US embassy cable - 06HONGKONG1469

SECRETARY CHERTOFF'S MEETING WITH HONG KONG SECRETARY FOR HEALTH, WELFARE AND FOOD DR. YORK CHOW

Identifier: 06HONGKONG1469
Wikileaks: View 06HONGKONG1469 at Wikileaks.org
Origin: Consulate Hong Kong
Created: 2006-04-08 02:52:00
Classification: CONFIDENTIAL
Tags: PREL PGOV ECON KFLU AMED TBIO HK CH
Redacted: This cable was not redacted by Wikileaks.
VZCZCXRO6906
OO RUEHCN RUEHGH
DE RUEHHK #1469/01 0980252
ZNY CCCCC ZZH
O 080252Z APR 06
FM AMCONSUL HONG KONG
TO RUEHIN/AIT TAIPEI IMMEDIATE 3762
RHMFISS/DEPT OF HOMELAND SECURITY WASHINGTON DC IMMEDIATE
RUEAHLC/HOMELAND SECURITY CENTER WASHINGTON DC IMMEDIATE
RUEHC/SECSTATE WASHDC IMMEDIATE 6005
INFO RUEHOO/CHINA POSTS COLLECTIVE PRIORITY
RHHMUNA/CDR USPACOM HONOLULU HI PRIORITY
RUEHPH/CDC ATLANTA GA PRIORITY
RUEAUSA/DEPT OF HHS WASHINGTON DC PRIORITY
RUEAWJA/DEPT OF JUSTICE WASHINGTON DC PRIORITY
RUEATRS/DEPT OF TREASURY WASHDC PRIORITY
RUCNFB/FBI WASHINGTON DC PRIORITY
RHEHNSC/NSC WASHDC PRIORITY
C O N F I D E N T I A L SECTION 01 OF 03 HONG KONG 001469 
 
SIPDIS 
 
SIPDIS 
 
STATE FOR EAP, EAP/CM 
NSC FOR WILDER 
HHS FOR STEIGER/ELVANDER 
 
E.O. 12958: DECL: 04/08/2031 
TAGS: PREL, PGOV, ECON, KFLU, AMED, TBIO, HK, CH 
SUBJECT: SECRETARY CHERTOFF'S MEETING WITH HONG KONG 
SECRETARY FOR HEALTH, WELFARE AND FOOD DR. YORK CHOW 
 
SIPDIS 
 
Classified By: Consul General James B. Cunningham.  Reasons: 1.4 (b,d). 
 
Summary 
------- 
 
1.  (C) On March 31, U.S. Department of Homeland Security 
Secretary Michael Chertoff met with Hong Kong Secretary for 
 
SIPDIS 
Health, Welfare and Food (SHWF) Dr. York Chow.  They 
discussed Hong Kong's preparations for a possible Avian 
Influenza (AI) pandemic, AI-related border issues, 
international cooperation on AI, and the need for governments 
to remain transparent with AI information.  Chow briefed 
Secretary Chertoff on the Hong Kong Government's (HKG) past 
 
SIPDIS 
experience with AI as well as recent steps it has taken to 
deal with the resurgence of AI.  Chow did not think an AI 
outbreak would originate in Hong Kong but was worried about 
AI entering from other places, especially from mainland 
China.  On AI-related border issues, Chow said that 
temperature screening was a "symbolic" measure to reassure 
the public; he expected the first notice of a human AI case 
in Hong Kong would come from a hospital.  Hong Kong regularly 
sends its public health officials to countries and 
territories needing assistance with AI efforts and brought up 
the need to provide more aid to areas that lacked basic 
medical and scientific infrastructure.  Chow agreed with 
Secretary Chertoff on the need for governments to remain 
 
SIPDIS 
transparent about new AI developments and acknowledged that 
mainland China needed a greater degree of transparency on 
public health information.  End summary. 
 
Overview of AI Preparedness in Hong Kong 
----------------------------------------- 
 
2.  (C) On March 31, Homeland Security Secretary Michael 
Chertoff met with Hong Kong's Secretary for Health, Welfare 
and Food (SHWF), Dr. York Chow.  Chow was accompanied by 
Director of Health Dr. P.Y. Lam, Deputy Secretary for Food 
and Environmental Hygiene Eddy Chan, and Assistant Secretary 
for Health Howard Lee.  The SHWF began his briefing by noting 
that AI was first discovered in Hong Kong in 1997 at the 
Queen Elizabeth Hospital while he was Chief Executive of the 
hospital.  He continued that AI is not a human virus yet but 
resides mostly in reservoirs such as waterfowl, which is why 
no duck or goose farms are permitted in Hong Kong, and no 
imports of live ducks or geese are allowed.  Chickens usually 
have very visible outbreaks, but there is now evidence that 
chickens can also carry the AI virus without showing symptoms 
and thus act as reservoirs for the virus. 
 
