As of 13 May, the Chinese Ministry of Health has reported an additional 80 probable SARS and 10 new SARS deaths. The new figures bring the cumulative number of reported cases in China to 5086 and the death toll now stands at 262. In addition there are 2412 suspected SARS cases in China.

On the basis of data available from the Guangdong Health Department, there was 1 new confirmed cases of SARS in Guangdong, which was reported in Shenzhen. 5 people were discharged from hospital and no new SARS death occurred. Cumulative totals for Guangdong are 1510 confirmed SARS cases, 1327 patients discharged and 56 deaths. In addition there are now 415 suspected SARS cases in Guangdong.

From AITECE 2003-05-12
Dear AITECE Teacher, 
It is a week since I wrote to you and in the meantime the Sars situation has changed only a little. Personnel-wise, Nora Mary returned to Ireland from Kunming last Thursday (8th) as she is vulnerable to respiratory diseases. Jo , who had returned to England from Baotou on 26 April, has decided to return to Baotou to help her students who are preparing for exams.
In many universities travel has been further restricted with the teachers, in practice, confined to their campus. Some schools continue to have classes while others, such as in Beijing, have suspended classes for another two weeks. Soon those schools that have stropped classes will have to decide whether they should not close down altogether far the duration of the Sars threat and send the students home. 
Beijing, Shanghai, Shanxi and Inner Mongolia seem to be the main Sars areas with Hebei, the province around Beijing, joining them. Other provinces have a small number of cases and, though rumours are floating around about the extent, they seem to be relatively Sars-free.  Whether the situation remains on those lines will be very important to our teachers in China and also to those looking forward to the autumn semester. 
So, for the present, we must continue to “wait and see’. 
In Hong Kong the situation is improving with only four new cases reported yesterday. Shortly Hong Kong hopes to get off the list of countries which the WHO warns travelers to avoid. Looking forward to hearing if there are any changes in your local situation and wishing you peace and good health in this trying time,      Hugh and all in Hong Kong.

May 10: see article in Guardian (above) re SARS decline in Beijing

CAS update - May 9: SARS reports much the same as yesterday: good news from rest of world, not so good from China.....light at end of tunnel for Hong Kong....hope the same for Chinese cities soon...
Yesterday here was a normal (?) class day...routine shattered by discovery of broken eggs in food order....basketball practice for Iona dream team....Jock & Hazel's success in having dumplings delivered to school......water level rising in Olympic pool (...swimming next week is the hope...)..and birthday wishes to Michael's Mum Anita + her twin sister + another Anita in HK ...+ my dear Mum - all on May 8.
Reflection this morning while on morning walk (6.30): in 1965 my novitiate was spent on a large farm in Geelong, Australia.....went for months without leaving the property....I'm now doing my 2nd novitiate...

May 8:  BRITISH CONSULATE GENERAL GUANGZHOU

SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

Updated information as of 8 May 2003 shown in bold below

Following our previous advice notices, we would like to share with you our latest information about the outbreak of SARS.

The UK Department of Health and Foreign & Commonwealth Office have amended their travel advice to strongly advise against travel to Hong Kong, Beijing, Shanxi and Guangdong Provinces in China. Advice for the rest of Mainland China remains unchanged.

Some foreign companies and organisations are evacuating staff and/or dependants from Guangdong/Hong Kong on a voluntary basis. We are not issuing such a recommendation for British Citizens. British Citizens resident in Guangdong who are concerned about the situation in Guangdong will wish to make their own decision as to whether to remain here, based on the available information. Visitors to Guangdong/Hong Kong are advised to check with their insurance companies, where appropriate, to see whether the change in our travel advice affects their travel/medical insurance.

On the basis of data available from the Guangdong Health Department, there were 7 new cases yesterday, with all new cases reported in Guangzhou. 17 people were discharged from hospital and 1 new SARS death occurred. Cumulative totals for Guangdong are 1485 confirmed SARS cases, 1273 patients discharged and 56 deaths. In addition there are now 419 suspected SARS cases in Guangdong..

No new SARS cases have been reported in Guangxi. Cumulative totals for Guangxi are 20 cases of SARS and 3 deaths. Guangxi authorities have set up SARS checkpoints on all main highways, airports, ports and border crossings to prevent SARS infected people entering Guangxi. All confirmed SARS cases were infected outside of Guangxi.

In Fujian there have been no new SARS cases reported in the past 26 days although 1 new suspected case was reported yesterday. Cumulative totals for Fujian are 3 cases of SARS cases and no deaths.

To date there have been no reports of SARS in Hainan.

The symptoms of SARS are high fever (more than 38C) and one or more respiratory symptoms including cough, shortness of breath, and/or difficulty in breathing. If anyone experiences this combination of symptoms while in a SARS affected area or within 10 days of being in an affected area, they should seek urgent medical attention and ensure that information about their recent travel is passed on to health care staff. They should not undertake further travel until they have recovered. April/May is the peak season for flu in South China and Hong Kong and it is important not to confuse the symptoms of SARS with those of influenza, or of atypical pneumonia.

The Guangdong Government has specifically recommended to us the following three hospitals for treatment of foreigners:

Guangdong Provincial Peoples Hospital

Guangzhou First Affiliated Hospital

Guangdong No. 8 Hospital

On 23 April the British Consulate along with all other foreign Consulates in Guangzhou were invited to visit the Guangdong Provincial Peoples Hospital (GPPH) for a tour and SARS briefing. The main points arising from the visit were:

GPPH is one of the largest hospitals in China

1800 in-patients beds

900 doctors/physicians/surgeons work there

Internationally trained doctors (France, USA, Germany and Canada). English speaking doctors.

Deal with up to 2.3 million patients per annum

Since November, 130 SARS patients admitted (includes suspected cases)

75 diagnosed with SARS

22 remain "very sick"

65 cured/recovered and discharged

average stay in hospital 15.1 days

No mortalities

No infections amongst hospital staff

VIP rooms available

GPPH would allow 30minute daily visits for SARS patients (including "foreign" doctors) but under strict health and safety guidelines including the wearing of full protective clothing and decontamination procedures before and after the visit. Visitors would need to be checked for SARS symptoms two weeks later.

The Consulate General can make no guarantees about the standard of service in individual hospitals, and their capacity to receive foreign patients at any given time. However, based on the short time we were there, our impression of GPPH was of a well organised, clean and generally modern facility. We were also assured that the hospital would not refuse to accept any foreigner suffering from SARS.

