Monday, 21-Apr-2003 3:30AM Story from AFP / Peter Harmsen

BEIJING, April 21 (AFP) - Drastic Chinese measures designed to curb SARS have likely come too late to prevent the epidemic from threatening virtually all the country's 1.3 billion people, according to analysts.

A decision to cancel the week-long May Day holidays to keep people from traveling will also have little effect since the virus has probably already spread to all corners of the continent-sized country, they said.

"It's too late, they can't put the genie back in the bottle," said Andrew Thompson, an expert on Chinese health issues at the Center for Strategic and International Studies in Washington.

"It's got to be everywhere by now, and if it isn't, it will soon be there," he said.

So far, 14 of China's 31 municipalities and provinces have reported SARS cases.

The most chilling aspect for many in China is the lack of clarity about the extent of Severe Acute Respiratory Syndrome.

The government has reported more than 1,800 confirmed cases nationwide, and at least 80 deaths, but few believe the statistics are complete.

Even Beijing seems to lack faith in the data it gets from the provinces, dispatching special investigative teams to detect under-reporting or cover-ups.

In the provinces, too, doctors only have partial ideas about what is going on in their immediate neighborhood.

In Qingxu County, a part of north China particularly badly hit with up to five SARS deaths, doctors at the People's Hospital have not had contact with their patients for days.

"People are scared to come here because of the SARS cases we've had," said a female doctor surnamed You. "So they go to small rural clinics instead."

Showing the potential damage SARS can wreak, tuberculosis which spreads in much the same way, has infected 4.5 million people in China, according to official statistics.

The rapid spread of SARS has only been possible because China now, after 20 years of reform, is a freer society than anytime previously in history.

Chinese travel longer and more frequently than ever before, ensuring that new strands of virus inevitably get a free ride to all habitable parts of the country.

The biggest contribution to the spread of novel diseases is made by China's 94 million migrant workers who hail from the countryside and seek work in places like Beijing and Guangzhou.

When they return home for major holidays -- like the just-canceled May Day vacation -- they introduce not only new big-city fashions and habits, but occasionally also previously unknown diseases.

The result, as SARS reaches rural China this way, is likely to be disastrous, by the health ministry's own admission.

"Rural medical facilities are relatively weak, and the awareness among farmers of self-protection is generally not as high as in the cities," Vice Health Minister Gao Qian said at a briefing Sunday.

"So once the disaster spreads to these areas, the consequences will be especially grim," he said.

Illustrating the problems of the countryside, more than 60 percent of rural tuberculosis patients leave hospital before fully recovering because they cannot afford to pay for treatment.

The danger of a significantly higher death toll will come if or when SARS starts affecting parts of China already struggling with other widespread and lethal diseases, according to experts.

Tuberculosis patients are more drug-resistant, meaning that it will be much harder to cure them of SARS.

And impoverished Henan province, where two SARS cases have now been reported, is also the home of thousands of rural dwellers who had their immune defenses weakened by HIV.

"As it spreads in Henan, it will get much, much worse," said Thompson. "The mortality rate will rise to much more than four percent."


http://www.ptd.net/webnews/wed/aa/Qhealth-sars-china-spread.RFPV_DAL.html