Over-securitizing Public Health? The Recent Hong Kong Flu Case

March 17, 2008

Most of us who have lived through SARS and been bombarded with statistics about the likelihood of an Avian flu outbreak, understand that protection from infectious disease is critical to people’s sense of well-being in Hong Kong and China. So I was not surprised to learn that the Hong Kong government (HKSARG) decided to shut down primary and pre-primary schools two weeks before vacation was scheduled as a precaution against the further spread of an influenza strain that had already killed 4 children.

If my kids were in school in Hong Kong, I would no doubt be pleased with the government’s actions. Yet, from the vantage point of London, the HKSARG’s recent school closures seemed to indicate a very serious health threat, one which underscored Hong Kong’s relative vulnerability to global infectious disease pandemics.

I am interested in how human security students feel about the HKSARG’s response.

For example, since a consensus has seemed to emerge that this is not the start of a deadly pandemic, are these school closures an example of the Hong Kong government “over-securitizing” the influenza threat — needlessly elevating it to crisis proportions? Might this threat elevation not be more damaging to Hong Kong’s overall economic security then the actual influenza virus itself? Or did the Hong Kong government’s actions in this case give you more confidence in the government’s ability to handle public health threats? In your view, what impact will this vulnerability to infectious disease have on Hong Kong’s international standing?

For Hong Kong students, how vulnerable do you personally feel to this threat of infectious disease? Would you classify this health vulnerability as a threat to your personal security? If you do feel vulnerable, would your sense of insecurity compel you to seek alternative residency options or do you classify this vulnerability as a manageable concern that does not outweigh the many benefits of living in Hong Kong?

What insights does the human security approach have to offer Hong Kong in this case?

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22 Responses to “Over-securitizing Public Health? The Recent Hong Kong Flu Case”

  1. Bessie Chow Says:

    The decision of shutting down all primary schools and pre-primary schools in HK for two weeks due to influenza strain (four children were killed and a numbers of kids have flu) has received mixed comments from the pubic. Many parents welcome this decision while other critized that the government of being inconsistent, hasty and late in reaching the decsion.

    Within 24 hours the government stance has changed drastically. Early in the morning of 13 March, the Secretary for Food and Health, York Chow said there was no evidence for an influenza outbreak and the infectious rate was noraml. He further assured that there was no need to suspend classes and school authorities can close their inistution subject to their own circumnstance. But in 10:45 pm on the same day, the governemtn annoced that all primary and pre-primary schools shall be closed immediately to prevent the spread of flu. It was a little bit sudden to annoce the news at night. First some studnets were not infromed and still went to school the next day. Secondly, schools could not even assign homework to their studnets and deal with any logistics beforehand. Thirdly, some parents have difficult to seek child care as they did not expect the government to come to the decision at that moment. Consequently, there were some complaints from both the school authoriteis and the parents.

    Yet I think this is not important. I am more interested in why the officials changed their minds within such a short period of time. What information and standard guide their decsion making and what are the implication to local citzens and the international cmmunity?
    Appearntly, being trained as a doctor, York Chow seems to take the health of children and prevention of the disease more seriously. Or may be the official has learnt from the SARS lesson and is awared that taking precaution measures are the best way to avoid widespread outbreak. It is good to hear that the governemtn is consider to offer every child under 12 free flu vaccine.. I think the public genreally support this suggestion.

    Here I do not guess what factors has led the administration to shut down the schools. I only feel that sometimes it is hard to predict what the officials would do in time of infectious diseases as we as citizens lack sufficient information to judge whether there is an outbreak and we rely on governmental inforamtion to take precaution measures. SARS has forced HK to learnt a big lesson, both the administration and the public are more aware and alert of infectious disease and more actions e.g. setting up of a infectious disease unit and more cooperation with the Mainland authoirty, I still have doubt on ability of local governmetn to act promtly. Given the spread of Influenza virus these days and the fluctating peroframce of the administration, I do not have full condifence on the government to hnadle public health crisis.

    The Secretry’s decision to suspend classes has several implications.
    For the local community, it is a clear signal that the flu virus has spreaded and the public should be alert and take preventive measure without delay. But there is no panic in the society, eveything is going well. The weaker, younger and older are more vulnerable to the virus and I think the government is right to close school and prevent the young children to be infected. Human life is the most precious asset.

