Behind China's Aggressive Stance on Swine Flu

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Greg Baker / AP

Security guards march through a fenced-off courtyard to enforce a quarantine at the Yanxiang Hotel in Beijing on July 21, 2009

As swine flu continues to infect people around the world, governments are weighing measures like school closures and travel restrictions to dampen its effects. But no country has gone as far as China, where thousands of people who have come into contact with the disease have been quarantined. Beijing says that such aggressive steps will help slow the H1N1 pandemic, which has killed 816 people worldwide since emerging this spring in Mexico. As of July 27 China has reported 1,930 swine-flu cases but no deaths.

Infectious-disease experts say it is impossible to stop swine flu's spread and that extensive hospitalization and quarantine efforts divert important resources. Beijing's quarantine efforts have come under added scrutiny over the past few weeks because several large school groups visiting from the U.S. and Europe have been placed under isolation. One group of American high school students who planned to spend this month visiting China's cultural sites have instead endured two separate stints in quarantine. The 65 students and seven chaperones from St. Mary's School in Medford, Ore., were isolated in a Beijing hotel after arriving in mid-July, when one student tested positive for H1N1. After four nights at the Yanxiang Hotel in northeastern Beijing, a facility reserved for quarantined travelers, they were allowed to resume their trip.

But after touring Beijing sites and flying to Henan province, another student tested positive for the flu. That prompted officials from China's Centers for Disease Control and Prevention to quarantine the group once more. As their July 31 departure date approaches, six students with swine flu are in a hospital in the provincial capital of Zhengzhou. The rest of the group is hoping they will be cleared to fly home on Friday. "We came here for a three-week trip," says Scott Dewing, a chaperone and St. Mary's technology director. "When all is said and done, we'll have had at most three days of seeing sites in China."

Earlier this month, the U.S. State Department issued an alert for citizens planning to travel to China, warning that "the seemingly random nature of the selection process makes it almost impossible to predict when a traveler may be placed into quarantine." The U.S. embassy in Beijing says that 1,800 Americans have been quarantined for suspected swine-flu infections this year, and 200 of those tested positive. "Embassy staff maintain regular contact with Americans who have been isolated in quarantine, and we continue to raise concerns with the Chinese about the conditions in which individuals are being kept," says Susan Stevenson, an embassy spokeswoman.

Beijing has taken a firm stance on swine flu from the start. When the strain emerged in Mexico this spring, China began detaining visitors from that country. The aggressive measures sparked protest from the Mexican government that its citizens, including some who had not set foot in their homeland for months, were being singled out. As the virus has spread globally, China's quarantine efforts have ramped up. Crews wearing masks and medical suits walk through airplanes upon arrival, testing passengers' temperatures with pistol-grip thermometers.

The reaction stems in large part from China's painful experience with new infectious diseases over the past few years. In 2002 and 2003, official cover-ups helped SARS spread throughout the country, eventually killing 349 people. Last month Chen Zhu, China's Minister of Health, said the spread of swine flu required an aggressive response. "We are adopting an important containment strategy so that we have more time and space to develop technologies and stock up on preventive materials, including vaccines. It's also part of our contribution to global disease control, and therefore is not an overreaction." St. Mary's chaperone Dewing says he understands the need for aggressive steps to fight the disease. "It's necessary," he says. "If you have people who are H1N1 positive, or possibly positive, you need to be quarantined. That makes sense."

But some medical professionals question the value of such stringent measures. "They are not effective at all in my opinion," says Dr. Lo Wing-lok, a Hong Kong–based infectious-disease expert. "You might be able to pick up certain symptomatic cases at the point of entry, or you might be able to pick up a few person who surrender themselves, but for the majority of cases, you are not able to pick them up either at point of entry or inside the city."

In May, Hong Kong authorities were criticized for sealing off an entire hotel with 300 guests where an infected Mexican traveler — China's first swine-flu case — had stayed. The city's government encouraged people who feared they were infected to visit local hospitals. The result, says Lo, was misuse of resources needed to help actual cases and people suffering from other conditions. "The experience of Hong Kong and most countries is the same," he says. "By picking up these few cases, there isn't any real impact in control of the flu."

With reporting by Jessie Jiang / Beijing

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