Guangdong Department of Health has a 24 hour hotline for SARS related enquiries:

Contact name: Dr Shao-Min Feng (English speaking)

Tel: 13925123328 (mobile)

Hainan Department of Health has a 24 hour hotline for SARS related enquiries:

Tel: 0898-65339954, 13807571355 (mobile) - not all hotline staff speak English

Fujian Department of Health has a 24 hour hotline for SARS related enquiries:

Tel: 0591-7834708, 7673873 and 625925 (English speaking)

Website: www.fjphb.gov.cn/fdzl/8.htm

Guangxi Department of Health has a 24 hour hotline for SARS related enquiries:

Tel: 0771 5303201 (English speaking)

MEDICAL EVACUATION OF SARS PATIENTS
Medical evacuation of SARS patients by road to Hong Kong is possible in principle, but likely to be complicated, time-consuming and expensive.

The Guangdong Health Dept has said that it would not prevent medical evacuation to Hong Kong by road of someone suspected of, or confirmed as having SARS. The Hong Kong authorities have said they would accept patients into Hong Kong on a case-by-case basis, subject to the availability of hospital beds and respiratory equipment at the receiving institution. Medical evacuation involving cross-border ambulance between Guangdong and Hong Kong would need to be independently organised by an international assistance organisation such as International SOS. SOS have confirmed that they can organise evacuation, but on a case-by-case basis only. Evacuation organised by a local hospital would involve an ambulance change at the border and could be more difficult to arrange.

In either case, the viability of evacuation would depend on the condition of the patient, availability of a suitable ambulance, availability of a hospital place in Hong Kong and the completion of relevant bureaucratic procedures involving the authorities in Guangdong and Hong Kong. It may not always be a realistic alternative to hospitalisation in Guangdong. The British Consulate General would do everything it could to facilitate the evacuation of British SARS patients to Hong Kong. Nevertheless, the process could still be lengthy. We therefore recommend that if evacuation is to be attempted, it should happen at the earliest opportunity, in particular before the patient requires ventilator treatment.

The costs of medical evacuation can be substantial. Individuals should ensure that their insurance would cover the costs. These can vary, but could easily exceed HK$50,000. (The cost of medical treatment in Hong Kong must also be borne by the patient.)

Air-ambulance evacuation of SARS patients from China to another country is not possible.

Current information suggests that children are at low risk from SARS. As with other returnees, and as long as they are symptom free, they are not a risk to others. They should be allowed to continue their schooling and advised to seek medical attention if they develop any symptoms suggestive of SARS up to ten days after their return. Children should not return to school if they have any of the symptoms of SARS. In the exceptional situation where they have come into contact with a known case of SARS while in the affected areas, it would be prudent of the school to check the child's health status on a daily basis for ten days. All other returnees should be advised that they should seek medical advice if they themselves develop symptoms within ten days of their return. If any returnees become sick, they should be treated according to the guidance on the website of the former Public Health Laboratory Service.

We understand that many schools are advising parents that their children should return to the UK 10 days before the start of the new term in order for them to check their health over the period when symptoms might occur. By doing this, they believe that disruption to school activities will be kept to a minimum. It is not current Government policy in the UK to recommend this action.

One method of overcoming this difficulty is to calculate the case fatality ratio using only those cases whose final outcome - died or recovered - is known. However, this method, when applied before an outbreak is over, gives an overestimate because the average time from illness onset to death for SARS is shorter than the average time from illness onset to recovery.
PRECAUTIONARY MEASURES

Some simple measures can be taken to reduce personal risk in locations where SARS has occurred. These revolve around minimising exposure to potentially exposed persons and using personal hygiene measures and personal protective measures. According to WHO reports, SARS cases are most likely to be passed from close face to face contact with an infected person although some transmission is continuing despite the prompt isolation of patients and introduction of strict barrier nursing practices.

The actions listed below are not designed to be prescriptive but merely to give advice to people on the potential areas where precautions can be taken.

Avoiding interactions with people who are exhibiting symptoms of SARS including people coughing.

Where possible avoid crowded and confined situations.

Try to use stairs rather than elevators and private rather than public transport.

Minimise the amount of time spent in shopping centres and public areas.

Washing hands before eating is essential.

Avoiding facial and eye contact with hands where possible.

Smokers should wash their hands before smoking as contaminants on the hand are easily transferred to the mouth whilst smoking.

Do not touch disposed tissues or handkerchiefs as these may carry secretions with infected material.

 

We advise British Nationals to continue to monitor the WHO, FCO and UK Department of Health web-sites for the latest developments.

WHO website www.who.int

Frequently asked questions: www.who.int/csr/sars/sarsfaq/en/

FCO website: www.fco.gov.uk

DoH website: www.doh.gov.uk/traveladvice/emerg.htm

Public Health Laboratory Service: www.phls.org.uk/topics_az/SARS/community_guidance.htm

Boarding School Association: www.boarding.org.uk

Medical Officers School Association: www.mosa.org.uk/severe_acute_respiratory_syndrom.htm

Hong Kong Govt. website: <http://www.info.gov.hk/dh/ap.htm>

British Consulate General,

Guangzhou

8 May 2003

CAS update - May 8:  Just after 8am here....rain has stopped after morning storm....yesterday was a busy day of classes....Olympic pool 100% clean + some tiles have been replaced.....also a pool in Kieran's room 12.30 a.m. yesterday when pipe under kitchen sink broke...Kieran of the Overflow....Iona basketball team training seriously for next encounter (Junior One next Monday)......SARS news from Henan Province not good (see SCMP link above) ...AITECE  update below (May 6) excellent as usual...
....cicadas now not only give morning call (5.40am), but also - bless 'em - siesta time call (around lunch time). If only we could catch the ONE cicada which starts the orchestra, the conductor!

British Consulate General Guangzhou - figures for May 5 & May 6: (received May 7)
May 5:On the basis of data available from the Guangdong Health Department, there were 12 new cases yesterday, with all 12 new cases reported in Guangzhou. 6 people were discharged from hospital and 1 new SARS death occurred. Cumulative totals for Guangdong are 1465 confirmed SARS cases, 1251 patients discharged and 55 deaths.  In addition there are now 389 suspected SARS cases in Guangdong.

May 6:On the basis of data available from the Guangdong Health Department, there were 13 new cases yesterday, with 11 new cases reported in Guangzhou and 1 each in Jiangmen and Zhaoqing. 5 people were discharged from hospital and no new SARS death occurred. Cumulative totals for Guangdong are 1478 confirmed SARS cases, 1256 patients discharged and 55 deaths.  In addition there are now 403 suspected SARS cases in Guangdong.