    But this act has conveyed very different meesages to people around the world. Many of them as Dr Cumming has suggested that HK is really in a critical istuation and the virus is hitting. The World Health Organization mainitain that it is safe for traveller to visit HK and the outbreak is normal. But I do not think foreign press are taking their statements seriouly. From this example, I realize that it is difficult for government to disclose or even to close some of their instituions temporarily to prevent infectious disease as a bad impression is likely to be created despite the situation is not serious.

  2. lmcinhk Says:

    Bess —

    Thanks for your “blow-by-blow” description of the event itself. While you think that the HKSARG has done the right thing in this case (I agree), you still don’t have confidence in the government’s ability to handle a health crisis. Why not? What can the HKSARG do that would give you confidence? How do you relate this event to our study of human security?

    — LMC

  3. Luigi Says:

    Certainly any actions that are immediate and have an air of urgency can cause some tension as people question not only the seriousness of the problem but their own inherent safety and health concerns.

    I feel however, that Hong Kong is able to keep the attention on the problem in a much more subtle manner than, say the terrorist watch in America, which has people literally looking over their shoulder and doubting their neighbors.

    After Being affected by SARS, which became an epidemic that grew global, I think the HK administration was justified in taking the precautions as they have. To me, they did not blow the incident out to cause a mass fear, though they took careful steps to ensure that those most vulnerable and likely to further spread any virus, did not.

    The HKSARG have are friendly and humorous posters reminding people to wear masks if coughing and not to spit for it spreads disease, and they are not necessitating people to wear masks or die.

    HK is a very dense city with issues that run deep to the core of the city planning, including waste disposal, environmental pollution, and water safety. As that is, I feel the government has managed it quite well.

    I believe that this effective response might bring attention and more awareness to the problems of density and pollution in HK, but I don’t think to any economic degree. This is so, and this event can further relate to our study of Human Security as it highlights the steps that the government will take to quell concerns by further preventing the spread of any viruses. They were open in the press, they committed to tackling the problem at hand, and they are not mandating for everybody to wear masks.

    People understand that coming to HK is no, for instance, Vancouver, but with the positive steps that the HKSARG took, and the ways in which they manage the city to the effectiveness that they do, I feel that it enhances my confidence in the city’s planning and decisions.

  4. lmcinhk Says:

    Luigi —

    Good points. It is interesting to read your upbeat assessment in contrast with Bess’ lack of confidence. I wonder how the families affected feel about what more (if anything) the HKSARG could have done to prevent this outbreak.

    As for the long term impact on Hong Kong, I’m still mulling over this. I wouldn’t worry so much about HK’s health and environmental concerns impacting temporary residents or tourists. I would be concerned about the best and the brightest (your classmates) leaving HK because of a fundamental insecurity about long-term health and well-being.

    — LMC

  5. Bessie Chow Says:

    As a HK student, I do not feel vulnerable to this threat of infectious disesase for two reasons. First, I have a healthy and disipline life style. I am fit and healthy so I think I am less likely to be attacked by infectious diseases. I also take many preventive measure such as injecting vaccines.

    Apart from prevention on personal level, HK’s health care system is advnaced, affordable and deliver quality services ( I think this make a huge differnece with people living in developing nations). I have confident that at the front line health care workers are able to cope with the infectious disease even the health care officials may be indecisive ( their records are not good enough. Their poor performance during SARS is still fresh I my mind).At the moment I have no reason to move my residency because of health risks in HK. It is still a safe place to live in despite the SARS has shocked us and the Avian flu or any other flu knowks on our door.

    Yet there are still risks for outbreak of infectious diseases and the spread may be fast as well. HK is a densely populated city which is an ideal place for disease spreading.

    Also, there are millions of traveller visited HK every year, largely mainland residents. The high mobility of the population also increase HK’s vulnerability to infectious diseases. From the SARS outbreak, we learnt that a reliable reporting system between the neighbouring provinces and HK is a must to combat infectious diseases. Accordingly, high level working groups are formed. But I still worry that mainland officials will fail to report any unnatural or abnormal health conditions to HK honestly and promptly ( as during the SARS period, HK officials discovered that disclosure of spread disease was regarded as disclousure of state secretes which greatly hinder the prevention of SARS).

    I believe mutual cooperation will be key to fight against infectious disease at the preliminary stage especially HK and Mainland China are integrated and so proximate to each other.

