Cablegate: Cdc Finds Hong Kong's Influenza Preparedness

VZCZCXRO0647
RR RUEHCN RUEHGH RUEHVC
DE RUEHHK #1985/01 3000007
ZNR UUUUU ZZH
R 270007Z OCT 09
FM AMCONSUL HONG KONG
TO RUEHBJ/AMEMBASSY BEIJING 3636
RUEHC/SECSTATE WASHDC 8820
INFO RUEHOO/CHINA POSTS COLLECTIVE
RUEHPH/CDC ATLANTA GA
RHMFIUU/DEPT OF HOMELAND SECURITY IA WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC

UNCLAS SECTION 01 OF 02 HONG KONG 001985

SENSITIVE
SIPDIS

STATE FOR EAP/CM, OES/IHA, MED, CA/OCS/ACS/EAP
STATE PASS TO ENVIRONMENTAL SCIENCE & TECHNOLOGY COLLECTIVE
HHS PASS TO OGHA, NIH/FIC
CDC ATLANTA PASS TO BLOUT, KELLY, COX
BEIJING FOR CDC, HHS HEALTH ATTACHE AND RMO

E.O. 12958: N/A
TAGS: AMED CASC CH HK KFLU PREL SOCI TBIO
SUBJECT: CDC FINDS HONG KONG'S INFLUENZA PREPAREDNESS
SECOND TO NONE

REF: HONG KONG 1109

1.(SBU) SUMMARY: In meetings in Hong Kong, USCDC and Embassy
Beijing Regional Medical officers found Hong Kong,s
influenza surveillance and monitoring system &second to
none8. Hong Kong,s tragic experience during the SARS
crisis in 2003 shaped its current robust influenza
preparedness and response regime. The Government,s
political will, active development of technical expertise,
and devoted resources have created the infrastructure that
makes Hong Kong a model for pandemic preparedness. While
Hong Kong,s initial reaction to H1N1 may have been overly
aggressive, local officials and experts credit the measures
with delaying community transmission of the virus. Hong Kong
researchers and health officials regularly exchange infection
surveillance data with their Mainland counterparts, but
official-level coordination is still limited. The lack of an
effective pandemic monitoring system in China also limits the
exchange of reliable surveillance data. END SUMMARY

2.(U) Dr. Jeffrey McFarland, Country Director for the Centers
for Disease Control and Prevention (USCDC) in Beijing and Dr.
Wayne Quillin, Regional Medical Officer at U.S. Embassy
Beijing, visited ConGen Hong Kong on October 19 as part of
regional briefings to mainland China posts and Hong Kong on
H1N1. They held outside meetings with Dr. Malik Peiris, a
prominent HK University influenza scientist, and health
officials from the Center for Health Protection (CHP)and the
Hospital Authority(HA).

Hong Kong,s Initial H1N1 Response was Aggressive but
Effective
--------------------------------------------- ------

3.(SBU) Dr. Malik Peiris, Scientific Director of the
HKU-Pasteur Research Center at the University of Hong Kong
and prominent influenza expert famous for isolating the
causal agent for the SARS virus, told McFarland and Quillin
that the H1N1 influenza pandemic came as a surprise to the
scientific community. He commented that, in hindsight, Hong
Kong,s initial response to H1N1 containment may have been
&too much8, but that those measures did in the end delay
local transmission until June (reftel). With its pandemic
plan based on expectations of a more virulent form of avian
influenza, Hong Kong initially had a difficult time scaling
back response measures after H1N1 turned out to be a milder
virus, Dr Peiris said. CHP officials agreed that initial
containment measures were aggressive but were effective in
delaying more local H1N1 outbreaks.

