A former surgeon who survived SARS has some tips for Ireland in preparing for disasters. Eithne Donnellan, Health Correspondent, reports
SARS claimed hundreds of lives and engendered fear into populations around the world when it struck south-east Asia in 2003.
Few in the Republic will forget the pandemonium caused when teams from SARS-affected countries were initially banned from taking part in the world Special Olympic games then about to be staged in Dublin.
Eventually all countries were allowed participate and the Republic only had to treat one probable case of SARS, which was totally unrelated to the games.
That one case, which was treated at Mayo General Hospital, was of a local man who had been on business in Hong Kong and stayed at the Metropole Hotel at the same time as a professor from Guangdong province in China, who had travelled to Hong Kong to attend a wedding banquet. He was staying on the 9th floor of the hotel when he came down with a fever. He was admitted to a Hong Kong hospital and died a short time later.
Unknown to the authorities at the time he had already spread his infection in the transportation hub that is Hong Kong.
A Hong Kong citizen who visited a friend on the 9th floor of the hotel picked up the virus and was admitted to another Hong Kong hospital, the Prince of Wales Hospital, on March 4th.
By March 10th some 10 staff in the hospital had also developed fever and by March 15th - the day the World Health Organisation named the new disease as SARS - a total of 24 healthcare workers at the hospital had been infected.
The Hong Kong Hospital Authority was battling day and night to contain the spread of this new disease. Its chief executive, former surgeon Dr William Ho, visited the Prince of Wales Hospital every day to help those attempting to manage the situation.
"The whole hospital was shrouded in great fear. It was a mysterious disease, it struck down many healthcare workers, we didn't know how to protect the rest," Dr Ho recalls.
On the morning of March 23rd, the day after a Hong Kong University discovered the cause of the new disease as a corona virus, Dr Ho awoke with fever and quickly developed muscle pain, a cough and an intense headache.
By evening he began to feel he had something "sinister" and went to the Prince of Wales Hospital for a chest x-ray.
When he saw the results they confirmed his worst fears. He too had SARS and he was "shocked".
The hospital had begun treating SARS with Ribavirin and high dose steroids. "I stayed in hospital for three weeks and I suffered tremendously in the process both from the disease and the treatment... in the initial few days I continued to have this fever, profuse sweating, it was very difficult to sleep with all the lines hooked up and I was in solitary confinement obviously because I was supposed to be highly infectious. Even my wife and kids couldn't come.
"And then afterwards I suffered from the side effects of steroids. I got hyper excited, couldn't sleep, had palpitations of the heart, all the muscles were wasted and became floppy, the limbs were much thinner than before and the face got puffy."
But even from his sick bed as he improved he began working again. He communicated with staff and other hospitals where there were other outbreaks by email and telephone.
He lost six colleagues at the hospital and Hong Kong, which became the epicentre for the disease and the fight against it, lost 299 citizens.
"I've come through it but many who survived did have complications afterwards.
"Some still have complications - some have residual damage in the lungs, some have continuous muscle weakness and fatigue, some have long-lasting psychological effects and some had bone problems. Luckily I have none."
The experience has taught him much about being ready for disasters and last week he was in Dublin speaking at a conference organised by the new Health Service Executive on major emergency planning.
"In these last few years we had the SARS epidemic, 9/11 in the US and recently we had the Asian tsunami so I guess all the countries in the world are gearing up towards contingencies and disaster planning.
"So they asked me to come here to share our experience in the management of SARS epidemic in Hong Kong," he said.
He had a few clear messages for the Irish authorities. While he stressed no two disasters were alike, making it impossible to plan exhaustively, it was nonetheless important to plan.
"And there will be not just one plan because we are talking major disasters, we need a total system response. So at Government level they need a plan, the health authority will need a plan, the individual hospital will need a plan, and then the individual departments of a hospital, for example, the A&E department, will need their own plan.
"During SARS our A&E department had to split the department into two, one part of it catering for fever patients and one section catering for all the other emergencies.
"The message is to plan well in advance and to have multiple levels of plans and drills because unless you do drills, you do not know whether it works or not," he said.
Communications is also very important at times of disaster, he said, both inside organisations and to the public at large. Luckily in Hong Kong, hospitals were networked with a common computer system - something not yet in place in the Republic.
And as has been recognised here, Hong Kong realised it didn't have enough isolation beds to cope with a major infectious disease outbreak. "After the epidemic we have put up many more isolation beds. We have constructed a total of 1,400 across 14 acute hospitals in Hong Kong. Some were improved upon existing ones, some were new ones."
Hong Kong doesn't know what epidemic it will face next. And Dr Ho claims there's no knowing if there will be another SARS outbreak.
"Nobody can tell. Nobody can predict whether it will come back," he said.