The New Bird Flu In China Is Creating A SARS-Like Scare
"WE REALLY only have sporadic cases of a rare disease, and perhaps it will remain that way." The soothing words of the World Health Organisation's representative in Beijing, Michael O'Leary, on April 8th are still the prevailing view of H7N9, a new bird-flu virus that has killed at least nine people in China since March.
But even if it does not develop into a pandemic, the outbreak is putting China's new leaders under the spotlight. The coincidence of H7N9's emergence with the tenth anniversary of a China-centred epidemic of severe acute respiratory syndrome, or SARS, has not been lost on Chinese commentators. Legal Weekly, a Beijing newspaper, noted: "As more details of H7N9 flu cases are revealed, the shadow of SARS a decade ago is again spreading over the hearts of our countrymen."
The government's initial cover-up of SARS facilitated its rapid spread. By the time it faded away later in 2003, the virus had killed more than 770 people, over 80% of them in China (including Hong Kong). It also caused great disruption to business, preventing many from travelling to and within China.
SARS embarrassed China's then recently appointed leaders, Hu Jintao, the president, and his prime minister, Wen Jiabao. Ten years on, their successors, Xi Jinping and Li Keqiang, to whom the transfer of power was completed last month, are doubtless anxious to avoid a similar start to their time in office. A pandemic, or SARS-scale epidemic that is blamed on a cover-up or bungling by officials would cause serious harm to the country's reputation abroad. It could also fuel resentment in China of the Communist Party. It would be the first widespread health emergency since the take-off of social media, which have given Chinese people unprecedented opportunities to share their grievances.
So far the government's response has appeared far swifter and more open than it was in 2003. Mr O'Leary said the WHO was "very satisfied and pleased with the level of information shared" by China. After the first two deaths were reported on March 31st (both of them in Shanghai), the authorities looked for the virus among live poultry sold in the city's markets. When they found it, they were quick to close the markets and cull thousands of birds. By the time The Economist went to press, 33 people had been found to have the virus (including the nine who died). All of these cases were in Shanghai or in surrounding provinces, where the authorities have also been culling birds and stopping sales of live ones.
The public's response, however, suggests the government still has some way to go before ordinary people trust it to respond effectively. Even though no cases of the virus's transmission between humans have been reported, many people in Shanghai and the affected regions nearby are jittery. Pharmacies have been emptied of their stocks of a traditional flu medicine called ban lan gen, despite its dubious worth in dealing with H7N9. Sales of chicken in all forms have plummeted. McDonald's in Shanghai has responded by cutting the price of its Chicken McNuggets.
The bird-flu scare has hit the city at a bad time, with many citizens still distrustful of the authorities after the dumping in March of 16,000 dead pigs into tributaries of the Huangpu river. The government has still not said what killed the pigs, although it says it has found no trace of H7N9 in those tested for the virus. That the second H7N9 fatality was a pork butcher has done little to reassure the public.
Even in the official media, questions have been asked about why 27 days elapsed between the first death from H7N9 and its public announcement. The authorities say it took that long to confirm the cause, because the virus had never before been identified in humans. They have not explained, however, why on March 7th, three days after the first death, health officials in Shanghai denied rumours in social media that people had died of bird flu in a local hospital. One man was later proved to have died there of bird flu, along with one of his sons who was not found to have the virus. Despite official denials, suspicions remain that this could have been human-to-human transmission.
Time to come clean
Since SARS, the central government has stepped up efforts to prevent local authorities from trying to conceal outbreaks of infectious diseases (before 2003 local officials commonly did so in order to protect their economies from the impact of culling or quarantine). In 2007 it ended a ban on unauthorised media coverage of public emergencies. In 2008 it introduced a law requiring local governments to release non-secret information to citizens who request it. But a culture of secrecy still pervades the handling of crises. A search of Chinese government websites reveals several local regulations that stress the importance of reporting outbreaks of disease to higher levels, as well as the need to uphold secrecy. Rules published by a township in the north-eastern province of Jilin last July ban the release of any information about bird-flu cases without authorisation from the local government's bird-flu prevention office.
Ever fearful of the growing power of social media, police have been rounding up people they say have used such tools to spread rumours about H7N9. Caijing, a Beijing magazine, said that at least 13 people had been jailed so far.
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