(by Vice Mayor Li Zhuobin at the Briefing organized by News Office of Guangdong Provincial Government, May 22nd ,2003)

Dear friends,

Good morning! In late January this year, an infectious disease, SARS (severe acute respiratory syndrome), broke out in Guangzhou, which has aroused great public concern. Today, I am very delighted to give you this briefing on the key developments of the outbreak in the past few months as well as the major measures that have been taken to contain SARS.

I. Epidemic Outline
By May 19, the total number of reported SARS cases is 1,273, among them 1,149 were cured and discharged from the hospitals with a cure rate of 90%. There were 43 deaths, with a mortality rate of 3.4%. Currently, there is one severe case among all the hospitalized SARS patients.

The SARS outbreak in Guangzhou can be divided into three stages. It initiated in January (26 cases), peaked in February (637 cases with up to 56 cases in a day), and gradually declined thenceforth. There were 338 reported cases in March, 46.9% fewer than February. The number of SARS cases continued to drop in April, with 179 confirmed cases and 47% fewer than March. In the past 11 days, the total number of reported cases in 8 with the daily new cases less than 3. There were 7 days with zero case report. In general, the SARS outbreak has now been effectively under control with only sporadic cases reported.

¢ò. Major Prevention and Treatment Measures

(¢ñ). Commanding organizations have been established and strengthened and responsibility system imposed on leaders at all levels. After the outbreak of the epidemic, top officials of the Party and the State Council as well as those at the provincial level have expressed their great concern. The Party's Secretary General Hu Jin-Tao, Premier Wen jia-Bao gave important instructions several times and came to Guangzhou to inspect our work and visited the medical professionals. Mr. Zhang De-Jiang, Secretary of the Party's Committee in Guangdong and Governor Huang Hua-Hua went down to the frontlines of the fight-back against SARS in Guangzhou several times and gave detailed instructions. With a view to protecting the citizens from the disease and maintaining the social stability, the Party's Committee in Guangzhou and the Municipal Government of Guangzhou have firmly carried out the instructions by the state and provincial leaders, and adopted positive measures to contain SARS. A commanding group was established to cope with the epidemic in Guangzhou and a panel meeting system set up to discuss the latest developments in the prevention and treatment of the disease once a week. Furthermore, governments at district and county levels accordingly set up their own commanding groups and coordination mechanism to take care of the prevention and treatment work in places under their jurisdiction. In order to enhance the capability to handle emergencies, Guangzhou SARS Emergency Office was recently established and located in the General Concierge Office of the municipal government to be on 24 hour duty to handle the emergent cases. Governments at district and county levels also set up the same organizations and network accordingly to be on 24-hour duty to report and handle the epidemic timely.

(¢ò). Close cooperation has been established between different government departments form strong adherence. The fight-back SARS has now entered a crucial stage, and Guangzhou is the main battlefield. The municipal government has recently made an appeal to fight for the health of the citizens and obtain the complete victory of the battle against SARS forwarded by Party Secretary Zhang De-Jiang, and organized three major campaigns patriotic sanitation campaign, healthcare education campaign, and people exercise campaign. Different departments and institutions actively participated in the patriotic sanitation campaign, which has been greatly conducive to the improvement of the public health. All the resources in the city, those of healthcare especially, were reallocated to contribute to the prevention and treatment of the disease. Governments and institutions at all levels within the municipality were requested to work interdependently under the leadership of the Party s Committee and the Municipal Government of Guangzhou. The healthcare departments played an important role in the fight-back against SARS, whereas other government departments of education, labor and social security, finance, planning, science and technology, sanitation, transportation, tourism, commerce, medicine inspection, workers union and the media rendered close cooperation and support.