  6. Annie Wong Says:

    Personally I do not feel vulnerable to this spread of infectious disease, though I have been more sensitive about my health condition. One reason that I do not feel vulnerable is because of the quick response HKSAR government has done to acknowledge the society about the spread of influenza.

    I think this time the HKSAR government has done a good job making a quick decision to shut down primary and pre-primary schools. What’s more is that the HKSAR government is very transparent and has provided, I guess, most of the information they know about the situation to the public. This transparency of knowledge is very important because it allows people to get prepared for it and thus in the community, prevention is done before a great outbreak occurs.

    I think the HKSAR government has learned from the SARS on how to handle public health threats. After SARS, the HKSAR government has developed early warning systems in hospitals to notify the public about any potential infectious diseases outbreak. Hospitals start limiting the patient visiting time to minimize chances of transmission from patients to outsiders. Not only the infrastructure systems are better established since SARS, government’s quick decision to shut down schools has demonstrated it has learned from SARS experience, that better to prevent in the early stage and minimize the chance for widespread of disease than wait till everything is clear-an outbreak has occured and react to it.

    I am interested in this question: Are these school closures an example of the Hong Kong government “over-securitizing”the influenza threat. I am not sure about the definition of “over-securitizing”. In what way we can judge if we are “over-securitizing” something?
    Human Security Approach would suggest that dealing wih global health threat, prevention is at the core of the solution. And if we are to be people-oriented, we are standing from the affected people’s points of view to understand how the infectious diseases are threatening their lives. So to the affected people, there will not be any “over-securitizing” as doing all things to keep them survive is the most important afterall.

    A human security approach will be central to health and human survival for all and should thus be supported by the global public through all member governments. Yet, diverse priorities would be expected among different communities and countries. (CH.6, Better Health for Human Security) While in Hong Kong, the greatest health-related security threat might be avian flu or SARS, in Africa it will be HIV/AIDS. Should we establish some threshold that diseases is evidently globally widespread enough to securitize the issue on global level and urge international communities to act on it together?

  7. lmcinhk Says:

    Bess —

    Good points about the importance of Mainland central and provincial government reactions to infectious disease threats to Hong Kong’s own public health.

    Annie —

    One of the critiques of the human security approach is that “securitizing” issues, like public health, doesn’t necessarily help communities better deal with the problems and in some cases can hurt (hence the notion of over-securitizing).

    In the HIV/AIDS segment, for example, we learned of the Libyan government accusing Bulgarian nurses of deliberately infecting Libyans — blaming “outsiders” is a classic national security technique. Many foreign universities canceled exchange programs with Hong Kong students during the SARS outbreak, just as China does not grant visas to HIV positive persons. Public health experts argue that these types of steps are ineffective, yet when public health is “securitized” these types of policies are not uncommon.

    You have laid-out the reasons why you think the HKSARG response in this case was effective, not a “knee-jerk” over-reaction. I largely agree with your analysis. Yet, while HKSARG policies may be said to be good in terms of preventing further spread of the virus to the healthy, I would be interested to read more about what policies (if any) might have been undertaken to prevent the outbreak in the first place. How are vulnerable and marginalized people being served by the HKSARG approach? Upon further investigation, you may discover that HK is a wonderful example of human security principles applied.

    By the way, the Word Health Organization does have an “Epidemic and Pandemic Alert and Response (EPR)” unit that is concerned with the “global threshold” issues you discussed.

    — LMC

  8. Pretty Chan Says:

    The HKSARG’s prompt response in this case can be analyzed in two folds:
    i)Post-SARS fears; ii)Potential adoption of human security approach.

    i) Post SARS fears
    As discussed above by Bessie and Annie, after the SARS epidemic, the HKSARG fear that there will be another pandemic in Hong Kong, which would cause the halt of the whole city. Even though some may criticize HKSARG as over-reactive, since the flu is not as wide-spread as that as SARS now. Objectively speaking, the government’s reaction is appreciated as humans cannot predict the speed of how bacteria spread. The criticism in town on how irresponsive the HKSARG worked has put political pressure on HKSARG to be preemptive in any possible health threats, which would affect not only the health of citizens, but also tourism and economy.

