HONG KONG: H1N1 LESSONS LEARNED

UNCLAS SECTION 01 OF 02 HONG KONG 001066

SIPDIS

STATE FOR EAP/CM, OES/IHB AMBASSADOR LOFTIS, CA; HHS PASS
CDC, HHS FOR OGHA

E.O. 12958: N/A
TAGS: KFLU AEMR ASEC CASC KFLO TBIO KSAF KPAO PREL
PINR, AMGT, HK
SUBJECT: HONG KONG: H1N1 LESSONS LEARNED

REF: A. STATE 54435

B. HONG KONG 940


1. Summary. The recent and ongoing H1N1 outbreak has loomed
large on the consciousness of the Hong Kong Government (HKG)
and its citizens. This issue was especially sensitive in
Hong Kong, given the collective memory of the SARS outbreak
in 2003. Our task became more difficult when public and
media attention focused on the fact that most cases of H1N1
were imported from the United States and that the U.S.
Government (USG) was not screening passengers departing from
U.S. airports for H1N1. While the net result was a
validation of our preparedness for a pandemic event, it is
also apparent that Post and the USG need to address several
important issues as this public health crisis continues and
before the next one develops. On June 11 the HKG announced
extensive school closures following confirmation of a cluster
of H1N1 cases (Septel). End Summary.

Post Management: A Valuable Test of Capabilities
-------------- ---


2. Post was conducting regular Avian Influenza Working Group
(AIWG) meetings long before the H1N1 crisis unfolded, and
during the initial stages of the H1N1 outbreak the AIWG met
in order to coordinate Post's response to events on the
ground. Eventually, the AIWG expanded to include the entire
Emergency Action Committee (EAC),bringing all of the
members, expertise and capabilities together to address the
current outbreak as it unfolded. As part of the ongoing AIWG
meetings, Post regularly reviewed the tripwires for a
pandemic outbreak, both for relevance and to ensure
flexibility and responsiveness. This continuous review and
refinement led to the establishment of robust yet flexible
tripwires that have remained relevant and useful throughout
the whole H1N1 outbreak.


3. Post was well prepared for prevention and/or treatment of
an outbreak among the staff. The Health Unit stocked
adequate personal protective equipment (masks, hand wash,
etc. and maintained sufficient supplies of antiviral Tamiflu
and Relenza to treat an outbreak among Consulate staff, to
include Direct Hire Americans, Eligible Family Members (EFMs)
and Locally Employed Staff (LES). Additionally, the
Management Section had already established and successfully
operated internal communications systems including phone
trees, SMS messaging and AIWG work and personal email
distribution lists, enabling Consulate leadership to
communicate routine and emergency messages in response to
changing conditions.


4. One issue we identified as an area for improvement was
the need to designate a single point of contact for Consulate
staff who may be sent into quarantine in the future. In
response to this identified need, Post designated the duty
officer as the point of contact for all personnel, in order
to ensure a rapid response from Consulate leadership in the
event of staff involvement in the quarantine.

Consular Issues: Amcits ) Handle With Care
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5. The HKG's quarantine program affected American citizens
from the beginning and continues to impact Americans arriving
in Hong Kong and transiting to other destination through Hong
Kong. In total, the HKG ordered more than 30 Americans into
quarantine, of whom six tested positive for the H1N1 virus.
Additionally, dozens were and continue to be placed in
medically supervised self-isolation and treatment and
prevented from departing Hong Kong. The ACS Unit coordinated
with the numerous HKG agencies involved to obtain assistance
for the affected Americans for a variety of issues related to
their involuntary quarantine or self-isolation. We continue
to provide updates and information to affected individuals by
telephone, as well as to the larger American community in
Hong Kong via warden messages and the consulate website.

Public Diplomacy: Responding to Hysteria
--------------


6. (SBU) As a result of statements by Hong Kong officials,
the Hong Kong media and political groups accused the USG of
¬ doing enough8 to prevent the spread of H1N1. They
were particularly critical that the USG was not screening
departing passengers from U.S. airports for H1N1. In one
unfortunate incident, Hong Kong's Secretary for Health went
public with criticisms of the USG's response to the crisis

HONG KONG 00001066 002 OF 002


before raising them directly with Post or Washington. Post
tried to overcome this negative perception by developing
talking points and messaging tailored to demonstrate the
positive steps the U.S. federal, state and local governments
were taking to prevent the outbreak from spreading.
Privately, the Consul General pressed both the Secretary for
Health and the Chief Executive on the matter, reiterating
steps we were taking to halt the spread of H1N1 and its
transmission outside of the United States.


7. Once the H1N1 outbreak spread to Hong Kong, the HKG and
the public perceived it as an &American8 disease and, as
such, we needed to address significant political and public
relations issues. We would have benefited from a coordinated
effort in Washington to counter this widespread public
perception. A quick and coordinated interagency response
would have done much to halt the steady stream of negative
press and public sentiment surrounding the origins of H1N1 in
North America and its spread via U.S. outbound travelers.

Interactions with the Hong Kong Government: Hits and Misses
-------------- --------------


8. Post had developed an extensive network of contacts at
the working level in the HKG who were accessible and able to
provide a continuous stream of information about the
situation during the outbreak. The statements and actions of
policy-level actors in the HKG, however, were more difficult
to predict and, without authoritative guidance from
Washington, difficult to respond to. U.S. Secretary for
Health and Human Services Kathleen Sebelius, meeting with
Hong Kong Secretary for Health York Chow on the sidelines of
the World Health Organization Assembly in Geneva was an
invaluable reinforcement of Post's message about the
sustained and positive response the USG was making to contain
the spread of H1N1. However, while Secretary Chow went
public with his account of the meeting within an hour or two,
we have yet to receive any reports from within the USG on
what they discussed.


9. The HKG asked Post for USG assistance on several
occasions, including requests to screen passengers and
provide informational and advisory signs at airports for
outbound passengers. Post relayed the requests to Washington
but did not receive a response.


10. The HKG response to the H1N1 outbreak evolved as their
understanding grew and as they saw how difficult it was to
contain the spread of the disease. As a result, the rhetoric
coming both from the HKG and the media has calmed
considerably. We continue to cooperate closely with both
Hong Kong and Macau, and maintain an active and positive
campaign to inform the media and the public about actions the
USG is taking to combat H1N1.


11. The H1N1 outbreak has been less serious than initially
feared and has served as a valuable opportunity for Post and
the Hong Kong and Macau Governments to refine plans and
procedures for dealing with pandemic outbreaks, as well as to
identify areas for closer cooperation. This issue is far
from over, however. The HKG announced the first confirmed
local transmission of H1N1 in Hong Kong on June 10 (Septel),
followed by confirmation on June 11 that 12 students were
infected in a cluster of cases at the same school. In
response the HKG announced a series of additional steps,
including closure of all nurseries, kindergartens and primary
schools for two weeks, in an effort to contain this community
outbreak. In the face of this ongoing public health crisis,
we will continue to build relationships and maintain close
lines of communication with our partners in Hong Kong and
Macau in order to increase our ability to respond to this and
future outbreaks.
DONOVAN