(¢ó). Medical professionals have been devoting themselves untiringly to the treatment of the disease, regardless of their own safety. The No. 8 People s Hospital, Guangzhou Thorax Hospital, and the First Affiliated Hospital of Guangzhou Medical College used to accommodate approximately 60% (up to 70%-80%) of all the SARS patients in Guangzhou. Despite of knowing that the disease is infectious, the medical staff stood fast at their posts and went all out to rescue the patients around the clock at the risk of their own lives. They have made great contributions in saving the patients, hygiene prevention and scientific research. They are the hero of the new century and guardians of the people. When asked to dispatch some medical staff to support these hospitals, all the other hospitals responded positively and sent their key staff. The Respiratory Research Institute of the First Affiliated Hospital of Guangzhou Medical College received many SARS patients who were severely ill and also undertook a lot of medical consultation missions outside. Yet under the leadership of Mr. Zhong Nan-Shan, the medical staff put forth great efforts and worked out 5 principles in the treatment of SARS early discovery, early report, early isolation, rational use of hormone, and rational use of respiratory machine, which proved to be effective in rescuing the majority of the severely infected patients in Guangzhou. While summarizing the helpful experience in the prevention and treatment of SARS, our medical professionals have also rendered large amount of medical support to the other provinces. To date, we have sent 32 medical professionals in 10 groups to 8 provinces and cities including Beijing, Shanghai, and Hebei to support the local combat against the epidemic. The fearless, professional, devoting, rigorous, and team spirit displayed by the medical workers is indeed a vivid reflection of the Guangzhou spirit in the new century.

( ¢ô). Rescue and treatment of the SARS patients have been effectively organized while the reception and treatment system has been gradually standardized and improved. At the early stage of the outbreak, the No. 8 People's Hospital, the Respiratory Research Institute of the First Affiliated Hospital of Guangzhou Medical College, the Third Affiliated Hospital of Sun Yet-Sen University, and Nanfang Hospital were appointed to accept and treat the SARS patients. Later on, the Thorax Hospital and the No. 1 People's Hospital were also added to the list. Medical workers and equipment were reallocated from other hospitals to give support. The municipal government also appropriated special funds for the relevant hospitals to purchase the required medical equipment and materials to ensure the smooth going of the rescue and treatment work. With the increase of the number of patients, some other qualified hospitals at or above the district level were also organized to receive SARS patients so as to ensure the timely and adequate treatment of all patients. Recently, the Central Committee of CPC and State Council's have acknowledged the guideline of "sum up the experience, consolidate the achievements and prevent the rebound in those places that have made effective progress". With Guangzhou being at the high risk season of respiratory epidemic, the city government has accordingly stipulated the "Decision on Strengthening the Prevention and Treatment of Atypical Pneumonia (SARS) by Guangzhou Municipal Government" on the basis of "Preventive Law on Infectious Diseases of People's Republic of China" and "Implementation Measures of the Preventive and Treatment Law on Infectious Diseases of People's Republic of China" to standardize and improve the receiving and treatment of SARS patients and protect the health of the people. The government has established the Medical Resource Allocation Center to deploy various medical resources in Guangzhou and carried out categorized receiving and treatment on both the patients and their close contacts. It has also designated first-rank and second-rank receiving and treatment units and medical observation units. The system of receiving, treating and transferring patients and those suspected is on continuous improvement. The hospitals have set up fever outpatient clinics according to the Working Guideline of Receiving and Treating SARS Patients to ensure timely treatment of suspected patients. Both the new confirmed and suspected cases were isolated and treated in accordance with the requirement of National Health Ministry and the Guangdong Provincial Government. Patients who met the criteria of severe case were closely monitored and their wards were strictly sterilized as demanded. Lately, directors of designated hospitals held daily meetings for better communication and coordination as well as timely and complete information about the disease so as to implement all preventive and curative measures. In accordance with the requirement of "dispersed clinic consulting, concentrated receiving and treatment", eight hospitals were appointed to receive and treat new confirmed cases. The 8 hospitals, together with other 39 hospitals were divided into 12 groups and under the unified command and coordination of Guangzhou Medical Resources Allocation Center. In this way the receiving and treatment network was improved.

(¢õ). Set up and improve disease prevention and control mechanism such as disease monitoring and report system, epidemiological study as well as isolation and sterilization system and ensure their implementation. Guangzhou has established epidemic monitoring network and a "zero report system" in the early stage. Disease Prevention and Control Centers (DPCC) at municipal, district and county levels were organized to engage in the control of the disease and intensify the epidemiological survey on the new cases, suspected cases and their close contacts. Based on the epidemic evolution and various cases distribution in districts, medical and disease control staffs were allocated under unified command. Districts with few cases to handle supported those with more cases. Mutual supported and cooperation was forged to conduct survey on all cases and suspected cases, carry out medical observation on their close contacts and disinfect their houses and work units. An observation and isolation model based on the household with the involvement of community was created, ensuring effective isolation and observation and social stability. Recently, with the application of "aero distance" epidemiological survey, DPCC staffs were sent to designated hospitals to find, report, isolate and treat SARS patients at an early stage. Control of infection source from the very beginning helped to contain the spread of the disease. After an inspection tour to Guangzhou, the World Health Organization (WHO) experts highly praised the efforts and achievements the city has made, thinking that its epidemic information and data were accurate and convincing and the effective practices explored by Guangzhou experts and doctors could be referred by the rest of the world.

