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After a trying period of three months battling against the severe acute respiratory syndrome (SARS) epidemic, Hong Kong was ultimately removed from the list of infected areas by the WHO on 23 June 2003. As we were struggling along our path against this epidemic, the disease unfolded its characteristics. It was a disease that would bring rapid progression to respiratory failure, it posed greatest threat to the health workers, the origin of its aetiological agent coronavirus was not firmly established, hypothesised to be of animal origin, there was no formalised standard way of treatment, no rapid method of diagnosis, and the disease was spreading rapidly internationally within Asia and to Europe and North America.
After introducing vigorous control measures and with the strong commitment of the government and the support of the healthcare workers and the community, assisted by experts from the WHO, the SARS epidemic in Hong Kong was brought under control after this hectic period of three months from March to June 2003.
After the victory over the epidemic, Hong Kong has quickly started its post-SARS activities to revitalise its economy, to strengthen its surveillance measures both locally and regionally including the Pearl River Delta region in mainland China, step up research activities to establish the origin of the aetiological agent, and to develop vaccines and new rapid diagnostic methods.
Three committees have been set up by government to take up specific responsibilities after the SARS epidemic. One committee was responsible for the overall cleansing campaigns and environmental improvements of the housing estates in the city. The second committee was responsible for drawing up plans and programmes to revitalise the economy of the city including tourism, trade, and employment. The third committee undertook to draw up strategies and plans to promote community involvement and partnership in improving the physical, social, and economic environments of the city.1
In June 2003, the government announced that an expert committee would be set up to review the management of the recent SARS outbreak in Hong Kong. The objective of the committee was to identify lessons to be learnt, and to make recommendations on areas of improvements to better prepare the system for any future outbreaks. Members of the committee comprise both overseas and local experts. The committee started its work at the beginning of July 2003. It will submit its report to the government by September 2003.
In the meantime, considerable amount of activities after the SARS epidemic have started. These include the introduction of a “Hygiene Charter” to promote personal and environmental hygiene in all settings such as schools, communities and workplaces, the mounting of city wide cleansing campaigns, joint meetings of pubic health workers from Hong Kong, Macau and Guangdong Province in mainland China to strengthen communication and expand the surveillance system on SARS and other major infectious diseases, and joint research activities on SARS between the academic institutions in Hong Kong and Guangzhou. Additional resources have been allocated by the government to promote research, to improve the ward conditions in hospitals including their isolation and ventilation facilities, to set aside specially designed bed facilities for the isolation and treatment of infectious disease patients, and to establish outbreak management plans in hospitals to deal with future outbreaks.
In the coming months, Hong Kong will continue case identifications through surveillance, to determine whether the infection is endemic or seasonal, or whether it has disappeared from human populations. It will continue collaboration with mainland China, particularly Guangdong Province in studies to identify animal reservoir and risk factors for transmission to humans. This measure is necessary to manage the risk and prevent future outbreaks. It will continue to participate in major WHO networks of global surveillance for influenza and other infectious diseases. This step is necessary in order to identify major emergence of new influenza strain or other infection of international importance.2
These activities could well demonstrate that Hong Kong will continue to maintain a high level of vigilance and preparedness to deal with another SARS epidemic should it occur in future. In the light of these observations, it is anticipated that in the coming autumn of 2003, Hong Kong is unlikely to face another SARS epidemic of such a magnitude as the last one. However, as respiratory illness is usually more prevalent in the cold season and bearing in mind the large volume of people travelling between Hong Kong and China, some sporadic cases of atypical pneumonia may occur, but it is not expected that another SARS outbreak will come again in such a short time.