From AITECE 2003-05-06  Dear AITECE Teacher,
 I wonder what kind of May Day celebration you had. Most of the teachers, and students, had travel plans for the long-awaited break but nearly all had to be cancelled. Some places had no holiday at all. In the past few days there have been some interesting comings and goings all the same. Ray and Marie got a month’s break from the medical college in Guiyang to attend a family celebration in England in April. At the beginning of this week they returned to Guiyang even though they will have to spend a ten day quarantine period in their apartment before they can teach again. They were given the choice of staying at home but preferred to return.

In Changchun Teddy  got the news that his brother-in-law had died and he applied to go to London for the funeral. The Foreign Affairs Office suggested that it would be permited and  he went home to an early break. The situation in the various universities seems to differ. In Beijing, which is one of the cities worst hit by sars, Michael  says that classes have been called off for another two weeks but the students are still on the campus. Michael has being showing  DVD movies followed by a discussion each morning for any English major who wants to attend in order to pass the time usefully.

Here in Hong Kong the number of cases has risen to 1637, with 187 deaths but only 8 new cases yesterday. For the past two days the number of new cases has come down to one digit so people hope this is a sign that the virus is dying out. However in certain areas of the mainland new cases are increasing while a few provinces remain sars-free. It is obvious that we are still in the middle of a very uncertain situation and need to keep informed on local developments. So continue to take care of your health and get that extra rest and nutrition. With every best wish from Hugh and all in Hong Kong.

May 6 - see diary (updated today) and also, update from British Consulate-General in Guangzhou (May 5):
"Since our last update, on the basis of data available from the Guangdong Health Department, there have been 55 new cases of SARS, with 47 cases in Guangzhou, 5 in Shenzhen, 1 each in Zhanjiang, Chaozhou and Jiangmen.  44 people were discharged from hospital and 4 new SARS deaths occurred. Cumulative totals for Guangdong are 1454 confirmed SARS cases, 1245 patients discharged and 55 deaths. In addition there are 361 suspected SARS cases in Guangdong."
(no new cases in Zhaoqing....DG!)

May 5 - CAS update: No new figures or news for Zhaoqing or China.
Some photos from last Sat, yesterday and this morning to show we are alive and well DG.
Stopping people from entering/leaving CAS are our 40 security guards (..a great group of young people...some of them ex-soldiers..) but this morning I reflected: they too are inmates...the guards are prisoners!
...Floor of Olympic pool is now 2/3 clean....
....Iona is our official nurse...taking our temperature each morning (under arm). A daily ritual for all staff and students.
...Jade is official bursar/treasurer for daily food orders (which yesterday included 2 bottles of Dynasty red and 6 bottles of SingTao beer....what sort of prison is this?...InnMates...)
...5 staff attended Luke chapter 8 English last night....
...China8 email was down yesterday....if you happened to have used it, please kindly re-send message.
....Basketball this afternoon after classes: Iona vs Primary 6
(word usage for new readers: Iona is name of young lady from Philippines...and name of College in Brisbane where 5 of us went to school)

May 4 - CAS update: Famous date in Chinese history (1919..).  Overseas news report says that Guangzhou has had no SARS deaths in the past 2 weeks ....good news if accurate.
Yesterday at CAS: for me personally - am: computer jobs/repairs, special English class 10.30 till lunch, food orders, badminton competition (thrashed by Mat), table tennis practice, reading, Mass, meal, evening English class (Luke). All overseas teachers involved in badminton & table tennis competitions...and....all teachers now on line - can use MSN messenger to save phone calls...
Holiday today (...with some special activities to help everyone keep busy...)
I was due to go to HK for annual OMI retreat this week, but because of SARS situation in HK   I cancelled several weeks ago....and now that our CAS vessel is going through a SARS storm, not a good time to abandon ship...+ fact of travel restrictions....
Good news: as I went for morning walk  around grounds this a.m., near swimming pool, I noticed that our small 25 metre pool has been cleaned...and cleaning has started on the Olympic pool...which means....maybe swimming season about to open in a week or so DV!  (...how many prisons have an Olympic pool?..)

May 3 - CAS update:  Like any group of captive creatures, we are getting organised and adapting to the situation.  Jock & Hazel  are running a very popular badminton & table tennis competition for staff and students; some of our younger overseas teachers yesterday and on Thursday refused to take a "holiday" (offered at expense of local English teachers who would have had to cover ) and showed up for classes as usual; some of us are also arranging extra English activities for student and staff groups. 
Computers for overseas staff rooms came back from doctors last night, and today  every overseas teacher  (except Iona who has special access to kindergarten computer)  should be on line in their own unit. Computers went to "doctor" for upgrade + check up....and when they arrived back at CAS, had to spend 3 hours in isolation at front gate guard house (...germs don't last more than 3 hours...?)
Growing highlight each day is the daily delivery of our food orders - kindly bought and brought  by a local shop keeper - followed inevitably by an in-depth discussion about  the price of eggs (!), tomatoes, oranges etc as people try to work out how much each one needs to pay
AITECE letter below shows our situation is not unique.  And I doubt if many other "prison" situations are as comfortable as ours.....situated as we are on a large and beautiful property at base of hills.  Interesting how new AITECE teachers are still getting ready for September 2003.

From AITECE 2003-05-02
Dear AITECE Teacher, As promised, this is the regular monthly news bulletin and not a SARS-extra! I began last month’s news bulletin by comparing the disinterest in SARS on the mainland when I was in Chongqing at the end of March (it was called “the Hong Kong disease” then) with the growing fear of it in mask-wearing Hong Kong on my return there. Now it is almost the opposite – Hong Kong people feel they have seen the worst of it and expect life to return to normal shortly while people on the mainland are just beginning to feel the discipline of containment and fear for the future. Limiting teachers and students to their campus and restricting travel continue to be seen as the best way of preventing the disease spreading on the mainland. The May holidays have been shortened and the plans of many, including our teachers, have been curtailed to their disappointment. 
The news I gave you a few days ago –that our two teachers in Changzhi have left – was a bit premature. Since Shanxi is one of the “hot spots” they were advised to leave by the  university authorities and will return home next Tuesday (the 6th). So far, everyone else is staying put though, depending on the region, anxiety on many campuses must be rising especially among those with chronic weaknesses. The university authorities seem to be very understanding and if they advise anyone to leave their suggestion should be followed. Early in April Gerry  visited the teachers in Fuzhou, Xiamen and Nanchang. All were in good form and were highly praised by their institutes. Gerry enjoyed the visits and so, I believe, did the teachers. Again, as well as the usual urgent request for more AITECE English teachers, there was also a desire for lecturers in WTO related subjects. 
I hope the SARS concern will not deter our new candidates from coming. At present we have a list of twenty-one and are in the middle of placing them. Their nationalities are: Australia, 4; Britain, 5; Ireland 3; Philippines 5 and United States 1. There are also two returning from the U.S. and one from Canada. Thank you for all your emails and up-dates on your own situation. Many of the experiences are similar though some areas are closer to the “hot spots” than others and reflect that reality. Some universities have suspended classes, while keeping the teachers and students on the campus, and others continue class with in locked campus gates but I hope you have time to relax, eat well and “up” your immune system. With best wishes from all here in Hong Kong at this difficult time, Hugh.