 (¢ö). Bring the experts'role into full play and improve the prevention and treatment level. Shortly after the outbreak of the disease, Guangzhou has established medical expert group, epidemiological study group, pathogen -- inspection expert group, who were to analyze the disease, work out prevention and treatment guidelines and measures to serve as a reference for the government and medical authority. After medical research and tests,17 prevention and control guidelines were made, covering the areas of clinic diagnosis as well as the disease prevention at hospitals, community, public places, countryside, enterprises, vehicles, subway, stop -- over places, swimming pools and radiology departments of hospitals. A series of mature and systematic preventive and treatment guidelines was formulated. At the same time, clinic experts were organized to discuss all the severe and fatal cases to explore and summarize
treatment methods. They gradually worked out the clinic diagnostic criteria, severe case criteria, treatment and discharge criteria and a relatively mature treatment method to increase the recovery rate and reduce mortality rate. Recently the medical experts group has conducted research on the protection of medical staff, establishment of fever clinic and wards for suspected patients and the  establishment and operation of wards for confirmed patients. Relying on the strength of the experts, focus was put on confirmation of cases, exclusion of suspected case and saving severe patients. Medical experts in both Guangdong Province and Guangzhou city conducted group consultation on all the hospitalized patients. Confirmation of a new case and exclusion of a suspected case were based on the opinions of at least three experts. As for severe and fatal cases experts made group consultation to work out effective treatment plan to save them.

(Vll). Launch promotion campaigns to improve the awareness of prevention and treatment methods of SARS. The action plan of the campaign included a serial of health education campaign entitled " Every Person Joins in the Prevention of the Disease", the Third Health Education Week, a photo exhibition of health education and expert consultant activities. On April 29, the 24 - hour hotline was opened. Expert Dialogue Programs and various forms of education and promotion activities on SARS prevention and treatment were held with the help of the media. A total 120,000 copies of "Guidelines on SARS Prevention and Control in Guangzhou" was compiled and distributed. Moreover,4.5  million pamphlets on prevention of SARS, digestive communicable diseases, cholera and dengue fever and on prevention and control of mosquito have been compiled and distributed to each student, who would impart the knowledge to their family members. 600,000 copies of 11 Guidelines on SARS Prevention and Control in Rural Areas" have been compiled and distributed to each rural household and 1. 39 million copies of promotion materials have been distributed to every township enterprise and school in the countryside. At the mean time, training of medical staff on the knowledge of SARS prevention and treatment has been further strengthened. Staff at municipal and district levels trained has totaled 3,000 person -- times. Medical and health agents in county -- level cities have also arranged trainings for their staff.

(Vlll). Schools, public places, rural areas and communities have been the centers of prevention work. The government departments of health and education work closely in the measures of morning physical test, case report, isolation treatment for suspected cases, overall sterilization in the schools, and health education for teachers and students. As the result, the spread of the disease has been prevented effectively. In addition, according to the guidance of preventing SARS in public places and public transportation, different government departments work together to ensure the carrying out of a series of measures. In the last ten days of late April, 1600 health inspectors had been distribute to examine the public places such as department stores, hotels, restaurants, subways and schools, kindergartens and hospitals in the areas of environmental sanitation, circulation facilities, cleanliness and disinfections, cleansing of filters of air conditioners. Problems had been solved promptly. Through the carrying out of the prevention measures, supervisions and surveillance, the spread of SARS in schools and public places have been prevented effectively. In order to prevent the spread of the disease in the rural areas, the guidance of the prevention and treatment of SARS in rural areas and & relevant working systems have been drafted and established. Furthermore, 6,800 medical professionals in the rural areas have been trained and a network of case reporting, receiving and treatment was established. The district and county governments drafted the working plan of the prevention and treatment of the disease according to their own situation, set up leading groups of different levels to take different responsibilities. The governments of municipal, district or county and town levels set up surveillance groups to supervise the carrying out of the preventionand treatment measures.

