China's Countryside Facing "Extremely Serious" SARS Epidemic

Agence France-Presse ^ | Wednesday, May 07, 2003 | Robert J. Saiget

[Dog Gone]

BEIJING, May 7 (AFP) - Millions of migrant workers have ignored government warnings against returning from SARS-affected areas to their rural homes, as Premier Wen Jiabao warned Wednesday of a serious outbreak in the Chinese hinterland.More than 800,000 migrant workers have returned in recent weeks to central Henan province, one of the country's most populous areas, while one million have returned to neighboring Anhui, local officials and press reports said.

"At present there has not been a large epidemic in the rural areas, but we must be on high alert; neglecting prevention work in the rural regions will not be tolerated," Wen was quoted by the People's Daily as saying.

"The basic rural medical facilities are weak, technical capabilities are not adequate (and) the epidemic surveillance system is not sound."

During a nationwide teleconference with top provincial officials on Tuesday, Wen said that the nation faced "stark challenges" in controlling the spread of Severe Acute Respiratory Syndrome (SARS) in the countryside.

Stopping the epidemic from spreading to rural areas would be key to containing the virus nationwide, Wen said, as he repeated an apparently ineffective demand for migrant workers not to return home.

"It has been very difficult to advise migrant workers in (SARS) affected areas not to return home," the China News Service said, citing efforts by Henan to control the migrant population.

"The situation of SARS prevention in the entire (Henan) province is extremely serious."

Some 75 percent of an estimated 290,000 migrant workers that returned to Henan between May 1 and May 4, came from SARS-affected areas, it said.

The "recent" return of up to 800,000 migrants to the province appeared as part of an exodus from SARS hotspots like southern Guangdong province and Beijing, despite government warnings ahead of the May Day holiday.

Henan, a largely rural province of 91 million people -- bigger than any European country except Russia -- has more than five million migrant workers that have spread to prosperous urban areas in search of a better livelihood.

Such workers in SARS-hit areas like Beijing and Guangdong were unlikely to return immediately to their jobs due to the epidemic, while many have been laid off from restaurant and hotels because of the slump in business due to SARS.

The situation was similar in neighboring Anhui province, which boasts a population of nearly 63 million and has some five million migrant workers, local officials said.

So far Henan has only reported 15 SARS cases and 15 suspected cases as of Wednesday, while Anhui had nine confirmed cases and 11 suspected cases, far below the more than 2,049 cases in Beijing and more than 1,400 in Guangdong.

China reported 159 new cases and five more deaths Wednesday, bringing the total nationwide to 4,560 and 219 fatalities. Beijing is the worst-hit city with 110 deaths.

Meanwhile, a team of experts from the World Health Organization (WHO) will visit Hebei province Thursday, which surrounds Beijing and is home to many of the capital's migrant workers.

The number of infections in Hebei have more than doubled to 134 in the last week.

Police around the country have also beefed up regulations on SARS prevention, arresting a man in Inner Mongolia for "recklessly endangering public safety," after he infected his family, including his father, who died.

Li Song was also charged with refusing to cooperate with medical officials while quarantined and for escaping quarantine.

SARS' spread into the hinterlands could also seriously threaten China's estimated one million HIV-positive patients, many of whom are in Henan.

"If SARS hits HIV areas, that will decimate all the people who are HIV positive right away," said Ray Yip, head of AIDS prevention for the United Nations Children's Fund's China office, has said.

China's government, which refused to acknowledge the extent of the epidemic for months after it was discovered in Guangdong in November, has only appeared to fully address the outbreak since April 20.

[Malsua]

Rural China is very Rural but people tend to clump up in China, so while you may travel 20 miles without seeing a soul, you might run into a "village" with 10,000 people.

All of them sharing the same squat toilets.

[FITZ]

One would think that a disease with a low infection rate such as SARS would spread even more slowly in rural areas where the opportunity for infection is less than in highly populated areas and concentrations such as hospitals.

It seems like that to me ---rural people tend to be stronger and healthier, exposed to more animal viruses, less exposed to human waste and contamination.

[Beck_isright]

Nothing to fear here people, the CDC has this under control.

