Posted on 04/27/2003 6:11:05 AM PDT by zook
April 27 2003: A SARS Story
Last Tuesday, the day before we flew to Taipei, we heard on the news that SARS had broken out at the city's Hoping Hospital. This is where my sister-in-law, Shiang-Yi, works as a nurse. We called her to see if she was alright. Sure, she said. I'm not even in that part of the hospital. Don't worry. So, the next day we flew from Pingtung to Taipei and had a terrific day. We visited with Taipei's Deputy Fire Chief and his wife and Eva Mei got to see a lot of neat fire stuff. Later that evening, Shiang-Yi came home and we went out to dinner at a very nice place. We ate a ton of food and at one point, very stuffed, I said something like, "It's a good idea to eat a lot because you never know what your next meal might be a box lunch slid under your door by a community health worker!" And we all laughed.
Little did we know.
The next day, the news about Hoping Hospital was getting worse. The SARS cases occurred in various parts of the hospital and no one really knew how it was being spread. Shiang-Yi went to work anyway. That morning I said to Lillian, "you know, they could quarantine her!" Lillian called Shiang-Yi and asked her about this. She said, "don't worry, I know where all the windows are. I'll jump out if I have to!" And we went shopping.
About 4:00 PM we got back to Shiang-Yi's apartment and were surprised to see her home. She told us that the hospital officials, after telling everyone the previous day that the hospital would not be closed, had shut down and sealed the place off around noon. No one, no patient, no staff, no visitor, would be allowed to leave for at least 2 weeks. People who had gone to visit family members were now under "quarantine" and it didn't matter if you had kids on their way home from school, a job to get back to, or whatever; you were going to be held there.
Shiang-Yi was true to her word. She found a window and jumped, along with numerous other detainees. The main reason she had jumped was to talk to us, take a shower, and pack a bag to go back. I, however, raised a number of questions. First of all, she had just been found free of SARS the day before, and to go back now would dramatically increase her chances of catching the disease. Second, what kind of scoundrel hospital administration "tricks" its employees into quarantine in this way? Third, does the hospital need her services as a nurse? Or is this just the government's way of showing its strength and resolve to a frightened public?
For several hours, we all talked. Eva Mei was so upset by this that she actually wrote Shiang-Yi a beautiful letter in Chinese telling her why she should not go back. At one point, Shiang-Yi had decided not to go back. But most of her friends were going back, and the TV news was calling on all staff to go back, and--worst of all--it was made known that staff members might be fined the US equivalent of $2000 or even be fired for not going back.
Faced with all this, and having just one more year to work before retirement, my sister-in-law went back. We were all terribly sad. We offered to help her pay any fine. We continued to express our frustration with the apparent irrationality of the government's response. But in the end, Shiang-Yi had to make the decision. And when she did, I tried to explain to Eva Mei that we had to help "Jao-Jou Yi" by being brave and giving her a big hug. This was very hard for Eva Mei (and for me). Before she left, Shiang-Yi picked up her back and swinging her arms in a marching sort of way said in Chinese, "Eva Mei! I'm off to join the army!"
The next day we found out some disturbing things. First, all family members of Hoping staff were to be quarantined in their homes for 14 days. Guess what, folks. That's us! We made plans to get out of the apartment as soon as possible. Second, we found out that -- and this is so hard to understand -- even Hoping staff who had been on vacation, who had not even been at the hospital during the outbreak, were to report for quarantine. Third, we found out that many doctors and higher level administrators had not shown up for quarantine. Apparently, if you had enough clout, you could evade the order. We also found out that some visitors had been allowed to go quarantine themselves at home for 14 days. Some, however, were required to remain at Hoping.
Then something encouraging happened. I had been wondering why everyone just seemed to accept all of this without much question. Suddenly the cable news was reporting on a major protest at one of the hospital doors. Several nurses had made a banner that read in Chinese something like "How long? 14 days? 30 days? Forever?" The nurses were shouting about how they had been lured or duped into coming back to the hospital. One nurse said she had been threatened with a fine even though she had been on vacation for a week and was perfectly healthy. A small group of them burst through the quarantine line, past a line of police. They handed out flyers and messages to the media who were there. None of them tried to leave the area and eventually they all returned inside.
Today (Sunday) these nurses are being threatened with large fines. A political cartoon in one paper compared them to firefighters who refused to enter a burning building. I think this is an awful comparison. Why? Because all but about 30 of Hoping's patients were transferred to other hospitals the previous night. As of today, there are 19 confirmed SARS patients at Hoping. So, how many nurses does it take to serve 19 patients? Let's assume that each patient needs at least six nurses, two for each eight hour shift. Do the math. Oh, let's make it 10 nurses, just to be really safe. We're talking fewer than 200 nurses and we haven't even taken into consideration the fact that one nurse can serve more than one patient at a time. Now, how many nurses were forced into quarantine? Hoping has about 500 nurses, all of whom are being forced to report, even those who are currently out of the country or on vacation. To me, this sounds less like "quarantine," more like "involuntary servitude."
We successfully evaded the "quarantine police" for the remainder of our trip. On Friday, we took Lillian's brother's family out to dinner. It was a bit of fun, but dampened greatly by the absence of Shiang-Yi. I wanted to leave the following day, but Lillian and Eva Mei thought we could hold out until Sunday (today). So, we are now back in Pingtung.
But I have a new feeling now. I am ready to leave. I fear SARS a little bit, but I fear civil panic even more. I don't want myself or my family to be forced into any quarantine situation, particularly if we are healthy. I've asked Lillian to begin packing. My "trip wire" has nearly gone off. I think we'll stay for now, but we'll be watching this situation very closely. If anything like this begins to creep southward, that "trip wire" will send us back home.
Other than all that, it was a nice trip. (Sarcasm).
Bye for now
And bureaucratic knee-jerk reactions.
Public health has been so good during the last few decades that we have forgotten how common this kind of scare used to be.
. . .have to say, my 'trip wire', would have gone off by the end of the first paragraph. . .
This letter shows the fearful reality of SARS; the disease itself and Government responses to it. . .and also why 'containment' may slow the numbers; but not stop the spread of this disease.
The Chinese Government needs to address the issues/causes of 'why' these viruses are born and then borne, in China and clean up the practices that lend to these health disasters. . .and sooner, not later.
i understand your sister-in-law's ptrdicament: she sees her primary duty to her co-workers and patients, with her own health a secondary consideration. in addition to being worried, you should be proud of her for taking the high road.
the government is treating the health-care workers abysmally: socially supported conscription of the educated for high-risk work.
good luck, keep posting, and get your family (sister-in-law included) out when safe...
depends on the test. pcr (polymerase chain reaction)should pick it up before significant symptoms. unfortunately, the test isn't fully available yet.
once you've been exposed to a disease with a high attack and mortality rate (i have) it's difficult to castigate others in the same situation for not following the party line(i don"t).
would you stay in quarantine with known carriers if you had a low risk of being infected. if so, there's a nice hopital in taipei that needs some workers.....
Especially if the "crisis" might not really be a crisis:
Self-preservation of the unpaniced comes first. It is vital! Better to scoot and play a self-imposed quarentine out in a non-paniced venue.
precisely.....
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