ISOLATED TREATMENT: A patient is wheeled into Beijing's designated SARS facility in suburban Xiaotangshan Township on May 19, 2003 (SUN YANXIN)

The Chinese disease control system responded swiftly to brace for the possibility. On April 30, 2009 all passengers and crew members of flight AM098, the first direct flight from Mexico to China's mainland since the outbreak began, received quarantine checkups upon arrival in Shanghai. Two days earlier, a pandemic emergency response system was activated in Shanghai where even community-level clinics were required to screen patients with fevers for swine flu. The response plan was made after the SARS outbreak and proved useful for controlling bird flu at the end of 2003.

After Hong Kong confirmed its first human H1N1 case on May 1, 2009 Mao Qun'an, then spokesman for the Ministry of Health, told the Xinhua News Agency on the same day that the ministry had been ramping up surveillance and disease control arrangements for a worst-case scenario. Ten days later, the ministry released information about the first H1N1 case on the Chinese mainland on the day it was confirmed.

Zhong Nanshan, a renowned respiratory disease expert who is also known for giving out early warnings about the transmission of SARS, said that China's response to the H1N1 outbreak was totally different from the response to SARS, as "preventive measures were taken early on so as to avoid waste of medical resources due to ineptitude later."

Thanks to the timely information of the public on new cases and the government's comprehensive, multi-faceted and swift response, the H1N1 outbreak didn't cause mass panic in China.

Clinical tests of China's H1N1 vaccines kicked off in July 2009, supervised by the CDC.

Liang Wannian, Deputy Director of an office in charge of health care reform under the Ministry of Health, said at a forum on public health emergencies in Beijing last November that China has built up a national public health emergency management system and 27 national emergency teams respectively in charge of emergency medical rescue, infectious diseases control, poisoning treatment and medical services concerning nuclear and radiological threats.

Xu Ke, Vice Minister of Health, said at the same forum that over the past decade China had successfully controlled severe epidemics and handled medical emergencies caused by disasters like the catastrophic earthquake in Wenchuan, Sichuan Province, on May 12, 2008.

New challenges

Yao Zhibin, who was appointed head of the Health Department of Guangdong during the SARS outbreak, said in March that the province is much better prepared in terms of epidemiological monitoring and medical service levels for an epidemic like the SARS outbreak. Yao said that governments of all levels in Guangdong had injected around 20 billion yuan ($3.22 billion) into improving local disease control and prevention system over the past decade. Last year, China's first provincial-level hospital dedicated to handling public health emergencies was put into use in Guangdong.

However, cover-ups of epidemics still exist as some local officials still worried that "real casualty numbers" would become an impediment to the future of their careers. Moreover, some experts point out that although the CDC has established a vertical system with local branches, the center can hardly mandate them in daily operation.

Li calls for more government intervention to address the problems. "Government's forceful intervention is the key to China's victory against the SARS outbreak," Li said. He believes that public health is not only related to a country's medical level, but also a society's overall economic, cultural and scientific development levels and political circumstances.

Since the beginning of this year, hazy weather has affected a vast area in China and lasted for days in some cities where many residents chose to wear facial masks during outdoor activities for self-protection against air pollution. "However, no systematic evaluation of the smoggy weather on human health is available in China," said Wang Yu in March.

Wang said that an institute under the CDC was conducting comprehensive research on impacts of haze on human health and would shortly launch a risk alert system. In his opinion, disease control and prevention agencies should play a leading role in the establishment of a nationwide system to cope with hazy weather-related medical emergencies.

Email us at: tangyuankai@bjreview.com