VZCZCXRO0647
RR RUEHCN RUEHGH RUEHVC
DE RUEHHK #1985/01 3000007
ZNR UUUUU ZZH
R 270007Z OCT 09
FM AMCONSUL HONG KONG
TO RUEHBJ/AMEMBASSY BEIJING 3636
RUEHC/SECSTATE WASHDC 8820
INFO RUEHOO/CHINA POSTS COLLECTIVE
RUEHPH/CDC ATLANTA GA
RHMFIUU/DEPT OF HOMELAND SECURITY IA WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC

UNCLAS SECTION 01 OF 02 HONG KONG 001985 
 
SENSITIVE 
SIPDIS 
 
STATE FOR EAP/CM, OES/IHA, MED, CA/OCS/ACS/EAP 
STATE PASS TO ENVIRONMENTAL SCIENCE & TECHNOLOGY COLLECTIVE 
HHS PASS TO OGHA, NIH/FIC 
CDC ATLANTA PASS TO BLOUT, KELLY, COX 
BEIJING FOR CDC, HHS HEALTH ATTACHE AND RMO 
 
E.O. 12958: N/A 
TAGS: AMED CASC CH HK KFLU PREL SOCI TBIO
SUBJECT: CDC FINDS HONG KONG'S INFLUENZA PREPAREDNESS 
SECOND TO NONE 
 
REF: HONG KONG 1109 
 
1.(SBU) SUMMARY:  In meetings in Hong Kong, USCDC and Embassy 
Beijing Regional Medical officers found Hong Kong,s 
influenza surveillance and monitoring system &second to 
none8.  Hong Kong,s tragic experience during the SARS 
crisis in 2003 shaped its current robust influenza 
preparedness and response regime.  The Government,s 
political will, active development of technical expertise, 
and devoted resources have created the infrastructure that 
makes Hong Kong a model for pandemic preparedness.  While 
Hong Kong,s initial reaction to H1N1 may have been overly 
aggressive, local officials and experts credit the measures 
with delaying community transmission of the virus.  Hong Kong 
researchers and health officials regularly exchange infection 
surveillance data with their Mainland counterparts, but 
official-level coordination is still limited.  The lack of an 
effective pandemic monitoring system in China also limits the 
exchange of reliable surveillance data.  END SUMMARY 
 
2.(U) Dr. Jeffrey McFarland, Country Director for the Centers 
for Disease Control and Prevention (USCDC) in Beijing and Dr. 
Wayne Quillin, Regional Medical Officer at U.S. Embassy 
Beijing, visited ConGen Hong Kong on October 19 as part of 
regional briefings to mainland China posts and Hong Kong on 
H1N1.  They held outside meetings with Dr. Malik Peiris, a 
prominent HK University influenza scientist, and health 
officials from the Center for Health Protection (CHP)and the 
Hospital Authority(HA). 
 
Hong Kong,s Initial H1N1 Response was Aggressive but 
Effective 
--------------------------------------------- ------ 
 
3.(SBU) Dr. Malik Peiris, Scientific Director of the 
HKU-Pasteur Research Center at the University of Hong Kong 
and prominent influenza expert famous for isolating the 
causal agent for the SARS virus, told McFarland and Quillin 
that the H1N1 influenza pandemic came as a surprise to the 
scientific community.  He commented that, in hindsight, Hong 
Kong,s initial response to H1N1 containment may have been 
&too much8, but that those measures did in the end delay 
local transmission until June (reftel).  With its pandemic 
plan based on expectations of a more virulent form of avian 
influenza, Hong Kong initially had a difficult time scaling 
back response measures after H1N1 turned out to be a milder 
virus, Dr Peiris said.  CHP officials agreed that initial 
containment measures were aggressive but were effective in 
delaying more local H1N1 outbreaks. 
 