3. (C) There were two previous outbreaks in Hong Kong, in 
1997 and in 2003.  As a result, all chickens in Hong Kong, 
whether locally raised or imported, are now vaccinated. 
Until recently, 30,000 locally raised live chickens and 
30,000 imported live chickens were put on sale in Hong Kong 
every day, accounting for about 50% of the chicken consumed 
in Hong Kong.  As a result of this love for freshly 
slaughtered chicken, Chow ruefully commented, the HKG's 
proposal to set up a central slaughtering house was "driving 
people to riot."  The H2N2 poultry vaccine used by Hong Kong 
poultry farms, and by farms in Guangdong Province exporting 
to Hong Kong, seems to be effective.  Although the Guangdong 
Provincial Government has decreed that all chickens in the 
province must be vaccinated, Chow doubted whether it was 
possible to vaccinate all of the 1 billion estimated chickens 
in Guangdong province.  All of the chickens imported into 
Hong Kong, however, should be fine. 
 
4. (C) Secretary Chertoff said that compensation for major 
chicken culls was an important issue and asked what Hong 
Kong's policy was.  Chow said that the HKG would compensate 
poultry farmers $38 Hong Kong Dollars (approximately $5 USD) 
per chicken but would only do so in the event of an actual AI 
outbreak in poultry. 
 
Preparations for Human AI Cases 
-------------------------------- 
 
 
HONG KONG 00001469  002 OF 003 
 
 
5. (C) Chow said that a recent human AI case in Guangzhou had 
led to a temporary ban on all live chicken imports from the 
province.  Backyard poultry farms have also been banned, so 
the likelihood of an AI outbreak in Hong Kong poultry farms 
is low.  However, it would be impossible to prevent any human 
AI cases from showing up in Hong Kong, especially when 
dealing with people who have traveled to other countries. 
The key, said Chow, is to catch the first case and lower the 
chance of human-to-human transmission.  After its experience 
with SARS, Hong Kong has set up a network of 14 hospitals 
that have 150 isolation rooms each, meaning that Hong Kong 
has 2,100 isolation rooms ready to deal with a pandemic 
disease outbreak at any time.  As for other preparations, 
Chow said that Hong Kong holds "visible" drills more than 
once a year and is in the planning stages for a combined 
drill with mainland China. 
 
6. (C) Besides drills, Chow also said that the HKG was 
conducting a wide ranging public information campaign on AI 
emphasizing personal hygiene and teaching the difference 
between AI and normal flu using radio, television, the 
internet, signs, and even classroom outreaches.  The outreach 
efforts were timed to begin in October and November so that 
Hong Kong residents would be ready for the flu season in Hong 
Kong, which runs from January through March. 
 
Antivirals and Vaccines 
------------------------ 
 
7. (C) Hong Kong has stocked enough Tamiflu to cover 20% of 
its population.  Chow warned, however, that the difficult 
issue would be determining how the Tamiflu should be 
distributed.  Hong Kong will give first priority to actual AI 
patients, second priority to anyone who has any contact with 
an AI patient, and finally keep the rest of its Tamiflu in 
reserve to give to people running essential services in the 
event of a true pandemic situation.  If Tamiflu is 
distributed too broadly, there is a risk that the AI virus 
will rapidly develop resistance to the antiviral medication. 
Chow said that Hong Kong is also conducting research on 
different antiviral medications but has not found anything as 
effective as Tamiflu. 
 
8. (C) Chow suspected that current vaccines being developed 
around the world might not be effective against an actual AI 
outbreak.  HKG labs as well as labs in Hong Kong University 
have received samples showing multiple genetic changes.  The 
H5N1 AI virus recently discovered in wild birds in Hong Kong, 
for example, is considerably different from the H5N1 virus 
isolated in 1997.  Many of the human AI vaccines that have 
been developed to this point are based upon old Vietnamese 
samples and may not work against the currently circulating 
forms of the H5N1 virus.  In any case, he concluded, the time 
gap that exists between the formulation of a vaccine and the 
production of mass quantities of a vaccine is a major problem. 
 