May 2: Unofficial reports of several  new cases in Zhaoqing.... University students/staff confined to base....more people in city (one in a hundred) wearing masks
CAS confinement strict from yesterday....no going or entering....parents who wish to see their children do so through iron front gate, with students a further 2 metres away behind a rope stopping them from getting close to gate....same practice in many institutions in China....overseas staff in good spirits...hope to get photo today or tomorrow (..waiting for Iona boys to have their black F4 shirts ready...)..yesterday May 1 was a working day in primary, holiday in secondary....local shopkeepers in village are making daily deliveries for overseas staff: people put their order on a piece of paper on my window before lunch, I phone at lunch, goods (fruit, bread, eggs, vegetables, beer  etc)  delivered in early afternoon....school canteen meals available breakfast, lunch and dinner...what more could you want?....this situation may last at least a month, maybe longer...anyone for table tennis?
Jock & Hazel planning to use their video camera to make a Great Escape documentary...a la "Chicken Run" (which we all watched many times earlier in the year with primary students.....and now fiction has become fact...)
Update on what we did/bought in last day(s) of freedom: - from Michael
Over the past few days I bought the "essentials" to help me survive the imprisonment of the school. As all 17 year olds are bound to do, I bought large quantities of coke, beer, juice and milk - you would think that I like an entirely liquid diet. Wrong! I also stocked up on porridge, what the ....? I never thought I'd actually say that.  I also bought a whole heap of biscuits to keep me occupied during meal times. The crowning achievement of my pre-imprisonment shopping spree was a Y1,600 entertainment system, minus the TV.
Dad, if you thought I had the music up loud at home imagine what 6 speakers, an Amp, a subwoofer and a DVD player can do.   
(...what's a subwoofer????)

April 30: Overseas  news good - SARS not even a headline in some services (e.g. Guardian).
But in China - things are getting worse...could be a long campaign......in my view not so much restricted by lack of resources as hindered by "True Lies?" (...don't admit someone died in a certain place, then you don't have the cost of closing/disinfecting that place...but then you have other people in that place getting sick...)

Here at CAS we are not allowed to make quick shopping trips to village as earlier reported. Shopping will be done for us...and a store/shop will be set up inside the school where we can buy things. All classrooms and teachers' units disinfected yesterday....maybe a daily ritual?......Everything possible is being done to protect the students' health. We are lucky being in a boarding school that is like a self-contained city ....and lucky being at the foot of the mountains where the air is so clean (compared with the polluted air of the city below us)...
Everyone in good spirits....will try to get photo today of the 4 Iona boys in their F4 shirts.... (which reminds me....Donna: Kieran looks great in a shirt....please ask him not to go around without a shirt on!?!)
Our situation is not unique - see AITECE letter below

From AITECE 2003-04-29
Dear AITECE Teacher,
I hope you have being putting up well with the developments of the past week. Most universities have a very strict quarantine, with teachers and students confined to  campus. Steps have been taken to keep the environment healthy, even though it can cause inconveniences.  I think it can be said that the authorities are doing everything in their power to deal with the disease and that the Foreign Affairs Offices have been very understanding and helpful to the foreign teachers. In many schools, classes have been suspended but the students remain as travel home is discouraged for the present. If the schools do close down completely then the teachers will have no option but to return home.

Here in Hong Kong, the WHO believes the spread has peaked. The number of new cases is decreasing gradually and we should be in good shape in a week or so. On the mainland, the spread seems to be slower and over a wider area so it will take longer to contain. The good news is that the insurance companies that we work with (IMU and Christians Abroad) say their usual coverage is not affected. Of interest is the move in certain countries to quarantine travelers from affected counties, like China, but the situation in each country differs and will change on a daily basis according as the risk status of the country in question is altered by the WHO. It is best to check with the country in question before believing rumors.

It is a fact that international flights out of Beijing, Hong Kong and other cities are fewer but that is not because the airlines refuse to fly to those cites, rather it is because they cant fill the seats. So, in that sense, it is a good time to fly. As of today, three of our teachers have returned home: one from Mongolia and two from Changzhi in Shanxi, one of the high risk areas. In both cases the FAOs have been very understanding and facilitated them in getting tickets etc. All three expect to be back in the autumn. That is about all the news for now. Later this week I hope to get out our regular news bulletin to show there is more happening than SARS! With best wishes in these anxious times,   Hugh and all in Hong Kong.

April 29 (from British Consulate 27/4):

On the basis of data available from the Guangdong Health Department since 24 April there were 21 new cases of SARS, with 15 cases in Guangzhou, 3 in Zhaoqing and 1 each in Shantou, Shanwei and Heyuan. 11 people were discharged from hospital and 1 new SARS deaths occurred. Cumulative totals for Guangdong are 1395 confirmed SARS cases, 1191 patients discharged and 51 deaths.  In addition there are 233 suspected SARS cases in Guangdong.

April 29: Unconfirmed report that Mayor of Zhaoqing has issued a decree: no one may enter or leave Zhaoqing!?

April 28 - 5.30pm  CAS authorities have decided that from May 1st until the Summer holidays (mid-July):
* All staff (teachers, office workers, cleaners...everyone!) must live in at the school and may not leave the property (except for very quick shopping visits to local village)
* No meals outside
* No going to town (Zhaoqing)
* No outside evening classes
* Morning walk??? (I forgot to ask about this...maybe ok?)
* Do not pass "Go", do not collect Y200....
How do you spell "quarantine"/"prison"....do we laugh or cry??

Seriously: given the situation in Zhaoqing, the above makes sense. 
Please God SARS will go away soon!

April 28 - 2.30pm  - from a most reliable local source - see April 23 below
* Zhaoqing is now the 2nd most SARS affected place in Guangdong Province (Guangzhou city is no. 1).
* 2 people died of SARS yesterday in Zhaoqing
* Zhaoqing's No. 3 (mental) Hospital has been designated a SARS hospital.  Mental patients are being moved to a traffic police living quarters
* Officially there are 21 people with SARS in Zhaoqing
* "going out" strongly advised against. "Stay home"....

