While epidemiologists are predicting the return of severe acute respiratory syndrome (SARS) this winter, Guangdong and Hong Kong are already geared up for the possibility. They are prepared to mobilize all available resources to stem the disease once it breaks out in the community again.

Unexpected events can be handled and any crisis diffused when we are prepared for the worst and are backed up by a contingency plan. We must not rely on luck and grope our way forward. It will only allow minor matters to turn into disasters.

In Hong Kong, by the end of October, close to 1,000 beds will be converted for isolated treatment of SARS patients. Most of them are placed in single-person wards with good ventilation. By the end of the year, all 1,300 beds for infectious disease patients will be in place.

The government has also come up with a contingency plan - to set up a makeshift infectious disease hospital in containers situated in an open area such as the site of the former Kai Tak Airport.

The containers would be fitted with toilets, ventilation and sewage systems and supplied with running water.

Epidemic drills will enhance the efficiency of the mutual notification mechanism between Hong Kong and Guangdong, and allow the two governments to synchronize their disease-combating measures.

The two places will adopt the same alarm system. As the human interflow across the border intensifies, the adoption of effective advance warning measures and identical isolation mechanisms will help prevent the spread of the virus.

Nevertheless, what is more important is for Hong Kong and Guangdong to co-operate in medical research with a view to enhancing the effectiveness of treatment and lowering the mortality rate.

During the previous outbreak, Hong Kong and the province implemented different measures to combat the disease, resulting in a big difference in death rates - Hong Kong's was double that of the mainland.

Since the SARS medication used in the territory had very strong side effects, many of the patients were unable to fully recover even though they survived the deadly disease and were discharged from hospital.

The mainland, on the other hand, used a combination of Western and traditional Chinese medicine, stirring the immunity system to fight the virus. As a result, many patients recovered without having to take medication.

In contrast, Hong Kong hospitals administered antibiotics, ribavirin plus steroids on SARS patients. This approach led to long hospitalization periods, high medical costs and low efficacy.

Research by the Chinese University of Hong Kong has proven that ribavirin does not lower the concentration of SARS virus in patients' blood, meaning that this drug results in many side effects without showing obvious results.

Since there are many ways to treat a disease, Hong Kong must seek one that is inexpensive and more reliable instead of sticking stubbornly to the first prescription that seems to work.

Hong Kong could put patients into different corresponding groups in which they are treated with different medications. After the accumulation of cases, a better and more effective cure could be identified.

Some physicians stress uniformity and disallow discrepancy, approving only one prescription for treating millions of people. This kind of conservative attitude is not in keeping with the Hong Kong spirit.

In a place where people are not allowed to explore different ways to treat a disease, and where, under the pretext of "equality for patients", the medical authorities refuse to use the grouping method to find out the best cure, it is not possible to gain progress in the medical sector.

For the same disease, different doctors may prescribe different medications for patients in different physical conditions. How can that be interpreted as being unfair to patients?

On the whole, Hong Kong's SARS patients have suffered from a particularly high rate of mortality. If we do not consider adopting more exploratory measures, that will be unfair to all SARS patients in the territory.

As a matter of fact, experts in the two local universities with medical schools have put forward proposals for new treatments and new drugs.

The medical authorities ought to respect science and experts and not shrug off views from outside the government.

They should have the modesty to accept the wisdom of experts because only through using more effective treatment and drugs could the territory fend off another epidemic outbreak.

(HK Edition 09/16/2003 page5)