VZCZCXRO7092
PP RUEHAST RUEHDH RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD RUEHTM RUEHTRO
DE RUEHHK #1066/01 1630044
ZNR UUUUU ZZH
P 120044Z JUN 09
FM AMCONSUL HONG KONG
TO RUEHC/SECSTATE WASHDC PRIORITY 7823
INFO RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHINGTON DC

UNCLAS SECTION 01 OF 02 HONG KONG 001066 
 
SIPDIS 
 
STATE FOR EAP/CM, OES/IHB AMBASSADOR LOFTIS, CA; HHS PASS 
CDC, HHS FOR OGHA 
 
E.O. 12958: N/A 
TAGS: KFLU AEMR ASEC CASC KFLO TBIO KSAF KPAO PREL
PINR, AMGT, HK 
SUBJECT: HONG KONG: H1N1 LESSONS LEARNED 
 
REF: A. STATE 54435 
     ¶B. HONG KONG 940 
 
¶1.  Summary.  The recent and ongoing H1N1 outbreak has loomed 
large on the consciousness of the Hong Kong Government (HKG) 
and its citizens.  This issue was especially sensitive in 
Hong Kong, given the collective memory of the SARS outbreak 
in 2003.  Our task became more difficult when public and 
media attention focused on the fact that most cases of H1N1 
were imported from the United States and that the U.S. 
Government (USG) was not screening passengers departing from 
U.S. airports for H1N1.  While the net result was a 
validation of our preparedness for a pandemic event, it is 
also apparent that Post and the USG need to address several 
important issues as this public health crisis continues and 
before the next one develops.  On June 11 the HKG announced 
extensive school closures following confirmation of a cluster 
of H1N1 cases (Septel).  End Summary. 
 
Post Management: A Valuable Test of Capabilities 
--------------------------------------------- --- 
 
¶2.  Post was conducting regular Avian Influenza Working Group 
(AIWG) meetings long before the H1N1 crisis unfolded, and 
during the initial stages of the H1N1 outbreak the AIWG met 
in order to coordinate Post's response to events on the 
ground.  Eventually, the AIWG expanded to include the entire 
Emergency Action Committee (EAC), bringing all of the 
members, expertise and capabilities together to address the 
current outbreak as it unfolded.  As part of the ongoing AIWG 
meetings, Post regularly reviewed the tripwires for a 
pandemic outbreak, both for relevance and to ensure 
flexibility and responsiveness.  This continuous review and 
refinement led to the establishment of robust yet flexible 
tripwires that have remained relevant and useful throughout 
the whole H1N1 outbreak. 
 
¶3.  Post was well prepared for prevention and/or treatment of 
an outbreak among the staff.  The Health Unit stocked 
adequate personal protective equipment (masks, hand wash, 
etc. and maintained sufficient supplies of antiviral Tamiflu 
and Relenza to treat an outbreak among Consulate staff, to 
include Direct Hire Americans, Eligible Family Members (EFMs) 
and Locally Employed Staff (LES).  Additionally, the 
Management Section had already established and successfully 
operated internal communications systems including phone 
trees, SMS messaging and AIWG work and personal email 
distribution lists, enabling Consulate leadership to 
communicate routine and emergency messages in response to 
changing conditions. 
 
¶4.  One issue we identified as an area for improvement was 
the need to designate a single point of contact for Consulate 
staff who may be sent into quarantine in the future.  In 
response to this identified need, Post designated the duty 
officer as the point of contact for all personnel, in order 
to ensure a rapid response from Consulate leadership in the 
event of staff involvement in the quarantine. 
 
Consular Issues: Amcits ) Handle With Care 
------------------------------------------ 
 
¶5.  The HKG's quarantine program affected American citizens 
from the beginning and continues to impact Americans arriving 
in Hong Kong and transiting to other destination through Hong 
Kong.  In total, the HKG ordered more than 30 Americans into 
quarantine, of whom six tested positive for the H1N1 virus. 
Additionally, dozens were and continue to be placed in 
medically supervised self-isolation and treatment and 
prevented from departing Hong Kong.  The ACS Unit coordinated 
with the numerous HKG agencies involved to obtain assistance 
for the affected Americans for a variety of issues related to 
their involuntary quarantine or self-isolation.  We continue 
to provide updates and information to affected individuals by 
telephone, as well as to the larger American community in 
Hong Kong via warden messages and the consulate website. 
 
