MACAU HEALTH CARE: ABLE TO HANDLE CURRENT H1N1,

C O N F I D E N T I A L SECTION 01 OF 02 HONG KONG 002023

SENSITIVE
SIPDIS

STATE FOR EAP/CM, OES/IHB, MED, CA/OCS/ACS/EAP
HHS PASS TO OGHA, NIH/FIC
CDC ATLANTA PASS TO BLOUT, KELLY, COX
BEIJING FOR CDC, HHS HEALTH ATTACHE

E.O. 12958: DECL: 11/03/2034
TAGS: AMED CASC CH HK KFLU PREL SOCI TBIO
SUBJECT: MACAU HEALTH CARE: ABLE TO HANDLE CURRENT H1N1,
BUT CONCERNS ABOUT FUTURE SURGE

REF: 2007 HONG KONG 1773

Classified By: Acting Consul General Christopher J. Marut for Reason 1.
4b


1. (SBU) SUMMARY: Macau's health care system has thus far
coped well with the relatively few H1N1 cases confirmed
there. However, a more severe wave of infections would
quickly overwhelm local capacity. Macau officials have
adopted internationally recognized surveillance standards but
lack the resources to make effective use of these measures.
Cooperation with Hong Kong and Zhuhai (Guangdong) occurs
regularly but is not close. An H1N1 vaccination program is
expected to begin in November, with "high-risk" groups
receiving priority. END SUMMARY


2. (U) Econ Officers recently met with Macau SAR Health
Bureau officials Dr. Ka-io Tong, Head of Macau's Center for
Disease Control and Prevention (CDC),and Dr. Maria Dulce
Maia Trindade, Coordinator of Health Planning Unit and Public
Health Chief of Service, to assess Macau's preparations for
pandemic influenza.

Adoption of IHR, But Lack of Resources Constrain Effectiveness
--------------


3. (C) Although Macau adopted WHO's International Health
regulations (IHR) in 2008 before the global H1N1 pandemic
started and has strengthened public health surveillance and
response capabilities, measures such as filling out health
declarations at ports of entry and scanning using infrared
cameras were "meaningless," said Dr. Tong, as Macau lacked
the capacity to process this information. He revealed that
the visitor health declarations were collected and then
stored in a warehouse for a period of three months, after
which the forms were destroyed. He did not recall a single
instance when the forms were reviewed for puroses of an
outbreak investigation. He noted thatwhile Macau was willing
to implement IHR recommedations, it lacked the resources
necessary to mae use of border surveillance measures. (Note:
We bserved camera operators sleeping as visitors stremed
by, confirming that these measures were not aken seriously
by enforcement officals. End Note)


4. (U) Dr. Trindade emphasized the importance of both Macau
CDC's adherence to WHO guidelines and cooperation with Hong
Kong counterparts as it continued to upgrade its public
health reporting capacity with the aim of being more open and
timely. Macau exchanged influenza data with Hong Kong and
its mainland Chinese neighbor Zhuhai on a monthly basis, she
said, and also cooperated with Zhuhai on health training
programs.

Emergency Capacity Not Tested, Concerns over Future Surge
--------------


5. (U) Our interlocutors stated that the current mild H1N1
pandemic had tested but not exceeded Macau's health care
system capacity. However, they expressed concern about
Macau's ability to handle a larger crisis. Local H1N1
transmission was delayed by such measures as postponing
summer school, but since the regular school semester began,
the number of H1N1 cases had risen. To date, Macau has
reported only two H1N1 deaths, but health officials predict
more critical cases in the future with the anticipated second
wave of H1N1.


6. (U) Macau's two hospitals - a government hospital and a
private facility - have thus far been able to handle the
current H1N1 pandemic. However, officials acknowledged that
Macau's capacity needed to increase in the long term. Since
April, the hospital staff had been working at maximum
capacity, but Macau's ICU capacity had not yet been tested
because of the relatively low number of critical cases.
However, with only 50 ICU beds, health officials expressed
concern about Macau's ability to handle a surge of more
severe cases. Macau has begun building a third hospital, but
it will not be completed until late 2012. Health officials
worried also about Macau's lack of research and laboratory
capacity. Macau continues to rely heavily on Hong Kong
health authorities for assistance with influenza specimen
testing.

HONG KONG 00002023 002 OF 002



H1N1 Vaccine Expected by End of Year
--------------


7. (U) Health officials stated that Macau would be able to
treat the expected number of H1N1 cases as it had stockpiled
Tamiflu sufficient to cover 30 percent of Macau's population.
They estimated that 80 percent of its population might have
been exposed to the H1N1 virus already, and medical staff had
been instructed to administer Tamiflu to patients with
flu-like symptoms.


8. (U) Tong said Macau placed an order with Novartis in June
for 700,000 doses of the H1N1 vaccine to cover Macau's
population and tourists. He expected the first shipment to
arrive in November. Local medical staff and high-risk groups
including children, the elderly, and patients with chronic
illness, would be vaccinated first. The remaining shipments
were expected in January 2010. According to Tong, health
officials intend to vaccinate the entire Macau population,
utilizing schools, elderly centers and other public community
centers for vaccine distribution.
MARUT