    Michael Richardson, “Bird Flu and Bio Security: Is the World a Dead Duck?” explains how unpredictable such epidemic can be. In my view, HIV and SARS or Bird Flu are different, in the sense that the effect of any epidemic in Hong Kong, a financial hub in the world, would be detrimental on its international reputation, as well as hazards on humans.

    ii)Potential adoption of human security approach.
    The prompt response of HKSARG reflects its potential adoption of human security approach in decision making process. HK is not vulnerable to infectious disease when compared to the HIV in Africa. This does not mean HK is free from health threat

    Different from HIV in Africa, I think HKSARG’s response is more focus on the unpredictable spread of the disease, but not on the economic security of people. Even when you are rich, that doesn’t guarantee you would not be infected since this is not 100% curable, as in SARS. However, HKSARG’s response to close schools can ensure equity in protection from possible infection, since some well-off families might be able to provide children with better immunity (food, medicine, environment), poor families are comparatively vulnerable. The HKSARG attempts to lower the possibility of infection in public places regardless of their wealth, status, but the overall health condition of HK. The HKSARG plays a role of mobilizing social action and investing in supportive social arrangements, including the access to information, to remove the root causes of ill-health, to provide early warning systems in case an epdiemic occurs. This is consistent with what is outlined in Report of the Commission on Human Security.

  9. lmcinhk Says:

    Pretty —

    Yes, I do think an argument can be made that the HKSARG approach is in line with human security principles since the government placed the needs of vulnerable persons in front of the potential negative macro-economic effects that a school closures announcement may have on Hong Kong more broadly.

    I did not understand your point — “hiv and sars and bird flu are different in the sense that the effect of any epidemic in HK…would be detrimental on its int’l. reputation.” Doesn’t that make these viruses equally as destructive?

    — LMC

  10. Winson Sau Yin Chu Says:

    I think that there was no need for such a dramatic response in light of the statistics of flu incidents being comparable to the statistics of previous years. Thus, I would like to argue that government had largely made its decision for a territory-wide closure of pre-primary and primary school to be based on public opinion instead of scientific fact. Thus, conversely, it is irresponsible of the government, because if the government were to adopt such decision-making formula again, there might be situation where scientific fact suggests the occurrence of an epidemic while public opinion might not be reflected accordingly. This type of decision-making might be damaging to human security, which in the end will damage the health of the vulnerable.

  11. lmcinhk Says:

    Winson —

    I’m not sure if I understand your argument. I understand that you see the HKSARG’s response in this case as excessive, but I don’t understand if you are concerned about whether governments might only act based on public opinion, even if that opinion is contrary to scientific fact? Or are you suggesting that unless public opinion demands it, governments will not act? Perhaps if you illustrate your argument with an example, it would clarify your position.

    — LMC

  12. Eugenia Chan Says:

    Hong Kong is facing a wave infectious diseases. After the attack of SARS and a serious threat of outbreak of Avian Flu, Hong Kong people have become aware that infectious diseases are closely linked with security. The HKSAR Government has also become much more vigilant in handling crisis of infectious diseases.

    Before the decision of the government to close down all primary and pre-primary schools, the cases of influenza in young children have been mounting according to the Secretary for Food and Health, York Chow. Also, already 4 children have been killed by influenza.

    Children and the elderly are most vulnerable. Some in society call for closing down of primary and pre-primary schools. Widespread worried remind Hong Kong people of the terror of SARS. The Government is under intense public pressure to take pre-emptive action to prevent outbreak of influenza.

    As Bessie suggested, the Government insisted on not closing down schools until late at night on 13 March. Many parents were not informed and still took their children to school the next day after the announcement. Due to the suddenness, schools did not take any preparatory measures such as to give out homework or to handle logistics.

    Taking the lesson of SARS, I personally think that the Government’s decision is right. Many people think that the influenza is not as serious as SARS and the Government was over-securitizing the situation. However, the situation is that the cases of influenza have been mounting as mentioned above. Also, in the early stage of SARS, nobody could predict that the disease can be so serious. The situation of influenza could have become much more serious if the decision was not taken timely. One cannot risks anything concerning health and lives.

    At school children are densely packed together and due to their relative weakness they become very vulnerable to the disease. It can be observed that after the closing down of schools, the number of cases of influenza has plummeted. For the sake of better security, I think the Government is right.

    Second, many people think that the closing down of schools send a message to the rest of the world that the situation in Hong Kong is really serious and this might affect the economy as well as the image of Hong Kong.

