6 November 2005

A few short years ago, bird flu used to be our problem. Now it ’ s becoming the world ’ s problem and in cities across Europe, north America, Africa, Asia and the mainland, people are preparing for the threat of a flu pandemic. Here in Hong Kong, there is a particular urgency for us to make sure we are ready for that potential terrifying scenario.

Before, the threat of bird flu came from the poultry in our markets. Now, the most worrying threat is from migratory birds and we must look at ways that we can confront this threat. We must also make sure the Hong Kong people are prepared and informed so they can survive a virulent outbreak.

We have some of the world ’ s top experts in avian flu in Hong Kong. We have unrivalled experience of the H5N1 virus from the 1997 and 2003 outbreaks - but what we lack is sound, practical advice in what to do in the event of a new, more severe outbreak.

Of course, no one knows exactly what would happen and the way we react would depend on multiple factors. If it was an outbreak among birds, for instance, our reaction would be different from the way we would react if the H5N1 virus mutated and began to spread from human to human.

However, there is a clear need for simple, understandable contingency plans to be explained to the public to avoid panic in the event of an outbreak – and at the moment I do not believe the government has been successful in providing this.

What lies ahead may prove to be the first big test of the strength of Chief Executive Donald Tsang ’ s strong governance – and the implications if that leadership is found wanting are immense.

The government ’ s contingency plans for dealing with an outbreak are currently described in a Department of Health leaflet called: “ Preparedness plan for influenza pandemic ” . It explains how there will be three response levels according to the situation – stage one “ alert ” , stage two is “ serious ” and stage three is “ emergency ” .

The eight-page leaflet is rich in detail on which government department will take priority in the command structures and who will chair steering committees, but surprisingly and woefully short on advice to the public on what to actually do.

In fact, I can boil the useful advice on what to do at each response level down to the following sentences: During stage one, maintain normal way of life and pay attention to government announcements; during stage two, maintain normal way of life, pay attention to government announcements and make sure you have enough face masks; during stage three, use your face mask appropriately and pay attention to more government announcements.

The leaflet does give a list of general preventative measures that can be taken now such as washing your hands properly, avoiding contact with live poultry, staying fit and avoiding crowded and poorly-ventilated public areas.

These are useful and commendable advice, but it is limited, unspecific advice that will be of little use in a crisis. It tells us nothing about the stage at which schools will close; nothing about how to deal with your employees if you run a business; nothing on the questions of quarantine and which hospitals are equipped to deal with bird flu victims.

One might argue that it is too early for that kind of specific advice. After all, it might never happen. No one knows if bird flu will strike here, and no one knows what form it will take if it does. Going into this kind of details, you might argue, will only serve to worry people unnecessarily.

I beg to differ. I believe that forewarned if forearmed. If people know in advance what to do in the event of a pandemic, they are less likely to panic. If they have clear guidelines on a worst case scenario, they are likely to be calmer and better equipped to survive.

If the government waits until the outbreak begins before telling people what to do, the spread of the virus may be so rapid that there is no time to educate and prepare people.

We only have to go back to 2003 to see how panic itself can be a pandemic. When, at the height of the Sars crisis, a teenager send out a bogus message about Hong Kong being declared an infected port, the whole city was thrown into turmoil.

There are already signs of confusion and a lack of understanding about the H5N1 virus. People are trying to build up personal stockpiles of Tamiflu even though the government is advising them not to. School parties have stopped visiting the Mai Po reserve for fear of migratory birds bringing the virus to Hong Kong, even though there is no evidence of any cases there yet.

Detailed contingency plans are being drawn up, but not announced. The government has already staged emergency dress rehearsals on how to deal with an outbreak but only the officials involved know the full details. Multi-national companies too have drawn up their own plans to protect key staff and provide them with anti-viral drugs to combat the risk of infection but only their executives know the full details.

Hong Kong is not alone in having made public little of its contingency arrangements in case of a bird flu outbreak.

However, as fears mount, it is practical, “ what to do ” information that people are crying out for and it is practical information that will do the most to allay their fears.

Hong Kong, with our previous experience of the virus as well as the parallel experience of Sars, should be the world ’ s number one in terms of preparedness - and in terms of safeguards and expertise - we probably already are.

But we have more need than almost anyone else to be prepared, because of geographical position. If there is an outbreak of human-to-human bird flu on the mainland, there is every chance it will spread here no matter how strong our defences and no matter how thorough our hygiene.

Hong Kong is in the frontline of the bird flu crisis and every one of us is exposed to the potential of infection, not just government officials, emergency services and executives employed by multi-nationals.

It is time for more transparency in our contingency plans. It is time for practical public information on what to do in the event of an outbreak. It is time to make sure everyone is informed and everyone is prepared.

Of course a pandemic might never happen and I pray that it won ’ t. But as anxiety over bird flu mounts, Hong Kong needs clear and unequivocal guidelines on what to do, if only to ease those anxieties.

Our Chief Executive is riding high in the popularity polls, but it is during a crisis that the true test of leadership always comes. We stand on the edge of that crisis now and it is the job of our chief executive to make sure we are ready for the absolute worst.