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Posted on 04/21/2003 9:58:26 AM PDT by Dog Gone

HONG KONG—How long can a city of 7 million people hold its breath?

How many weeks can they keep their kids out of school? Stay away from work? Avoid seeing the dentist? Delay going to the pool?

How long can people stay scared of SARS?

When the new killer virus hit here hard last month, it spread old-fashioned panic faster than the disease itself. Residents quickly hoarded food and hunkered down at home, braced for Armageddon.

Now Hong Kong is learning to live with severe acute respiratory syndrome.

No one is breathing a sigh of relief just yet. The territory is reeling from news that 19 patients died in the past two days, including 12 on Saturday, the highest daily toll yet.The reality has set in: SARS is here to stay. Politicians and physicians who started with short-term damage control, then switched to medium-term crisis management, are now pondering long-term coping strategies. Hong Kong is starting to realize there is no happy ending in sight.

"Will the virus disappear all of a sudden? Probably not," Hong Kong's chief executive, Tung Chee-hwa, told residents last week. "We have to accept that it will be with us for some time. We have to accept it. And learn how to live with it."

Living with the fear of death doesn't come easily to Hong Kong. Some 1,380 people are afflicted with SARS — with about 40 new cases a day occurring. In more than a week 53 people have died, accounting for more than half of the five-week death toll of 88.

Tung donned a surgical mask in public for the first time yesterday as he joined thousands of ordinary people with mops and pails scrubbing Hong Kong's grimy streets in a symbolic public hygiene campaign. Only the day before, the chief executive had suggested that SARS might "stabilize gradually," but by the weekend he conceded that "no matter which way you look at it, it is a disaster."

Despite the fact that more people die of regular pneumonia than SARS, the local media are brimming with scare stories. In a city that thrives on commerce, where people love to congregate in large groups and spend money at restaurants and shops, there is an eerie quiet.

At first, everyone seemed psyched out and opted to lie low. But the initial hysteria is slowly subsiding as the reality sinks in that people have nowhere to hide.

They have to co-exist with risk. There are no miracle vaccines, nor any magic carpets for people trying to flee.

Dual nationals who sought the traditional escape route to Canada reached a dead end when Toronto's infection rate rose dramatically. Malaysia, Thailand, and many Middle Eastern countries have also slapped entry restrictions or imposed quarantines on Hong Kong residents.

In any case, waiting it out abroad could take an eternity. So with nowhere to go, people are no longer running away from SARS.

"It is probably safer to stay in Hong Kong than to travel elsewhere," said Tsang Yok-Sing, head of the Democratic Alliance for the Betterment of Hong Kong.

"Now, a month after the outbreak began, we have acquired a much better knowledge of the disease... There is, therefore, very little chance of being infected by someone in public. We cannot wait for the virus to disappear before returning to our normal way of life.

"Instead, we should learn to lead a normal life with the outbreak around, taking the necessary preventative measures."

Not everyone is putting such an optimistic spin on the virus. Health officials speculate that the disease is spreading like wildfire because of Hong Kong's densely populated high-rises and crowded public venues.

"We believe that every citizen could become a carrier of the virus," said Dr. Leung Pak-yin, deputy director of health.

Fearing the worst — wholesale infections of their staffs — many major corporations have barred employees from coming to office skyscrapers that recirculate stale air and ordered them to work from home. Door knobs and elevator buttons in public buildings are covered in cellophane that is discarded daily. Notices proclaim that elevator buttons are sanitized hourly.

Movie attendance has slumped by 50 per cent because film buffs fear sitting beside strangers for the length of a feature film. Video stores report business is booming as people seek refuge in their television rooms.

Public television ads advise that shaking hands is out and kissing is to be avoided, replaced by polite Asian bowing. After centuries of spitting on the streets, no one dares to hork in Hong Kong anymore.

At church communion, priests drop wafers into people's palms instead of their tongues. At ATMs, customers use the corners of their wallets or shirt sleeves to press the buttons for withdrawing cash. Yoga teachers lay down bleach-soaked towels to disinfect people's footwear, and scrub down mats in between classes.