April 28: 8.30am:Locally there is more anxiety....CAS May holidays may be cancelled?....CAS  may be quarantined?? (to stop anyone getting sick through contact with outsiders).....everyone entering CAS (including overseas staff) now having temperature checked on entry (thermometer under arm). Other boarding schools in Guangdong Province not allowing students to leave the premises (just like CAS).
Some Zhaoqing people now wearing masks...
But...best advice still: Fr McMahon's words in AITECE update April 25 below (..."an increase of anxiety for 2 weeks then getting on with life...")

April 28 - Guardian  -Sars deadlier than first thought - British expert says the death rate is double the WHO's estimate but the battle is being won

Gaby Hinsliff in London, Nicola Byrne in Dublin and John Aglionby in Jakarta - Sunday April 27, 2003
The Observer

Sars, the virus that has caused panic across the globe, is deadlier than was first thought, British experts will reveal this week. But predictions that it will kill millions of people are unlikely to come true.The disease apparently kills one in 10 of its victims, more than twice the mortality rate suggested by the World Health Organisation. It is less contagious, however, than was feared, says a study of the Hong Kong outbreak by Professor Roy Anderson, a top epidemiologist.

His verdict came amid reports that a group of children recently back from Hong Kong were forced to leave a Blackpool hotel by 'abusive' fellow guests worried about infection, while a retailer of surgical masks said it had thousands of inquiries from panicking Britons.

However, the UK Health Protection Agency said this weekend that there may have been no genuine cases of Sars in this country at all.

The six 'probable' British cases all had pneumonia-like symptoms and been in contact with infected areas, but none of them seemed to have had contact with people definitely known to be infected, said the agency's head of respiratory diseases, John Watson.

'Most of those six cases are probably not even Sars cases at all: most will probably be discarded in the end,' he told The Observer . 'It's not unlikely that there would be one or two that will turn out to be true Sars, but we don't yet know.'

A seventh possible case reported last week in Plymouth is no longer being treated as Sars. So there have been no new cases in Britain for more than a fortnight, suggesting that any outbreak has been contained, experts said.

'If we don't see it here for another week, that is probably it,' said Professor Ian Jones, a virologist at the University of Reading. It was possible, however, that new cases could still emerge as people who did not know they were infected entered this country.

Vivienne Nathanson, head of ethics at the British Medical Association, said Sars was not the global pandemic feared at first, but she called for a review to clarify the law governing infectious diseases. She urged airlines to give passengers leaflets explaining the symptoms.

The growing belief that Britain has escaped the worst follows signs that the WHO may shortly lift travel restrictions slapped on Toronto, which has not had a new case for a week.

Vietnam too appears to be getting on top of the bug, while the rate of new cases in Hong Kong appears to be slowing. Kuwait, which has remained Sars-free, yesterday banned all travellers from infected countries.

Anderson said his study of 1,400 cases suggested 'gloom and doom' forecasts of the spread of Sars could be exaggerated.

'It has been effectively contained in most of the developed countries in the world with a very limited number of cases,' he told BBC Radio 4's Today programme.

'The concerns really lie in the large populous regions of the world, China and Indonesia, where the disease reporting systems are to some extent limited. It is much less clear what is going on there.'

The virus appears to remain infectious longer than most, however, he added, and doctors had 'a long way to go' to improve its clinical managements. It has exposed the limitations of the world's antiviral armoury, with no cocktail of drugs so far totally effective.

The WHO said it accepted that Anderson's findings were 'likely to be as close as possible to accurate'.

Attention will now shift to helping struggling countries tackle the virus. The speed with which the outbreak criss-crossed the globe demonstrates that no country is safe until it is under control worldwide.

There were particular concerns over Ireland's handling of the crisis, as its doctors voted yesterday to intensify a strike by public health specialists.

Last week it emerged a Chinese woman showing Sars symptoms had been turned away from a hospital in Dublin. Doctors gave her a face mask and told her to return to her hostel. She is now listed as a probable case and her fellow hostel residents are in quarantine.

Sars has now killed at least 293 of the more than 4,600 people infected worldwide. Heads of government from South East Asia, China, Hong Kong, Japan and South Korea are to hold an emergency summit in Bangkok on Tuesday to decide how to tackle the disease.

Yesterday their Health Ministers approved a plan to boost screening at international departure points, to bar travellers with Sars symptoms, and require written declarations of good health from travellers from the affected countries.

Philippines President Gloria Arroyo said she wants the entire region to adopt strict measures like those in Singapore, which jails people who break out of quarantine for up to six months and punishes those who fear they are infected yet go onmixing with others.

China's Health Minister was dismissed yesterday following reports that his country's death toll was covered up in the initial stages.

April 28 - History of SARS - Guardian
The day the world caught a cold

It began in a province of China, spread through Hong Kong to reach three continents and now threatens to plunge the world economy into freefall

Gaby Hinsliff and Mark Townsend in London, Ed Helmore in Toronto and John Aglionby in Jakarta
Sunday April 27, 2003
The Observer

Nursing his pint of Guinness in a bar in downtown Toronto, Mike Smith was sanguine yesterday about his chances of surviving the deadly illness sweeping his native city. 'People have over-reacted,' scoffed the media analyst. 'You have a better chance of being hit by a comet than contracting Sars.'

It is less infectious than flu, rarer than TB, less deadly than cerebral malaria. But the sheer speed with which Severe Acute Respiratory Syndrome has hitched a ride around the planet - from the hinterlands of southern China to more than 26 countries worldwide, including Canada and Britain - has captured public imagination worldwide.

The fear of the millennium's first jetset disease is such that in Hong Kong, citizens scared of touching contaminated surfaces tap their pin numbers into cashpoints using their wallets. In Singapore, webcams and electronic tagging are being used to enforce the virtual house arrest of 2,800 people suspected of harbouring the virus. In London, phones are ringing off the hook at Maxmi, a small online business selling £9.99 surgical masks: it says one foreign embassy recently tried to place a bulk order for millions of them.

What the past week has demonstrated is that for all Smith's optimism, convalescing from Sars itself may be easier than recovering from the shock to global confidence. Only one thing travels faster and more unpredictably than a virulent infection: and that is fear itself.
The story begins last November in the heart of the Pearl River Delta, a once remote rural area of China now booming thanks to the overspill of nearby Hong Kong and a rash of sweatshops producing cheap plastic toys.

The first report of a mysterious pneumonia-type bug was here in Guangdong province, in the small university town of Foshan. One theory is that a shrimp salesman carried it the few miles to the nearby larger town of Guangzhou. However it arrived, by February Guangdong was reporting at least 305 cases, many of them treated at Guangzhou hospital - enough for its respiratory disease specialist, Liu Jianlun, to be familiar with its symptoms.
Which makes the elderly doctor's motives in boarding a bus, late in February, for Hong Kong a focus of speculation. Was he, as his family claimed, simply attending a wedding, or did he suspect he was harbouring something local medicine could not cure?