Public Diplomacy: Responding to Hysteria 
---------------------------------------- 
 
¶6.  (SBU) As a result of statements by Hong Kong officials, 
the Hong Kong media and political groups accused the USG of 
¬ doing enough8 to prevent the spread of H1N1.  They 
were particularly critical that the USG was not screening 
departing passengers from U.S. airports for H1N1.  In one 
unfortunate incident, Hong Kong's Secretary for Health went 
public with criticisms of the USG's response to the crisis 
 
HONG KONG 00001066  002 OF 002 
 
 
before raising them directly with Post or Washington.  Post 
tried to overcome this negative perception by developing 
talking points and messaging tailored to demonstrate the 
positive steps the U.S. federal, state and local governments 
were taking to prevent the outbreak from spreading. 
Privately, the Consul General pressed both the Secretary for 
Health and the Chief Executive on the matter, reiterating 
steps we were taking to halt the spread of H1N1 and its 
transmission outside of the United States. 
 
¶7.  Once the H1N1 outbreak spread to Hong Kong, the HKG and 
the public perceived it as an &American8 disease and, as 
such, we needed to address significant political and public 
relations issues.  We would have benefited from a coordinated 
effort in Washington to counter this widespread public 
perception.  A quick and coordinated interagency response 
would have done much to halt the steady stream of negative 
press and public sentiment surrounding the origins of H1N1 in 
North America and its spread via U.S. outbound travelers. 
 
Interactions with the Hong Kong Government: Hits and Misses 
--------------------------------------------- -------------- 
 
¶8.  Post had developed an extensive network of contacts at 
the working level in the HKG who were accessible and able to 
provide a continuous stream of information about the 
situation during the outbreak.  The statements and actions of 
policy-level actors in the HKG, however, were more difficult 
to predict and, without authoritative guidance from 
Washington, difficult to respond to.  U.S. Secretary for 
Health and Human Services Kathleen Sebelius, meeting with 
Hong Kong Secretary for Health York Chow on the sidelines of 
the World Health Organization Assembly in Geneva was an 
invaluable reinforcement of Post's message about the 
sustained and positive response the USG was making to contain 
the spread of H1N1.  However, while Secretary Chow went 
public with his account of the meeting within an hour or two, 
we have yet to receive any reports from within the USG on 
what they discussed. 
 
¶9.  The HKG asked Post for USG assistance on several 
occasions, including requests to screen passengers and 
provide informational and advisory signs at airports for 
outbound passengers.  Post relayed the requests to Washington 
but did not receive a response. 
 
¶10.  The HKG response to the H1N1 outbreak evolved as their 
understanding grew and as they saw how difficult it was to 
contain the spread of the disease.  As a result, the rhetoric 
coming both from the HKG and the media has calmed 
considerably.  We continue to cooperate closely with both 
Hong Kong and Macau, and maintain an active and positive 
campaign to inform the media and the public about actions the 
USG is taking to combat H1N1. 
 
¶11.  The H1N1 outbreak has been less serious than initially 
feared and has served as a valuable opportunity for Post and 
the Hong Kong and Macau Governments to refine plans and 
procedures for dealing with pandemic outbreaks, as well as to 
identify areas for closer cooperation.  This issue is far 
from over, however.  The HKG announced the first confirmed 
local transmission of H1N1 in Hong Kong on June 10 (Septel), 
followed by confirmation on June 11 that 12 students were 
infected in a cluster of cases at the same school.  In 
response the HKG announced a series of additional steps, 
including closure of all nurseries, kindergartens and primary 
schools for two weeks, in an effort to contain this community 
outbreak.  In the face of this ongoing public health crisis, 
we will continue to build relationships and maintain close 
lines of communication with our partners in Hong Kong and 
Macau in order to increase our ability to respond to this and 
future outbreaks. 
DONOVAN