China: EV71 Outbreak in China Sparks Criticisms

 by George Sun

While not bird flu related, the recent outbreak of HFMD (Hand Foot and Mouth Disease) in China gives us an opportunity to see how the Chinese government responds to an epidemic. During the weekend china issued a countrywide alert to control the disease as it is also spreading in many other parts of china. Still, one can’t see the end of that trouble that is on rise with every passing day. BloggerChenguang [zh] shares his opinions comparing it with the outbreak of SARS in 2003.

在4月23日之前，安徽省疾病控制方面的专家一直为病因的确诊感到焦虑和担忧。但后来却发现引起此次公共卫生事件暴发的“真凶”，竟然是在40年前就已发现的常见肠道病毒EV71，而且这种病毒引发的“手足口病”在全世界很多国家和地区都已经出现过，就在去年的安徽邻省山东，也出现过近万例的报告，也有死亡病例。

Before April 23rd, the disease control experts in Anhui Province felt the anxiety and concern because of the confirmation of the cause of the disease. But later on they found the original cause of this public health event, which was the epidemic intestinal virus EV71 found 40 years ago, and this virus triggered the “hand, foot and mouth disease” in many countries around the world. Last year, in Shandong, Anhui’s neighbouring province, there were nearly 10,000 illness cases reported, including a few deaths.

当外界问责安徽省卫生厅“没有及时向卫生部上报病情”æ—¶,“肠道病毒EV71感染不是法定必须上报的传染病”这个最冠冕堂皇的理由就把应该承担的重大责任推得一干二净。而当时的实际情况是，阜阳已经因此死了十多个患儿了。

When the outside accountability comes to Anhui Provincial Health Office, asking for “a timely disease report to the Ministry of Health”, the high-sounding excuse that “intestinal infection EV71 virus is not a statutory infectious diseases that must be reported” has completely passed the buck to others. At that time, in actuality, more than 10 children had died in Fuyang.

事后，更有官员在接受媒体采访时说，“我国每天大约有2万到3万例各种传染病报告，每年大概有600多万个病例报告，每例都通报，不是造成社会不稳定吗？”

After the accident, more than an afterwit official said to the media, “China has about 20,000 to 30,000 cases of various infectious diseases reported daily and more than 6 million reported cases annually. If we report each one of them, won’t it inflict social instability?

思想上重视，实践上落后。在中国行政文化中，保一方平安，是官员不得不严重关注的事项，搞不好是要丢乌纱帽的。上级官员也会动辄以“祖国和人民”的利益教育下级官员。然而，这会促使管理者只重视“社会安全事件”，现对忽视”公共卫生”/“自然灾害”；为了尽可能“明晰”负责，遇有危机事件出现时，或者隐而不报，或者上报了事。缺乏超越常规处置应急事项的动力和机制，也极为缺乏预警的技术手段以及技术与管理有效对接的能力。年初的南方大雪，气象部门是事前有所预测的，但却没有将此预测转化为应急管理的一部分。阜阳EV71感染事件之后，人们会再次想到我们政府公共卫生应急管理能力的低下,急需为应急管理制定相应的法律。

Ideological attention, but backward practice. In China’s administrative culture, security is the matter officials have to seriously concern about. Otherwise, it may cost their official positions. Higher-level officials will often use “the motherland and the people” to teach the lower level of officials. However, this will only attach importance to managers of “social safety incidents” and ignore the “public health” / “natural disaster”. In order to “clear” responsibility, in the event of crises, they are more likely to hide, not report or just “report up”. Being devoid of the effective system and mechanisms to handle emergency matters, the local government also lack the early warning technology and the technical means to dock with the management capacity. The heavy snow in the South early this year had been forecasted by the meteorological department, but there is no forecast in this part of emergency management.

Blogger Lelelele [zh] says a lot suspicion can be raised from the issues of the mass infection of EV71.

安徽省卫生厅在4月29日的新闻通报中称，省财政安排了1000万元专款用于购置救治设备。但截至5月2日，大多数病童家属还不知道这一规定，也并未享受政策实惠，继续承受着医院高收费之苦。相对于以谎言辟谣，某种程度上还只属于行政良知的范畴，而当地对于专项拨款“去无踪”则显然远远超越了良知的边界，这令人费解！

On April 29th, Anhui Provincial Health Office announced that 10 million RMB has been deployed to buy the treatment apparatus. But until May 2nd, most of the victims’ families didn’t know this regulation and didn’t receive any profit of the policy, still enduring the high price of medicine. Compared with the refuting of the rumors, which is merely, in a sense, a matter about conscience, the “disappearance” of financial deployment is way beyond that. How inconceivable it is!

English blogger FLA_MEDIC thinks there is a lack of effectiveness in China’s health and sanitation system.

In 2003, China covered up the fact that they were seeing hundreds of cases of a new type of deadly pneumonia, what became known as SARS, for several months. They have in the past been less than forthcoming about their bird flu cases, and have been slow to send samples to the WHO.

Blogger Yin Minhong even says that PM Wen Jiabao should resign if the government can’t successfully control the spread of the disease.

The number of hand-foot-mouth disease (HFMD) cases reported in China this year has risen to 11,905 by Monday, resulting in 26 deaths, according to Xinhua counting of local official figures. Tang Xiaoping, an epidemic expert and deputy head of the health bureau of Guangzhou, said the drastic rise is a result of an order by the Ministry of Health on Friday, which classifies HFMD as a C class epidemic that must be reported to the ministry.

An anonymous author posts a few words saying the spread out of EV71 reflects much broader and inner social problems in China.

It might help to put this epidemic in perspective and look at the history of outbreaks in the past and also at the health condition of children in that part of China. Are these children at higher risk for some reason? Are they susceptible to other infections? What is health care, poverty, economics like in that part of China. The air looks very polluted there.