For a metropolis teeming with 13 million people, it was the most spectacular of disappearing acts. Overnight, Beijing, a city whose wide avenues are usually jam-packed with crowded buses, squadrons of bicycles and even the occasional donkey cart, had transformed into a ghost town. Panicked about Beijing's burgeoning severe acute respiratory syndrome (SARS) crisis, residents were fleeing or staying indoors to evade the deadly disease that had by week's end claimed 48 lives and afflicted 988 others in the capital. Restaurants, theaters and shopping malls resembled abandoned movie sets. Elementary and middle schools were closed for two weeks, while some universities confined students to their campuses. Three major hospitals were quarantined, including the Peking University People's Hospital with its 2,000 or so employees. Only the city's dilapidated railway stations bustled with activity as frantic, face-mask-clad citizens pushed and shoved for a ticket out of town. "I'm very worried about getting on a train with so many people," says a student surnamed Wang, who was waiting for the poorly ventilated train back to his native Changzhou in Jiangsu province. "But I'll do anything to get out of Beijing. It's simply become too dangerous."
It is a crisis the international community has known about for more than a month, but only now is it hitting home in China. On April 20 the government ended a weeks-long policy of massively underreporting SARS cases in the capital, sacking the city's Mayor Meng Xuenong and the nation's Health Minister Zhang Wenkang. In just one day, the city's SARS caseload was revised from 37 to 339. By week's end even that figure had almost tripled. But increased transparency has hardly meant an end to Beijing's looming biological nightmare, and the scramble to make up for lost time has only succeeded in spooking residents who had genuinely believed the city's original lowball SARS statistics. As nervous citizens cooked up exit strategies, the social stability that China's leaders were trying to maintain when they underplayed Beijing's SARS numbers has been shaken. The World Health Organization (WHO) slapped a travel advisory on the capital city, portending a slowdown of foreign investment in Beijing and sluggish economic growth.
Panics can happen anywhere, but they take on epidemic proportions in countries lacking a free flow of information. Unable to rely on government reports, Beijing's citizens were forced to depend on the rumor mill, which was turning at 1,000 r.p.m. last week. Grannies in Mao suits whispered that the entire capital was going to be quarantined, while Internet chat rooms buzzed with claims that the disease was a conspiracy courtesy of the Americans and the Taiwanese. Yu Jun, a worker at a private metal company, had heard that shops would soon be closed and was raiding a grocery store for basic food supplies. "I know this is probably a rumor," says the 32-year-old, whose neighbor has come down with SARS. "But right now I'd rather believe rumors than what the government tells me is true." Meanwhile, in villages on the outskirts of Beijing, terrified citizens have set up blockades to bar all outsiders from entering, creating an atmosphere of desperate vigilantism.
Even more worrying, hospitals on the epidemic's front lines are also spooked. Medical facilities in both Beijing and the country's impoverished interior are reeling, as the very doctors supposed to be fighting the disease are themselves falling ill; at the quarantined Peking University People's Hospital, 70 medical staff caught the disease after one virulent victim arrived at the emergency room. When that first patient checked into the hospital on April 7, doctors had not been adequately schooled in infectious-disease protocol, since Beijing was still denying the capital had a SARS problem. Medical staff quickly fashioned a makeshift isolation ward, but their quarantine techniques proved faulty when 20 patients and dozens of doctors were infected. "We just didn't have the right resources to handle the problem properly," says a department head at the hospital. "It was hard to do the right thing before the government started reporting accurate numbers." In an effort to prevent the disease from spreading to other vulnerable hospitals, Beijing has touted a soon-to-be-finished facility dedicated to treating SARS victims. The complex is a converted clinic formerly used to treat sexually transmitted diseases. Wards are being constructed out of sheet metal and resemble the temporary dormitories usually used to house migrant workers.
For the Chinese government, the SARS crisis presents the gravest threat since the student protests at Tiananmen Square 14 years ago. Confidence that the Party always knows best is badly shaken. China's leaders have parlayed their success at transforming the mainland economically into a depoliticization of the masses that enables continued one-party rule. But if the Communist Party cannot handle a public-health crisisa basic service in most developed countriesthen will it really be effective as China hurtles toward even greater transformations ahead?
How the crisis ultimately rattles China depends, in part, on what happens in the country's financial capital, Shanghai. The city is home to Jiang Zemin's power base, and if any heads roll there, the former President and his acolytes lose out. So far this city of 16 million has appeared largely untouched by the mystery virus. Last Saturday, local health officials had only confirmed two cases and 15 suspected patients, one of whom was an American. So worried were central-government officials that this last bastion of good health might be infected that they sent a directive to Shanghai authorities early last week demanding that local bureaucrats maintain the city's reputation as essentially "SARS-free," according to a vice-mayoral aide. Whether that meant Shanghai really was immune to the disease or whether they were just supposed to give outsiders the impression that China's biggest city didn't have a SARS outbreak wasn't clear. "All I have been told is that we must maintain the image of Shanghai as a place without a SARS problem," says a Shanghai health official, before adding: "Sometimes the reality can be different from the image, but if you want to attract foreign investment, image is the most important thing."
But as the week progressed, Shanghai's much-vaunted image was starting to fray. Local doctors, who have been instructed not to talk to foreign media lest they lose their jobs, haven't accused Shanghai of a cover-up as extensive as the one in Beijing. But they have voiced doubts about the veracity of the government's statistics. In a press briefing last Friday, the WHO, which concluded a five-day trip to Shanghai that day, said it generally accepted the government's confirmed caseload, despite having posted a notice on its own website the day before saying that it suspected Shanghai was underreporting the numbers. (An informal press conference set up by a WHO official on Thursday evening was halted by security personnel.) Though the WHO reported it had been given full access to medical facilities, a doctor at the People's No. 6 Hospital said the international experts were shown "a sanitized version of Shanghai's SARS problem." A doctor at the Shanghai Contagious Diseases Hospital told Time there were more than 30 suspected cases at his hospital alone, double the official suspected caseload for the whole city. He and other physicians also complained that Shanghai's requirements for diagnosing SARS had been much more stringent than elsewhere in the world and that if the standards used in, say, Hong Kong were applied in Shanghai, many patients in the suspected caseload would be shifted to confirmed cases. The same questionable accounting had been used in Beijing, before the capital became more forthright about its viral crisis. On Friday, the WHO reported that Shanghai would be adopting a less strict standard for calculating suspected cases and that the city therefore would soon be substantially increasing its suspected caseload.