Page 1 of 2 Swine flu tests confidence in China, Japan
By Peter J Brown
When swine flu (H1N1) came knocking on Asia's door, China's and Japan's crisis
management skills were duly tested. The way in which the two nations
communicate in emergency situations in particular deserves a closer look -
neither gets a passing grade.
Thankfully, no lives have been lost, at least so far, in either country.
Despite lots of practice, when it comes to public health-oriented incident
management, both Japan and China can tell that much work still needs to be
done.
Several dozen Mexicans have now returned home wishing to forget how China
swiftly singled them out once a confirmed case of H1N1 surfaced in Hong Kong.
China has explained its response as a prudent public health measure, but it has
demonstrated once
again that what you do is often not as important as how you do it.
A pivotal event took place on April 30, when China's Health Minister Chen Zhu
told the country and the world that China was fully prepared to handle H1N1.
"After the test of Severe Acute Respiratory Syndrome (SARS) and based on the
effective working experience to combat bird flu in the past few years, we are
confident and capable of preventing and containing an H1N1 influenza epidemic,"
he said at a press conference held by the State Council Information Office of
China in Beijing, according to Xinhua.
"We have to take into consideration the worst possibilities while making the
best preparations," he added.
It was this air of confidence, and the notion that China was "capable of
preventing" the H1N1 flu from impacting China, that set the stage a day later
for the start of China's "Mexico fiasco", which quickly became tantamount to a
disastrous setback as far as Sino-Mexican relations are concerned. The whole
thing could have been avoided altogether if China had a different and far more
pro-active external communications strategy in place.
Considering Chen's presentation, one cannot dismiss entirely the notion that
China was a bit too confident, yet perhaps a bit too hesitant, for reasons that
are difficult to discern. China must have seen early on that other governments
were in direct contact with the government of Mexico, and that warning flags
were flying everywhere. What is even more perplexing is that this episode was
unfolding when China was obviously quite willing to undertake its rapid
response to H1N1 out in the open and in a very public manner - in stark
contrast to the quite opaque and disjointed reaction by China to the SARS
outbreak in 2003.
Japan, on the other hand, stumbled badly due to a series of poorly executed
external communications blunders in the form of false alarms. This type of
error has plagued the country over the past two months, during both the very
volatile North Korean missile launch on April 5 and the H1N1 outbreak.
As H1NI concerns mounted, Japan's press talked first of a case at Narita
Airport in Tokyo, and then of a case in Yokohama. It was as if Japan was simply
ignoring the importance of effective communications in a crisis or public
health scare. The issuance of alerts and warnings seemed to be handed off by
the government to the media, and this was validated by the Japanese
government's seemingly casual approach to "on the record" interviews in the
process.
On Wednesday, April 29, Japan's Kyodo News reported that a direct flight from
Mexico - the first to arrive from Mexico at Narita Airport in Tokyo following
the decision earlier that same day by the World Health Organization (WHO) to
ratchet up its current phase of alert to phase 5 - was inspected by Japanese
quarantine officials. All 185 passengers and 13 crew members were cleared to
disembark.
It is more than a remarkable coincidence that the following day, China Eastern
Airlines Flight MU505 brought swine flu to Hong Kong - perhaps the best
prepared city in the world for anything highly contagious and respiratory in
nature - after a brief flight from Shanghai. All told, 176 passengers and 13
crew landed at Pudong International Airport in Shanghai on a fight from Mexico
aboard Aeromexico Airlines' Flight AM098. While approximately one-third of the
passengers disembarked in Shanghai, the vast majority dispersed to
approximately 18 other Chinese cities including Hong Kong via Flight MU505,
while a few went on to Japan and Thailand.
The same flight implicated in the introduction of H1N1 to Asia deposited its
passengers first in China and then several flew on to Japan. While this alone
does not win the arguement for tighter pan-Asian coordination in terms of
disaster preparedness and response in times of heightened vigilance, it
certainly furthers the case for such coordination. Only hours before Flight
MU505 landed in Hong Kong slightly behind schedule with its H1N1-positive
Mexican passenger on board, Donald Tsang, the chief executive of Hong Kong, had
concluded his tour of a local hospital where he emphasized the fact that the
clock was ticking and that the swine flu was coming to Hong Kong - no matter
what was being said in Beijing.
At an urgently convened cabinet meeting in Beijing two days earlier, Premier
Wen Jiabao and the cabinet finally sat down to review China's preparations for
the looming arrival of swine flu. Top government officials knew that H1N1 was
spreading, and realized that its epicenter was in Mexico City. Moreover, they
understood that this fast-moving public health headache would soon be on their
doorstep.
Why they hesitated - and ultimately at what cost - will remain a mystery. The
process of consulting with Mexican officials, and alerting them well in advance
that, among other things, China would take immediate steps to enforce its "Law
on the Prevention and Treatment of Infectious Diseases" and "Frontier Health
and Quarantine Law of China" never happened.
Only a week after this meeting ended, the first group of quarantined Mexican
citizens were boarding a charter flight at Pudong International Airport in
Shanghai for their long flight back home to Mexico. Their flight marked the
culmination of a series of bad moves in Beijing involving Mexico.
Absent of any advance warning, Chinese health authorities began identifying
Mexicans as part of the designated pool of infected outsiders in China. A
vigorous campaign was then launched to isolate them.
This caught the individuals in question and the Mexican government completely
by surprise - a communications meltdown if ever there was one. Beijing resident
Gustavo Carrillo told the Wall Street Journal how he was immediately identified
and removed from a Continental Airlines plane over the weekend and suddenly
placed in a Beijing hotel under quarantine. Carrillo had not even traveled to
Mexico during his latest business trip to the US.
Carrillo complained that the episode was set in motion the minute Chinese
health personnel detected his Mexican passport, and not as a result of any
health screening. "It was embarrassing and humiliating," he told the WSJ.
Top Chinese officials must have not been paying attention when, on April 28,
Japan's Health, Labor and Welfare Ministry required all inbound travelers to
disclose vital health and personal information at Japanese ports of entry upon
arrival. At the same time, passengers on these same airplanes began to be
subjected to intensive on-board screenings by Japanese officials. There was no
sign of such stepped-up surveillance in Shanghai at this time.
Foreign Minister Nakasone also announced the suspension of visa waivers, which
meant that all Mexicans traveling to Japan were required to apply for their
visas in advance. In effect, the Japanese government had gently yet firmly
started to close the door on Mexico. China, however, simply slammed the door
shut with little apparent regard for the repercussions of this action. In the
days that followed, China would go to great lengths to explain that the
quarantine of dozens of Mexican along with a handful of Canadian students and
others was a legal and proper course of action given the dire circumstances.
China flew tonnes of aid to Mexico in early May to battle the H1N1 outbreak,
but the damage was already done. The fact that Cuba and other Latin American
countries had preceded China in terms of imposing stringent measures aimed at
curtailing human interactions with Mexico is relevant to this discussion. These
countries are close neighbors and not engaged in the same sort of aggressive
partnership-building that China is pursuing in Latin America today. Mexico may
be wondering how reliable a partner China is today, given this unwelcome
sequence of events.
Still, valuable lessons may have been learned. Those who say that all sense of
proportion was absent from the start of the H1N1 outbreak, and that
overreaction escalated into near panic in a very short span of time can now
point to China, too. Like it or not, the view that an all out pandemic panic
was unleashed is a commonly held opinion which acknowledges that despite the
many lives sadly lost due to H1N1, it is a fact of life that all forms of flu
can be potentially fatal.
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