Infrastructure in Place but Concerns about Capacity 
--------------------------------------------- ------ 
 
4.(SBU) CHP officials noted that Hong Kong,s H1N1 cases 
peaked during the last week of September but anticipated a 
second wave of infections to coincide with the regular winter 
flu cycle.  They expressed concern that a mild but more 
widespread outbreak would put severe strains on the 
frontlines of Hong Kong,s healthcare system.  CHP officials 
also worried that if Hong Kong,s next flu wave was more 
severe, Hong Kong,s treatment capacity would be stretched to 
the breaking point. Hong Kong hospitals have 1,400 isolation 
beds available in the event of a massive pandemic.  Currently 
two-thirds of all ICU beds are allocated to H1N1 critical 
cases.  In order to mitigate the impact of mild H1N1 cases on 
hospitals, CHP set aside eight designated flu clinics to 
treat less serious cases.  HA officials identified their 
biggest challenge as ensuring that health professionals were 
sufficiently cross-trained to allow easier reallocation in 
the event of a surge in flu cases. 
 
No Scientific Exchanges, but Official Health Exchanges with 
Mainland China 
--------------------------------------------- ------- 
 
5.(SBU) When asked about official interaction with mainland 
Chinese counterparts, Professor Peiris acknowledged there 
were no formal scientific exchanges and only minimal 
cross-border influenza research cooperation.  However, 
informal professional exchanges do occur after studies are 
completed.  Dr. Peiris noted one on-going study to 
 
HONG KONG 00001985  002 OF 002 
 
 
investigate the seasonality of the flu in four cities: 
Singapore, Hong Kong, Guangzhou and Shanghai.  One 
interesting result thus far was that flu seasonality in 
Guangdong and Hong Kong appeared to be quite different.  Dr. 
Peiris speculated that the differences may be a result of 
Hong Kong,s high usage of indoor air conditioning. 
 
6.(U) CHP officials noted that although China,s Ministry of 
Health had no liaison official in Hong Kong, formal monthly 
data exchanges were held with counterparts in Beijing, as 
well as annual meetings where data was exchanged.  In 
addition, CHP held monthly tripartite meetings with Guangdong 
and Macau counterparts.  CHP also participated in monthly 
video-conferences with Macau health officials and has 
provided testing assistance when requested.  In the event of 
an outbreak related to Guangdong, both sides would exchange 
information and cooperate in the investigation, claimed CHP 
officials. 
 
Accuracy of Mainland Influenza Data Questionable 
--------------------------------------------- --- 
 
7.(U) In densely populated cities such as Hong Kong, 
aggressive surveillance is a central part of any health 
strategy.  Hong Kong,s high capacity to collect and report 
real-time influenza surveillance data draws on the city,s 
eight designated flu clinics that serve as providers of 
real-time data.  In addition, together with CHP, HA publishes 
weekly influenza surveillance and monitoring reports that are 
widely circulated for maximum transparency and 
inter-governmental communication. 
 
8.(SBU) In contrast, mainland China,s influenza data 
appeared to be less reliable.  Some of our interlocutors 
assessed that the existing health infrastructure on the 
Mainland was not robust enough to effectively monitor 
pandemics.  The lack of focus on influenza surveillance in 
Mainland hospitals contributed to shortcomings in influenza 
surveillance data.  One noted previous disagreements between 
the PRC government and the Hong Kong research community 
related to Avian Influenza research deemed threatening to the 
mainland agricultural sector.  CHP officials commented that 
the Hong Kong media had picked up on the vastly different 
H1N1 data coming out of Guangdong. 
 
SARS Laid the Groundwork for H1N1 Preparedness 
--------------------------------------------- --- 
 
9.(U) All of our Hong Kong interlocutors agreed that the 
lessons of the SARS crisis shaped Hong Kong,s influenza 
preparedness.  The devastating negative economic and social 
impacts of SARS in 2003-2004 forced Hong Kong to better 
prepare for infectious disease pandemics.  The HKSARG 
invested heavily in healthcare infrastructure, focusing on 
laboratory testing facilities, designated flu clinics, rapid 
influenza tests, infectious disease networks, and designated 
infectious disease wards.  As a result, Hong Kong has become 
a center of scientific and technical expertise in the field 
of influenza research.  Through greater political awareness 
and a ready infrastructure, Hong Kong was able to respond to 
the initial H1N1 outbreak quickly.  As a result of SARS, the 
Hong Kong public also became more aware of social distancing 
and personal hygiene practices, perhaps helping to slow the 
spread of infection in this city of 7 million people. 
 
10.(U) This cable was cleared by Dr. McFarland and Dr. 
Quillin. 
 
 
MARUT