The doctor checked into a room on the ninth floor of the Metropole hotel in Kowloon. The next day he walked the five minutes to a nearby hospital with a temperature and flu-like symptoms, and reportedly asked to be put in isolation.

If he had hoped to protect others, it was too late. One theory suggests he had a sneezing fit in the hotel lift, another that he inadvertently left traces of the virus on the lift buttons.

However it happened, seven other guests sharing his floor on 21 February caught the virus, making the late Liu Jianlun 'patient zero': the human conduit who unwittingly turned a personal tragedy into a global threat. One of the seven, Kwan Siu-Chiu, a 78-year-old Chinese-Canadian, is thought to have brought the disease home to Toronto, where it has triggered more than 330 cases and killed 19.

A Chinese-American businessman returning home to Hanoi brought the disease to Vietnam, while three young Singaporean tourists who had waited in the same lift lobby infected at least 17 medical staff on their return. Cases have now been reported from the Philippines to Bulgaria.
The first most British doctors heard of the mystery bug was when they clicked open an email on the morning of Thursday 13 March, just days before the Gulf war began. An urgent communique from the Department of Health's chief medical officer, Professor Sir Liam Donaldson, urged vigilance for cases of 'acute respiratory illness' in people returning from Hanoi, Hong Kong or Guangdong, with symptoms including muscle pain, coughing, and high temperature.

Asking for such cases to be reported and nursed using 'barrier' methods to prevent infection, Donaldson concluded: 'The cause of these illnesses is as yet unknown.'

His warning, the day after the World Health Organisation issued a global alert on the bug, proved timely. Six days later - just as the WHO announced in Geneva that it thought the Far East outbreak was probably under control - a London man recently returned from Taiwan arrived at Brent hospital with flu-like symptoms. Britain's first 'probable' case of Sars - meaning the victim has an unusual type of pneumonia, has visited an infected area and has signs of lung damage, although there is no conclusive test - had arrived.

By 5 April, the toll had risen to six probables, the last of whom had never left the country but had met a Hong Kong business contact at the Marriott Hotel near Heathrow. None needed intensive care, and all have now been sent home.

And at their headquarters in the north London suburb of Colindale, the newly-created Health Protection Agency - which formally took over the Public Health Laboratory Service's job of monitoring infectious diseases less than a fortnight after Britain's first Sars case was reported - is now trying to work out if there have been any true British cases at all.

John Watson, head of respiratory diseases at the HPA, said that while all six had been exposed to infected countries, none is thought to have had contact with a definitely infected person. The possibility remains that their symptoms may have been an awful coincidence. Asked if Sars had peaked in Britain, Watson said: 'It is not so much whether we have had a peak as whether we have had anything.'

The media frenzy over Sars in Britain certainly peaked last Wednesday, with the apocalyptic warnings of Dr Patrick Dixon that the syndrome could be more dangerous than Aids, causing a billion cases a year. Chilling stuff: except that Dixon is not an epidemiologist, but an ex-doctor turned trend forecaster running his consultancy from what he calls his 'cyberbubble', the green-painted attic of his house in Ealing.

A more considered verdict based on the Hong Kong outbreak is expected this week from experts at Imperial College, London. They will argue Sars is harder to catch than first thought - and so unlikely to spread so far - but deadlier, with a death rate closer to 10 per cent than the 4 per cent WHO claims.

But in the absence still of many hard and fast answers on Sars, fear has filled the vacuum. Nearly 1,300 Britons worried about catching the disease have rung the hotline NHS Direct. Boarding school pupils from infected countries are spending the weekend marooned in quarantine camps on the Isle of Wight: Shadow Health Secretary Liam Fox has called for travellers from Asia - such as the 30,000 foreign university students due to start their new term tomorrow - to be quarantined and for draconian new powers to detain and forcibly treat suspected cases.

Privately, Department of Health officials are exasperated by such demands. 'Are we supposed to start rounding up 50,000 people a week on the grounds that they have a cold?' asked one.

The British Medical Association agrees, arguing it is unlikely that people told they had a potentially lethal disease would refuse lifesaving treatment. The problem is not complacency but ignorance, it says. 'Sars shows how badly we deal with uncertainty,' said Vivienne Nathanson, the BMA's head of science and ethics. 'The things everybody wants to know are: is it going to come to Britain, how many people will die, when will there be a vaccine, will we have to live with it for ever - and the answer to all of these is simply: we don't know. A month ago it didn't exist here.'

Dr Michael Fitzpatrick, an east London GP who will lecture on health panics at a conference in London next month, says Sars fits a pattern of modern over-reaction to scares from bioterrorism to global warming.

'As there is a sense of people being more isolated and atomised in society, they are more turned in on themselves,' he said. 'People are obsessed with their bodies, whether they are exercising it, or tattooing it or having plastic surgery on it. Studies show that people feel more ill in western society than they do in Africa, although they clearly aren't.'

But there is a good reason why Sars has captured public - and medical - imagination. For years doctors have feared the emergence of a 'doomsday scenario': a new, contagious, hard to treat virus that would traverse the globe rapidly and kill millions, as Spanish flu did in 1918.

'Sars gave the infectious diseases people a fright because they are always looking around for the next Black Death to appear,' said Dr Joe Neary, chair of the clinical network at the Royal College of GPs. 'But it doesn't have the ingredients that would make a new global pandemic. It kills people, but very few. This isn't it.'

That does not, however, mean something far nastier is not lurking now in a remote corner of the planet. Since the early 1970s, at least 30 previously unknown infections have emerged worldwide, from an outbreak of plague in India to BSE in Britain.

Such new infections have always been with us. The difference is that 21st century humans offer them unparalleled chances to spread: two million people a day cross international borders, an unstoppable tide of human movement allowing versatile microbes - the corona-virus thought responsible for Sars belongs to a group of viruses that mutate unusually rapidly - to leap thousands of miles within hours.

'In historical times, these would have been local outbreaks that would not have spread, but cosmopolitan life means there is a route out,' said Professor Ian Jones, virologist at the University of Reading. 'If you were on a ship years ago and were sick you would go to the sick bay. Nowadays you get off a plane and you may feel awful but you haven't been isolated until it's too late.'

Hong Kong offered the virus an almost uniquely fortuitous mix of crowded living conditions and a huge pool of international travellers to export it.

