AI Update: Guangdong Authorities Coming Clean?

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TAGS: KFLU TBIO EAGR PGOV CH
SUBJECT: AI Update: Guangdong Authorities Coming Clean?

REFERENCE: A) GUANGZHOU 6294, B) GUANGZHOU 8517

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1. (SBU) SUMMARY: Guangdong provincial health and
veterinary officials are showing increased levels of
openness and cooperation. On March 29, officials hosted a
private information meeting for Guangzhou foreign consulates
about the March 2 human avian influenza (AI) death and
subsequent health policies. The initiative to hold such an
event and Chinese inter-agency cooperation are both good
signs. However, questions remain about the general AI
threat level and potential future transparency. END
SUMMARY.

Meet the Press: Cantonese Style
--------------


2. (SBU) On March 2, Guangdong province had its first
confirmed human AI death (reftel A). On March 4, Guangzhou
Consulates learned about the case. On March 29, Guangdong
officials hosted a private "press conference" for the
Guangzhou foreign consulates. The event was unique in terms
of the attempt at openness and inter-agency cooperation
among Chinese government officials. The event also builds
on previous breakthroughs by Post, namely a March 23
planning meeting for a possible digital video conference
(DVC) between Guangdong health and agricultural officials
and relevant U.S. medical officials housed at Embassy
Bangkok (reftel B). The March 29 special meeting included
officials from the Guangdong Veterinary Station of Epidemic
Prevention and Supervision, the Guangdong Health Department,
and the Guangdong Center of Disease Control (CDC).
Officials from about half of Guangzhou's 23 consulates were
in attendance.


3. (SBU) The Guangdong officials conveyed that they are
taking the recent human death case very seriously and
seeking to improve their policies. Officials are working in
six different ways to improve Guangdong's prevention and
response mechanisms: alerting and information abilities;
technical and personnel capabilities; vaccination storage
materials and implementation; cooperation with all relevant
departments; cooperation with other regions (i.e., Hong
Kong, Macau); and public awareness.

Background on Guangdong Poultry and Human Threat
-------------- ---


4. (SBU) Mr. Yu Yedong of the Guangdong Veterinary Station
began the meeting describing Guangdong's potential source
for AI and the government reaction before and after the
March 2 human case. Guangdong is China's largest source of
poultry. In 2005 the province was estimated to have 1.36
billion poultry, or approximately one bird for each PRC
citizen, accounting for 52.3 percent of China's overall
poultry population.


5. (SBU) Yu next described the events surrounding
Guangdong's only confirmed human AI death. On March 2, a 30-
year old Guangzhou native (surnamed Lao) died (reftel A).
On March 4, two national laboratories independently
confirmed the case was AI and the Ministry of Health
announced the results to the provincial authorities. On
March 3, the provincial health authorities enacted their
contingency plan to contain AI. All close contacts of Mr.
Lao (124 people) were quarantined, and special hospitals in
Guangdong were put on "tier-three alert". On March 6, Hong
Kong and Macau health experts met with equivalent Guangdong
officials. Throughout the ordeal, World Health Organization
officials were never contacted. The tier-three alert level

was recalled on March 14.

Scorecard of Guangdong Implementation Success
--------------


6. (SBU) The Guangdong officials described in some detail
how they are improving policies in the six aforementioned
areas. Alert and information abilities: Since 2004,
Guangdong Party Secretary Zhang Dejiang and Guangdong
Governor Huang Huahua have placed Guangdong on "high alert"
and asked all departments to implement relevant measures at
the three main levels of governance: provincial, municipal
and county. In October 2005, Guangdong began creating 43
provincial monitoring stations, which provide advance
information on the AI situation. (When asked by PolOff
about the capabilities of these stations, the officials
provided only a limited answer. In terms of staffing, some
stations like Guangzhou have 130 staff, Shenzhen has around

60. Other cities have only 10-20 people and in the
countryside the stations are even smaller.).


7. (SBU) Technical and personnel materials: Last year the
province invested 200 million RMB ($250,000) in AI programs
and this year has already spent 8.5 million RMB ($1.06
million) on vaccination programs. Additionally, health
officials have received special training on how to manage AI
cases.


8. (SBU) Vaccination storage materials and implementation:
Over 1.2 billion poultry have been vaccinated (98 percent of
the province's poultry) using a domestic Chinese
vaccination. Last year the veterinary department took
190,000 blood samples and found their vaccination to be 95
percent effective. After 14 days the birds develop a strong
immunity to the disease. Emergency materials for health
personnel have also increased, including increasing stocks
of Tamiflu.


9. (SBU) Cooperation with all relevant agencies: The
government has increased exchanges with other departments,
including broadening cooperation with the Department of
Education; Department of Transportation; Department of
Forestry (to collect dead birds for lab tests) and the South
China Endangered Species Center (to monitor migratory
birds).


10. (SBU) Cooperation with other regions: Guangdong CDC
and public health officials have had multiple meetings with
Hong Kong and Macanese officials on how to handle a public
health emergency.


11. (SBU) Public Awareness: The Guangdong government has
increased the amount of public "propaganda". There have
been more television interviews with doctors than during
SARS, and AI informational signs now hang in most hospitals
and medical centers.

Whodunnit?: Mr. Lao's Death Remains a Mystery
-------------- -


12. (SBU) Guangdong has over half of China's poultry
population and one confirmed human case, yet no confirmed
poultry deaths in the past two years. The burning question
at the meeting was: "What was the source of the human
death?" The officials said they still do not know the
source but assumed it came from one of the 12 marketplaces
in which Lao had spent significant time. Though Yu of the
Veterinary Station believed both future poultry outbreaks
and repeated human infections were possible, he ruled out
human-to-human outbreaks in the short term.

Transparency Issues
--------------


13. (SBU) PolOff asked specifically about the rules of
reporting suspected and confirmed AI cases. All final
confirmation of AI cases remains with the Ministry of Health
in Beijing, requiring two separate labs to confirm a death.
Information of an AI death can only be released to the
public after this confirmation. However, Guangdong
authorities may release information on any suspected cases
when they choose. The Guangdong officials agreed to
consider sending information via e-mail instead of the
slower diplomatic note process. The former method was used
during some of the worst days of SARS. (In the recent human
AI case, Lao was suspected of having AI on March 2, but the
information was not released until March 4).

Comment: Improvement and Continuing Problems
--------------


14. (SBU) The unspoken message from this special meeting
was obvious: Guangdong does not want another SARS. It is
believed Guangzhou city was the source of the SARS outbreak,
during which the provincial government was criticized for
apathy, cover-up and economic downturn. At the moment, it
is unclear whether the increased transparency resulted from
foreign or domestic pressure. In terms of influencing the
Guangdong medical response, Post will continue to increase
contact with officials through methods such as the planned
digital video conference. However, because of their access
to internal Guangdong meetings, Hong Kong officials also
remain an important conduit for expressing U.S. concern.
Overall, Guangdong officials should be praised for hosting
the meeting and working with other government departments.
However, they still seem reluctant to inform the public of
suspected cases and working with outside groups such as the
WHO and USG.

DONG