Infrastructure in Place but Concerns about Capacity
--------------------------------------------- ------

4.(SBU) CHP officials noted that Hong Kong,s H1N1 cases
peaked during the last week of September but anticipated a
second wave of infections to coincide with the regular winter
flu cycle. They expressed concern that a mild but more
widespread outbreak would put severe strains on the
frontlines of Hong Kong,s healthcare system. CHP officials
also worried that if Hong Kong,s next flu wave was more
severe, Hong Kong,s treatment capacity would be stretched to
the breaking point. Hong Kong hospitals have 1,400 isolation
beds available in the event of a massive pandemic. Currently
two-thirds of all ICU beds are allocated to H1N1 critical
cases. In order to mitigate the impact of mild H1N1 cases on
hospitals, CHP set aside eight designated flu clinics to
treat less serious cases. HA officials identified their
biggest challenge as ensuring that health professionals were
sufficiently cross-trained to allow easier reallocation in
the event of a surge in flu cases.

No Scientific Exchanges, but Official Health Exchanges with
Mainland China
--------------------------------------------- -------

5.(SBU) When asked about official interaction with mainland
Chinese counterparts, Professor Peiris acknowledged there
were no formal scientific exchanges and only minimal
cross-border influenza research cooperation. However,
informal professional exchanges do occur after studies are
completed. Dr. Peiris noted one on-going study to

HONG KONG 00001985 002 OF 002

investigate the seasonality of the flu in four cities:
Singapore, Hong Kong, Guangzhou and Shanghai. One
interesting result thus far was that flu seasonality in
Guangdong and Hong Kong appeared to be quite different. Dr.
Peiris speculated that the differences may be a result of
Hong Kong,s high usage of indoor air conditioning.

6.(U) CHP officials noted that although China,s Ministry of
Health had no liaison official in Hong Kong, formal monthly
data exchanges were held with counterparts in Beijing, as
well as annual meetings where data was exchanged. In
addition, CHP held monthly tripartite meetings with Guangdong
and Macau counterparts. CHP also participated in monthly
video-conferences with Macau health officials and has
provided testing assistance when requested. In the event of
an outbreak related to Guangdong, both sides would exchange
information and cooperate in the investigation, claimed CHP
officials.

Accuracy of Mainland Influenza Data Questionable
--------------------------------------------- ---

7.(U) In densely populated cities such as Hong Kong,
aggressive surveillance is a central part of any health
strategy. Hong Kong,s high capacity to collect and report
real-time influenza surveillance data draws on the city,s
eight designated flu clinics that serve as providers of
real-time data. In addition, together with CHP, HA publishes
weekly influenza surveillance and monitoring reports that are
widely circulated for maximum transparency and
inter-governmental communication.

8.(SBU) In contrast, mainland China,s influenza data
appeared to be less reliable. Some of our interlocutors
assessed that the existing health infrastructure on the
Mainland was not robust enough to effectively monitor
pandemics. The lack of focus on influenza surveillance in
Mainland hospitals contributed to shortcomings in influenza
surveillance data. One noted previous disagreements between
the PRC government and the Hong Kong research community
related to Avian Influenza research deemed threatening to the
mainland agricultural sector. CHP officials commented that
the Hong Kong media had picked up on the vastly different
H1N1 data coming out of Guangdong.

SARS Laid the Groundwork for H1N1 Preparedness
--------------------------------------------- ---

9.(U) All of our Hong Kong interlocutors agreed that the
lessons of the SARS crisis shaped Hong Kong,s influenza
preparedness. The devastating negative economic and social
impacts of SARS in 2003-2004 forced Hong Kong to better
prepare for infectious disease pandemics. The HKSARG
invested heavily in healthcare infrastructure, focusing on
laboratory testing facilities, designated flu clinics, rapid
influenza tests, infectious disease networks, and designated
infectious disease wards. As a result, Hong Kong has become
a center of scientific and technical expertise in the field
of influenza research. Through greater political awareness
and a ready infrastructure, Hong Kong was able to respond to
the initial H1N1 outbreak quickly. As a result of SARS, the
Hong Kong public also became more aware of social distancing
and personal hygiene practices, perhaps helping to slow the
spread of infection in this city of 7 million people.

10.(U) This cable was cleared by Dr. McFarland and Dr.
Quillin.

MARUT

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