The official acknowledgment that the problem extended beyond people already in isolation wards at hospitals came as local doctors have been increasingly critical of the government. Many doctors have been calling for the government to do more to warn residents of the dangers posed by what the World Health Organization has labeled Severe Acute Respiratory Syndrome, or SARS.
Dr. Leung Ka-lau, the president of the Hong Kong Public Doctors' Association, said in an interview today that in repeatedly playing down the gravity of the problem, the government was going too far in seeking to preserve Hong Kong's image as an attractive tourist destination.
"They have to balance the health of the public and the economy and image of Hong Kong," Dr. Leung said. "From the health point of view, I would tend to alert the public more."
Dr. Yeoh Eng-kiong, Hong Kong's secretary of health, welfare and food, defended the accuracy of the government's tallies of SARS victims, which Dr. Leung and other doctors here described as not including dozens of cases of atypical pneumonia that might well be SARS.
"We have not left out any cases because we want to cover up anything," Dr. Yeoh asserted today. Rather, the government has been concerned that the World Health Organization's definition of SARS is overly broad, he explained, adding that it has followed the advice of its own panel of local doctors in categorizing cases.
Professor K.Y. Yuen, a microbiologist at Hong Kong University, said at the same news conference that the disease did not appear to spread as easily through the air as influenza. Taking a position that American and European doctors are starting to adopt as well, Professor Yuen said that it appeared that the disease was transmitted when healthy people came in contact with fairly sizable droplets from an infected person, especially during medical procedures, and not through casual contact.
The government here also set up an Internet site today to provide the public with information about the outbreak, and has encouraged people to avoid crowded places with poor ventilation. But it has not taken other steps suggested by local doctors, like urging employers to provide sick leave to workers at the first hint of illness or quarantining Prince of Wales Hospital, where most of the cases have occurred.
Two more hospitals reported clusters of cases today, bringing the total to six. The appearance of new cases shows that not everyone with the disease has been found, Dr. Yeoh admitted.
By contrast, Dr. Yeoh said over the weekend and on Monday that increases in the official tally of cases here were occurring almost entirely among people already in the hospital with pneumonia who were being reclassified as having SARS.
Dr. William Ho, the chief executive of the Hong Kong Hospital Authority, said today that the tally of confirmed cases had risen since Monday by 28, to 111, while 12 more people are hospitalized and are strongly suspected of having the disease as well.
Dr. Leung, a surgeon at Prince of Wales Hospital, said doctors there were nervous that they might yet fall ill. He noted that it took two to seven days for symptoms to present themselves after infection. Some seemingly healthy doctors with families have moved into temporary housing to reduce the risk of infecting spouses and children, but Dr. Leung said that he lives alone and still goes home every day.
"Maybe we are clean or maybe we are in the incubation period," Dr. Leung said. "What we are waiting for is for the incubation period to expire."
Margaret Ng, a Legislative Council member who represents the legal community and has been a fierce critic of the government's move to impose strict internal security laws, said that she did not believe that information was being actively concealed from the public.
"I don't feel that they are really hiding anything, but I get the feeling they don't have the measure of it yet," she said.