Prophetically, the city was singled out as an example of how a new pandemic might start in a report by Prof Donaldson last year, Getting Ahead of the Curve. An outbreak of 'bird flu' in Hong Kong - where a virulent chicken virus infected a child sparking a human outbreak - was halted only by the slaughter of 1.6 million birds. The report added: 'Further newly emergency infectious diseases are inevitable. It is essential to expect the unexpected.'

Like bird flu, Sars is thought to have jumped the species barrier from either birds or pigs to humans, probably in rural China where humans and animals co-exist closely. Most 'jumpers' simply do not take: it is homo sapiens' bad luck that the new coronavirus, another form of which causes breathing difficulties in premature babies, did.

With a safe, clinically available vaccine up to seven years away, the best answers 21st century medicine can now offer are the old-fashioned remedies that helped eradicate smallpox - swift diagnosis, identifying contacts of the infected person, isolating them until they recover - and the knowledge that Sars will almost certainly not be the last such outbreak. 'We get new infections every year or so. Our expectation is that new things will continue to crop up,' says Watson.

But one of the nastiest stings in the tail of Sars is that in a globalised economy, it may infect human wealth just as much as human health.
Rod Eddington, the chief executive of British Airways, should have been in a good mood as he travelled in his chauffeur-driven car from home near Maidenhead to Heathrow last week. After a series of desperate disasters for the airline industry - foot and mouth, the 11 September atrocity, and two wars in the Middle East - the fall of Saddam finally looked set to trigger a much-needed rush of renewed bookings.

Then the 6.30am radio news bulletin announced that Sars had claimed another three lives in Hong Kong, a premier business destination. To make matters worse, it was his industry that was spreading the killer disease. 'This is the worst crisis the aviation industry has seen. It has been two years of non-stop bad news, and now this,' he said last week.

Passengers trooping off flight Air Canada 848 from Toronto yesterday, some wearing facemasks, will have given him little cheer. 'I had a head cold and I was scared that if I coughed in London, they would take me to court and lock me up,' said Sean Rogers, 24.

The old economists' axiom about recession is that if America sneezes, Europe catches cold: but this time it is Asia sneezing and the rest of the planet who may soon be sniffling over falling stock markets. The Bank of Canada has already slashed its economic growth projections for this year, while the City has revised down forecasts for China.

In London's normally bustling Chinatown, no reservations were required last week. One restaurant manager said a couple chomping noodles in the corner were his only clients during one of his busiest periods. In Toronto hotel occupancy is down to 30 per cent. 'You can clear a subway car with one cough,' says health worker Michael Greenway. 'Some people think it's the black plague. But it's not. It's like a bad case of the flu.'

One British health worker recently returned from the Far East was left shaking his head over the behaviour of a fellow passenger during a brief stopover in Singapore. 'He got off the plane wearing a surgical mask, and then asked where he could go for a smoke,' he added. 'A cigarette is a lot more likely to kill him than Sars. Now what does that say about our assessment of risk?'

April 27: Official figures, see below.... 2 new cases each day in Zhaoqing....
People in Zhaowing  are now taking more precautions.....going out less often....washing hands more often....CAS canteen staff now wearing masks.....CAS students not allowed home today for holiday.....parents access to students very restricted....
CAS  scheduled to continue till Wed (April 30) then 5 days holiday.....then?? 
Zhaoqing media still not allowed to report real situation....official figures very suspect.....and places in the city that have had a case are getting away without  dis-infection  "because there wasn't any infection.."
Four USA teachers working at Zhaoqing Univesity have returned to USA....as have many other overseas teachers from many other parts of China. Staying or going is an individual decision for CAS teachers at this stage....at this stage everyone wants to stay....there is no pressure to go, no pressure to stay. May the Good Lord help us all to make the right decision...
Best guidelines: Fr McMahon's words in AITECE update April 25 below

From AITECE 2003-04-25
Dear AITECE Teacher, 
My letters are getting more frequent as developments and concerns increase. So far the feed-back from the teachers is reassuring All are still at their posts though in some college classes have been suspended for two weeks. In most cities primary and secondary schools seem to have closed down for a month at least. 
In many of the universities the Foreign Affairs Office has had a meeting with the foreign teachers to explain the situation and has offered them herbal medicine, disinfectant for their rooms and a thermometer to check whether they are over 38 degrees. They also ask the teachers and student to stay on campus and not to travel to other cities.
At this stage there is plenty of good advice going around . Embassies and other groups issue pages of information. I see that the Irish Embassy wants all its citizens to register and gives a number of websites to consult. One site worth looking at is www.who.int for a general view of the situation.
Many of the precautions now being taken on the mainland are similar to those Hong Kong began taking two to three weeks ago and maybe that is a sign that the mainland is now going through what Hong Kong experienced then. In that case I would expect that there will be an increase in anxiety and cases over the next two weeks and then people will be more prepared to live with it. Behind this optimism, there is always the possibility that sars indeed is a major outbreak and if that is true everything is going to change. So we will just have to wait and see. 
If anyone feels under too much pressure I urge them to discuss the situation with their Foreign Affairs Office and consider leaving. Also, continue to take precautions and if any suspect symptoms occur report them immediately. I hope that you are living in one of the quieter areas and that the emergency does not limit your activities too much. Take care and stay in touch. With every best wish,  Hugh.

April 25: Mr Ma, CAS principal, has strongly recommended that overseas teachers not leave the CAS property unless really necessary

April 25 - Update from British Consulate General, Guangzhou:
On the basis of data available from the Guangdong Health Department there were 15 new cases of SARS reported in Guangdong yesterday , with 11 cases in Guangzhou, 2 each in Zhaoqing and Huizhou. 14 people were discharged from hospital and 1 new SARS deaths occurred. Cumulative totals for Guangdong are 1374 confirmed SARS cases, 1173 patients discharged and 50 deaths.  In addition there are 127 suspected SARS cases in Guangdong. 1 new case of SARS has been reported in Guangxi. Cumulative totals for Guangxi are 16 cases of SARS and 3 deaths. 

BRITISH CONSULATE GENERAL GUANGZHOU
SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

Updated information as of 24 April 2003 

The UK Department of Health and Foreign & Commonwealth Office have
amended their travel advice to strongly advise against travel to Hong
Kong, Beijing, Shanxi and Guangdong Provinces in China. Advice for the
rest of Mainland China remains unchanged.
Chinese authorities have now reported a cumulative total of 2305 SARS
cases with 106 deaths.

On the basis of data available from the Guangdong Health Department
there were 15 new cases of SARS reported in Guangdong yesterday with 6
cases in Guangzhou, 6 in Jiangmen, 2 in Zhaoqing and 1 in Zhuhai. 13
people were discharged from hospital and no new SARS deaths were
reported.  Cumulative totals for Guangdong are 1359 confirmed SARS
cases, 1159 patients discharged and 49 deaths.  In addition there are
102 suspected SARS cases in Guangdong.

