Doctor stayed at smaller hospital despite staff worries

The deputy director of a hospital in the southern Chinese city of Guangzhou deliberately suppressed fears that he might have Severe Acute Respiratory Syndrome (SARS) for days before checking himself into a larger hospital, RFA�s Mandarin service reports.

China announced its fourth confirmed case of SARS on Saturday, Liu Xingzhang, a 40-year-old doctor and deputy director at the Guangzhou Transportation Hospital�whose own colleagues sent him home with medicine after diagnosing him as suffering from pneumonia.

�When his fever didn�t go down, he was brought back and admitted to this hospital,� a hospital staff member told RFA reporter Xin Yu. �Actually, some of the more experienced staff here were already opposed to this.�

The woman, who declined to give her name, said concerned colleagues had approached another hospital deputy director, surnamed Meng, after Liu had suffered from a fever for several days. They feared he should be treated at a larger hospital with more accurate testing.

�We [said] � we didn�t think he should be treated here. Even if he had been tested, we couldn�t rule it out, because we know that tests aren�t always totally accurate,� the woman said.

The woman said Liu, rather than being worried, threatened staff with an investigation into who was saying that his was a suspected case of SARS. �One fact is that after his fever began, nobody reported it, and the other is that he was here at our hospital all the time. It should have been reported much earlier,� she said.

Under pressure, Liu went to the Guangzhou Hospital, where he was diagnosed with a type of pneumonia.

When contacted by RFA, deputy director Meng declined to respond to the allegations. �I don�t know about this. You�ll have to ask the Guangdong Provincial Center for Disease Control and Prevention. We can�t give out news from here,� he said. SARS falls under Meng�s area of responsibility.

China�s official Xinhua news agency reported that Liu checked himself into a hospital. Within five days, �his body temperature dropped to normal and his condition stabilized,� the agency said. But Liu�s colleague said his fever stubbornly refused to come down, which was a sure pointer to suspicions of SARS.

World Health Organization (WHO) officials have criticized China�s reporting procedures in light of Liu�s case, which was reported only after he had recovered fully. China�s Health Ministry was informed of the new case 12 days after Liu was diagnosed with pneumonia�on Jan. 26.

WHO spokesman in Beijing Roy Wadia said more stringent standards should have been applied in tracing the number of people with whom Liu came into contact. The government put that number at 48, and said none had exhibited symptoms so far.

�The fact that this person is a doctor in a hospital setting, to have found only 48 contacts, shows that the tracing system needs to be reviewed,�� Wadia told reporters. �We feel that perhaps many more contacts remain to be found. It�s also important for contacts to be found quickly.�

Liu reportedly had no known contact with any animals or SARS patients, making him the fourth case in which the path of infection is unclear. But he was apparently not quarantined or isolated until he was admitted to the Guangzhou Medical College�s No. 1 Hospital on Jan. 16 after his fever reached 39 degrees Celsius.

Nine days later, experts from the Guangdong Provincial Center for Disease Control and Prevention confirmed he had contracted SARS.

China�s Health Ministry, anxious to preserve its good relations with the WHO and stave off fears of a nationwide cover-up, moved quickly to comment. �The case demonstrates that there are some problems with communication between local and central government authorities, Mao Qun�an, a spokesman for the Ministry of Health, was quoted by the English-language China Daily newspaper as saying.

SARS emerged in southern China towards the end of 2002 and rapidly spread across the country, killing 349 people. Nearly 800 people died worldwide as the disease jumped to more than 30 countries. #####


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