(IX). All means were made to ensure the hygiene safety of Guangzhou Trade Fair. The opening of 93th Trade Fair during that special time indicated the faith in the health security work of Guangzhou and it was also a test for the government. In order to ensure the success of the Trade Fair, we organized complete and thorough plans to strengthen the prevention and treatment measures. First, a working group of health security was established, which drafted the implementing plan for the health security of Guangzhou Trade Fair with detailed arrangements for the designated  hospitals for the people who attended the Trade Fair, and the handling measures of discovering SARS patients in the Trade Fair. Second, 8 working guidance of health security for the public places, receiving guests units, exhibition halls, trade groups, transportation, medical facilities, individual health and food poisoning accidents were compiled and distributed. It was requested that the hotels, which receive guests, the exhibition halls and the transportation, should be disinfected every day. Third, the working mechanism of case reporting and emergency reaction system for the epidemic was established. 34 medical teams were sent to the receiving guests unit. And each trade group, medical clinic and exhibition room had responsibility person, who was responsible for the close surveillance of the health condition of the people attending the Trade Fair. Green passageways were set up indesignated hospitals for the immediate isolation of suspected cases. Other than that, the municipal and district centers for disease control and prevention had a clear division of responsibility and improved the mechanism of epidemic investigation, case reporting and emergency handling measures. Forth, medial professionals were trained to carry out the prevention measures. The chief medical staffs of 109 receiving guests units, medical clinics, trade groups, and exhibition centers, restaurants operators, health inspectors, and the assigned medical professionals to the exhibition center were trained separately. Fifth, supervisions and implementation of the measures were strengthened. The medical clinics in 84 receiving guests units and exhibition halls were inspected in the fields of catering, sanitation of guest rooms, ventilation facilities, and disinfection. Problems were discovered and solved promptly. The district and county level governments also inspected the hotels and restaurants under their jurisdiction, so that the cases prevention and reporting work could be done well.

Furthermore, the disinfection situation of taxis and public transportation was spot-checked. Sixth, health education for those who attended the Trade Fair was organized. The guidance of disease prevention was distributed to each attendant. Through the careful administration and implementation of the measures, the health security of the Trade Fair was protected effectively to ensure the success of the Trade Fair. As a result, there had been not a single case of the attendants who contracted SARS. The prevention measures had been proved to be successful.

(X). Most of the citizens have maintained a mature and healthy psychological state against the SARS epidemic. Being faced with the epidemic came all in a sudden, most of the citizens have shown a sound attitude, which reflects the contemporary spiritual feature as the people of Guangzhou to the world. The citizens of Guangzhou deserve high praise during this unexpected epidemic. Guangzhou people have remained calm at the fall of this disaster with the spirit of respecting science and being practical and realistic. No school class stopped, no factory operation ceased, no markets closed, the government carried on their work and the flow of transports and people could be seen everywhere as usual. All these above proves that Guangzhou people are relatively mature and of rationality and they can outlive the critical times. What Guangzhou has achieved against SARS and its people did have made it standing out across the state.During the work of prevention and treatment of SARS, the CPC Guangzhou Committee and the Municipal Government have strengthened the leading role in the work of disease prevention and treatment, sticking to the human - oriented principle that the health and lives of the citizens should be taken into account in the first place, and taking the attitude of being fully responsible to the people. The medical professionals bear no effort to work on the epidemic control and treatment, in the spirit of humanitarian of healing the wound and rescuing the dying and the dauntless heroism. Now, the fighting against SARS reaches the vital period. Under the leadership of the center and provincial government, we shall continue the following measures to fight for the people's health according to the requirements of high attention, intensified measures, overall prevention and treatment and avert rebound. We will keep on working hard on the implementation of prevention and treatment measures in order to stem the spread of the disease. Communities, schools and rural areas will remain the center of the prevention work. In addition, the medical resources of Guangzhou will be allocated as a whole in order to improve the recovery rate and reduce the mortality rate. Furthermore, experts will be organized to tackle the key scientific and technologic difficulties to achieve new breakthrough in locating the infectious origin and cutting the route of infection.

Editor: Wings