[FITZ]

"If SARS hits HIV areas, that will decimate all the people who are HIV positive right away,"

Do we know that the SARS deaths were in people completely free other other diseases like T-cell lymphomas and Hepatitis C which are endemic in SE Asia? A lot of health care workers would have Hepatitis C.

[Dog Gone]

For all the interesting speculation (which may be partly true) about various ethnic types being more or less susceptible to this disease, the one thing that seems perfectly obvious is that the Chinese are not immune to it. They are being hit the worst.

It's entirely conceivable that the Chinese government cares less about its rural population than the more educated residents of the large cities. But unless they care nothing at all about them, it would be wise to put severe travel restrictions througout the entire country. Otherwise, I don't see how they could prevent the spread throughout the entire country. They're not going to stop it through medical intervention.

[Dog Gone]

No, we don't know that valuable piece of information. In fact, China is still providing only summary information to WHO, and that is not sufficient to track down either the continuing source of infection in the community, or even tell us much about the victims.

In order for this to be contained in China, if it can be at this point, the Chinese will have to be far more cooperative and open than they have been to date. They've made great strides in being more open in that they're no longer in a state of denial, but we need to know neighborhoods, buildings, and far more details than have been shared so far.

Part of the problem may be that China simply can't assemble that information. My guess is that they could, at least within the modern cities. In the rural areas, it's probably impossible.

[Milwaukee_Guy]

Migrant workers live in deplorable conditions in factory barracks for up to 11 months out of the year. Only when they are to sick to work will they be released thus further spreading SARS.

Rural areas in China do not have anywhere near the medical or communications facilities that the urbanized areas do. Sanitation is very poor to say the least. A major outbreak could be occurring there and it would be weeks until the petty party officials would have the ability or willingness to report an outbreak to the party leadership.

Lastly the Communist Party will take all measures to protect the political and manufacturing centers of population and completely forsake the less indoctrinated rabble out in the hinterland.

I would expect a significant outbreak becomming apparent in most of China by Summer.

[Domestic Church]

"Just wait until you have farm workers wandering around in bare feet and knee deep in water"

Ugh...rice paddie nightmare! They'll never be able to get this controlled now.

[nomad]

There was an article posted a couple of days ago about how SARS can survive up to 5 days in stool, especially if its diarrhea, something about the lower PH levels. Really gross practice, they could at least compost it first.

[Carry_Okie]

Want to tell everybody how much food we're importing from China these days?

It's a lot, especially fresh fruit.

[Carry_Okie]

Yup, all that jabbering I do about food security means nothing to those free traders, until SARS comes into the US in food.

Um, I wonder if they've ever factored in the actuarial risk associated with their economic preferences?

[Betty Jo]

How quick can an infected Chinese illegal get to Mexico or Canada?

Since we know the incubation time is__?__,will they be communicable by the time they cross over into America?

Are the same people that are stopping illegal Islamic Terrorists the same ones that are stopping SARS infected Asians?

If so, we are all doomed

[Paul C. Jesup]

With lack of health care in the rural areas, this is like watch a wildfire turn into a firestorm.

[The Pheonix]

US Secy of Health, Tommy Thompson spoke by phone with China Vice-Premier and Health Minister, Wu Yi

Secy Thompson offered US assistance and suggested US-China cooperation in combatting SARS

[The Pheonix]

HK's Prince of Wales Hospital reported that serum drawn from the blood of SARS patients who recovered had cured 10 out of 20 SARS patients......there is still hope

[aristeides]

Officials told to bow in attempt to beat Sars.

[Dog Gone]

I wasn't aware that we imported any fruit from China. What kinds?

[The Pheonix]

On the contrary, China is potentially the largest market for the US farm and agricultural sector. eg the Australia wheat Board forcast that China will buy up half the wheat in the World's wheat market by 2020

American farmers are keen to capture the Chinese market for American agri products. eg if every Chinese eats one pound of steak a year, they will need millions of heads of cattle

[The Pheonix]

I wonder how China can export food when they could produce enough to feed their 1.5 BILLION people....

[The Pheonix]

typo

I mean ..."when they could not produce enough food for themselves...."