1 new case of SARS has been reported in Guangxi (next to Guangdong). Cumulative totals for
Guangxi are 15 cases of SARS and 3 deaths.  

2003-04-23 Zhaoqing Update - news which is still not really public (despite Beijing orders to make everything public...):
Since the Spring Festival (February) more than ten (10) people have died in Zhaoqing County (about 6 in Zhaoqing city)...about another 10 are in hospital....
The 6 in Zhaoqing city: a girl who worked in A-Best shopping centre, 2 secondary students from Zhaoqing Middle School (No. 3 School), 2 factory workers
This report is doubted by many people, especially people in official positions...but the source of this report is most reliable....we are now taking extra precautions (...not going out of CAS property so often etc...). Anyone who doesn't live on the property is given a temperature check on entering (..as is done for all students at the start of each day..)  April 26: this report re-confirmed by local source

From AITECE 2003-04-22

Dear AITECE Teacher,     I hope you had a chance to celebrate Easter even through you had no extra time off. Here people are not traveling as much because of the SARS so the number at celebrations and at local resorts has gone up. 
Today the secondary schools are re-opening with the other schools following soon. Last week the universities started again. Yesterday the death toll for SARS in Hong Kong was six and the total of new cases was 20. The situation seems to be stabilizing but it can change from day to day so we can only monitor the daily progress.

On the mainland wider public knowledge of, and concern for, SARS must have reassured you to some degree. We have not heard of any outbreaks in any of the universities in which our teachers live. Unfortunately, this is the time of year when the more typical flu breaks out and the symptoms are similar to those of SARS : a fever of over 38 degrees, a headache across the forehead, a dry cough, breathlessness, a sore throat, muscle and joint aches and sometimes diarrhoea. I know a number of teachers had those symptoms and were happy to discover they were only ordinary flu but if you get such symptoms, rather than waiting to see how they develop, it is important to inform your waiban and see a doctor immediately. If the disease is discovered early and treated immediately there is a far better chance of quick recovery.
Some, if not most, universities have brought the foreign teacher together to brief them on the outbreak so they are quite aware of the dangers. If you have reason to be seriously concerned about your own safety you should tell your waiban or Foreign Affairs Office representative and decide with them whether you would be better leaving. You are probably aware that, because of SARS fears, a number of countries will quarantine people from SARS-affected areas for 10 days.

As I indicated above, here people are accepting the reality of SARS and getting on with their lives. I hope that is the situation on the mainland also and that, with the warming of the weather, the danger will pass over soon. In the meantime, keep in touch and take good care. With every best wish,   Hugh and all in Hong Kong.

April 22: Two suspected cases  of SARS (one a policeman) in local village below CAS. But local people getting on with life and not canceling events.  In Beijing all schools will close for 2 weeks from tomorrow (?)

April 17, from British Consulate General, Guangzhou:

On the basis of data available from the Guangdong Health Department the SARS problem peaked in Guangdong around 18/19 February and has continued to decline thereafter. From 11 to 15 April, 47 new SARS cases were discovered in Guangdong Province, with 34 in Guangzhou, 10 in Shenzhen and 1 each in Shanwei, Heyuan and Shaoguan. As of 15 April, 1077 patients (or 83.7% of the total of people infected by SARS) have been discharged from hospital.

From AITECE 2003-04-16

Dear AITECE Teacher, I hope you are well and keeping up your immune system. Here in Ground zero life goes on as usual. The name Ground zero has been given to the Metropole Hotel (near us) because the first case in Hong Kong was traced to it and also a number of subsequent cases -- the American teaching in Shenzhen who died from SARS last week had also stayed in the hotel. Indeed, is seems SARS is referred to as the Hong Kong disease on the mainland and people believe it is mainly restricted to here and nearby Guangdong. 
The present situation is that yesterday there were 40 new cases here and seven deaths , bringing the total to 1190 cases and 47 deaths. Most of the deaths have been among the old and those with chronic diseases but in the last few days some of the deaths have been among younger people and those who seemed to be disease free. Over a quarter of those infected lived in two blocks of Amoy Gardens apartment building and another third are medical staff. The sporadic nature of the disease's spread and the comparatively low numbers in comparison to the general population are reassuring, as are the personal and public precaution being taken.

However, much about SARS is still unknown and until those investigating it get a better idea of its nature and how to treat it, people will continue to be anxious. You may have heard that last week the Peace Corps recalled its volunteers from China and also the Maryknoll Program recalled its teachers (most of them were in Guangdong). So far we have not heard of any outbreaks in the areas in which our teachers are active but if you hear any such news or have reason to be worried let us know. Here, in Ground zero all continue to be well and are not too worried. Being careful of possible infection contacts and keeping up one's immune system are the two best precautions. The Easter holiday is a time of hope and new life so celebrate by giving yourself a treat,  eat something nice (and nourishing) and sleep a little longer.   With every best wish,     Hugh and all in the Hong Kong office.

What has surprised doctors in Hong Kong, though, is that six of the people who died recently were relatively young with no other illnesses. Until now, many of the fatalities have been elderly people or patients suffering from other chronic health problems, such as heart or kidney diseases.

Doctors in Hong Kong have begun prescribing heavier doses of medicine during the early stages of Sars - severe acute respiratory syndrome.

Prior to the most recent deaths, Hong Kong officials had said that most patients without aggravating health conditions seemed to respond well to a treatment of anti-viral drugs and steroids.

The acting director of Hong Kong's hospital authority, Dr Ko Wing-man, warned of the potentially severe side effects of increasing doses of medicine for heart, blood and kidney problems.

The senior executive manager of the hospital authority, Dr Liu Shao-haei, said on Monday that some of the younger patients were hospitalised when they were already in a serious condition, and their health worsened even after they received intensive care.

Despite efforts to find an effective treatment for the disease, an expert expressed concern that the virus has mutated after he observed that patients at the Prince of Wales Hospital, which was hard-hit by a Sars outbreak, displayed differences in infectiousness, symptoms and the severity of their illness.

Early investigations had revealed that the virus believed to be causing Sars had "mutated, but not to a great extent", said Stephen Tsui, a biochemist at the Chinese University of Hong Kong on Monday.

"We want to find out whether it's because the virus is different that causes such differences," he said. "If we can figure that out, we can then predict which patient will be afflicted more severely."

Hong Kong reported 40 new cases on Monday, bringing the total number of infected people to 1,190. Some 229 people have already recovered.

Previous updates: see Diary in days before April 14