When SARS first struck in mid-March, Hong Kong's teeming sidewalks and overflowing escalators were transformed into a sea of surgical masks. The Chinese have a tradition of covering up when catching cold, so it's not surprising that a majority of locals strapped on the medical equivalent of facial veils without feeling self-conscious.

But monsoon season has arrived, the humidity index is soaring, and fewer people are willing to swelter in surgical masks all day long. Hong Kong is slowly coming up for air.

Public swimming pools that were closed last month will start re-opening tomorrow. All pools have been thoroughly disinfected and pool water will be tested hourly, the government announced yesterday.

High schools will also reopen across the city next week, after being closed since March 29. Primary schools and kindergartens will be phased back into operation by month's end.

To help nervous parents deal with their fear of infection, schools will require them to take their children's temperature every day before classes. They will have to sign a form daily certifying their children have no fever.

School-bus drivers and caretakers will also have their temperatures taken daily. The government will distribute 4 million face masks, 4,000 digital thermometers, and 800,000 ear protectors for students.

Similar measurements are already in place at Hong Kong's Chek Lap Kok Airport, where all outgoing passengers are being checked. The measure is designed to reassure foreign countries that Hong Kong is not exporting the disease through infected passengers — reducing the need for nervous nations to ban visas for residents of this territory. In fact, Hong Kong passengers are now pariahs in foreign airports.

"We need to reassure the international community that effective measures are in place to prevent the spread of the disease across borders," Tung said.

Incoming passengers will soon be tested with digital thermometers using disposable ear probes. With traffic down dramatically — to merely 30,000 passengers daily — officials are confident they can handle the workload, and passengers seem reassured.

"It makes me more comfortable to know that they're taking people's temperature," said Wan Chi-kwong as a health worker inserted the probe in his ear before he boarded a flight to Bangkok.

As the public address system resonated with warnings about the symptoms of SARS and reminders to wash their hands, Wan said most of his friends were avoiding the airport.

Major corporations have grounded their sales staffs, humbling once proud Cathay Pacific, Hong Kong's major carrier. The airline has slashed its schedule by 184 flights, or 37 per cent of its capacity, and is toying with the possibility of grounding its entire fleet as bookings evaporate. Dragonair, whose route network covers mainland China, has cut 44 per cent of its flights.

Cathay suffered another blow yesterday when it announced that a male cabin crew member had come down with SARS last week. The government launched an urgent appeal to trace all passengers on his Singapore to Hong Kong flight.

With the airport virtually deserted, the real challenge for officials is checking the hundreds of thousands of people who cross Hong Kong's land border crossing into mainland China every day, says government spokesperson Bob Howlett. The government hopes to install thermal imaging devices, already being used in Singapore, to measure the temperature of passengers as they walk through the device, much like a metal detector. "Everyone will have them as soon as they can make them," Howlett says. "If it's this simple, it'd be criminal not to put them in."

Newspapers now publish daily lists and maps disclosing which neighbourhoods and buildings have the highest infection rates, much like the pollution readings in the weather column. A mobile phone company, Sunday Communications Ltd., allows its customers to phone in for an automatic readout on infected areas within a one-kilometre radius of the calling area.

The government has plastered the city with posters — next to peeling notices from previous scares such as dengue fever and rat plagues — reminding people to wash their hands frequently.

People suffering from obsessive-compulsive behaviours, such as washing their hands 20 times a day, are now feeling vindicated by the government admonitions, says psychiatrist Sing Lee. "They feel normal now," Lee said in an interview. "This compulsive behaviour reduces anxiety."

But for the rest of Hong Kong, the fear of unseen germs is unsettling. It disturbs regular sleep patterns and increases anxiety.

"Atypical pneumonia (SARS) is driving Hong Kong people to a state of pathological anxiety and panic," he says. "People with anxiety are catastrophizing."

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