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