9. (C) Chow commented that Hong Kong is trying to attract 
pharmaceutical companies to come to Hong Kong to do more 
research, development, and production of innovative drugs. 
Secretary Chertoff pointed out that liability protection 
 
SIPDIS 
would be a key issue, and Chow responded that although 
insurance prices were high in Hong Kong he hoped the HKG 
would be able to help pharmaceutical companies overcome 
obstacles. 
 
AI and Border Issues 
--------------------- 
 
10. (C) Secretary Chertoff asked Chow for his risk assessment 
of the current AI situation in the region.  Chow replied that 
there are varying assessments on the actual threat posed by 
AI.  Some experts want more research funds and use scare 
tactics to achieve their ends, whereas some experts are very 
complacent.  Hong Kong will prepare for a medium threat 
scenario in which an AI outbreak occurs but is manageable. 
If a true disaster strikes, said Chow, there won't be much 
that the HKG can do in any case.  The best thing to do is try 
 
HONG KONG 00001469  003 OF 003 
 
 
to prevent the pandemic from happening, an effort that may 
largely depend upon carefully watching Hong Kong's borders. 
 
11. (C) Chow pointed to Hong Kong's land border with mainland 
China, through which over 300,000 people enter or exit Hong 
Kong day, as the area of greatest risk.  Although Hong Kong 
has instituted temperature checking since the SARS epidemic, 
against AI temperature screening is a largely symbolic 
gesture.  On the other hand, AI symptoms are so much more 
severe than normal flu symptoms that AI patients will almost 
certainly end up in one of Hong Kong's hospitals, where the 
case will be detected and reported.  Since it is not 
realistic to expect that the first human AI case will be 
caught at the border, Hong Kong must focus on tightening 
border controls after the discovery of the first AI case 
traveling into the territory. 
 
12. (C) Director of Health Dr. P.Y. Lam said that when Hong 
Kong first started temperature screening in 2003 during the 
SARS epidemic, the main impetus behind the move was to screen 
outgoing travelers to avoid "exporting" SARS cases out of 
Hong Kong.  Chow reassured the Secretary that even though 
Hong Kong would strive not to "export" cases in the event of 
an AI outbreak in Hong Kong, as long as the U.S. had set up 
screening and quarantine facilities in U.S. ports of entry 
the HKG would most likely allow U.S. citizens in Hong Kong to 
return home. 
 
International Cooperation on AI 
-------------------------------- 
 
13. (C) Secretary Chertoff said that since AI infected people 
can be infectious for between 24-48 hours before showing 
symptoms, the U.S. will put a great deal of emphasis on 
screening travelers based on their travel history.  Chow 
agreed with the Secretary and said that the best way to react 
to an actual AI outbreak that showed efficient human-to-human 
transmission would be to encircle the affected area and 
inject massive amounts of resources into the area.  The 
Secretary pointed out that this would only be effective if 
 
SIPDIS 
countries were both willing and able to identify such an 
outbreak.  Chow agreed and said that there is a great need to 
assist countries that do not have any labs or any other means 
to analyze an AI outbreak.  In some countries hospitals will 
be reluctant to report AI cases that show up in there 
facilities out of fear that the report will drive away 
"business" for several months -- a situation that would not 
happen in Hong Kong with its publicly funded health care 
system.  Chow asserted that he constantly tries to send his 
public health officials to other countries which need 
technical assistance with AI issues. 
 
The Need for Transparency 
-------------------------- 
 
14. (C) Secretary Chertoff emphasized to the SHWF that 
transparency and efficient communications were of the utmost 
importance in preparing for AI.  Chow agreed and noted that 
the HKG had good communications with the Consulate, a point 
that Consul General Cunningham concurred with.  Chow 
reassured the Secretary that he has told mainland Chinese 
officials that the HKG will not "hide anything" that it hears 
about.  The HKG may wait "just a few hours" to let mainland 
Chinese officials go public with its information first, 
though.  When asked by CG Cunningham whether the transparency 
situation had improved, Chow said that the Central Government 
was good but did not have complete control over local 
situations.  Shenzhen, Guangzhou, and Guangdong Province 
overall are good, but other provinces are less dependable and 
may be burdened by inferior capabilities.  In any case, said 
Chow, "we are telling mainland China that they need to be 
more transparent." 
 
15.  (U) Secretary Chertoff's party has cleared this cable. 
Cunningham 

Latest source of this page is cablebrowser-2, released 2011-10-04