    Taking lesson of the human security model, individuals should always be our top priority. We should focus on combatting the disease but not to retain our reputation and to hide things up from the rest of the world to protect our “national” interest.

    As seen from SARS, the Chinese Government in order to remain its reputaton hid figures of SARS patients. This action shut the doors to international cooperation to take timely collective action to fight against the disease. Finally, the disease spread to other Asian countries and developed into a quasi-epidemic. I can’t agree more with Annie that international collective standard or campaign is needed. If we are to better protect human security, we should be brave to ask for international cooperation and to inform other countries of the threat so as to curb the disease.

    Also, this expediency in taking active action against the influenza can retore confidence of foreign investors as well as international community towards the Government’s capabiliy to deal with another outbreak of infectious disease. The Government’s proposal to offer free influenza vaccines to children under 12 as mentioned by Bessie can be seen as a gesture of the Government’s determination against infectious diseases. This might also contribute to our international image.

    However, the Government can still improve on its measure. As mentioned above, the unpredictability lead to inconvenience of schools and parents. The Government should inform of the public of this decision in advance to allow 1 or 2 days for them to get prepared. Also, the Government can hand down guidelines on how to better fight against influenza.

  13. Jeni Cheung Says:

    Personally, I think the action to close schools is appropriate as I think it is always more important to secure human lives. Contrary to damaging HK’s international standing, I think it can actually provide an example to other states as how to prevent a potential health crisis. In terms of economic security, this attack of flu may bring unfavorable macro conditions to the worsening of the stock market, however, considering the medical cost it saves from a potential crisis and the utility level of citizens if a crisis really happen, I do believe the government’s action is reasonable.

    However, I think the majority of us seem to be underestimating the devastating effect the flu outbreak could have on us. This lack of awareness is most fatal. Fortunately, the government has agreed to provide vaccines for under 12 children. However, I think perhaps the government can advertise more to increase the public awareness such as promoting injection of flu vaccines.

  14. Sannie Says:

    I think the point of“over-securitizing” the influenza threat is very interesting. I guess this refers to the “fortress mentality” under the national security approach, that government starts to accuse some human security actors of undermining their national security, and attaching stigma to certain human security issues.

    1. First I would like to comment on the appropriateness of the policy.

    If we adopt that multi-dimensional response of the human security approach, the emphasis is on prevention and treatment strategies delivered by a multidimensional array of actors. I think the Hong Kong government is not over-reacting in this move, and is certainly operating due to an overriding concern of prevention. It is also suggested by the UN Human Security Final Report that there are strong links between health and human security. Good health is essential and instrumental to achieving human security. Sudden outbreaks of a contagious disease or other health crisis can destabilize the entirely society and surely the economy. In the Hong Kong context, a healthy environment is essentially an important asset to its economic stability – its economy is heavily dependent upon foreign investments and confidence. If we look back at the SARS crisis when investors were more cautious and reluctant to invest, we certainly have learnt the lesson that there is a strong link between health and economic security. This “ doing more is better than doing less” ( a common saying here) attitude is, I think , very appropriate.

    2. Moreover, I would like to point out that Hong Kong is a good example of application of human security.

    In this incident; the Hong Kong government targeted the most vulnerable group – the children. Indeed they are the group that needs the most protection. The government has also issued a report on Hong Kong’s preparedness for influenza pandemic-Prevention and Protection. The guard against influenza pandemic, the global outbreak of disease of influenza, reflects the government’s awareness of the global wide effect of infectious diseases, which is one of the most important elements of human security approach. The government is also working closely with WTO on the matter.

    On the prevention part – the government has set up the Centre for Health Protection to strengthen Hong Kong’s public health system against communicable diseases. It also make the authorities more prepared for emergencies and public health crisis. Each major public hospital also has an infection control team , to oversee infection control policies and practices. On the protection side, the government has contingency planning for potential outbreaks, spanning across many departments of the government. They also seek help from the civil societies. If there should be an outbreak, private doctors, associations, and non-governmental organizations will be involved to draw up volunteer lists for assistance in public health or clinical services. I do think that the government sees the importance of including all possible actors in human securities effort.

    Personally, I feel safe in Hong Kong, and this analysis into the public policy from the perspective of human security analysis further increases my confidence.

  15. Jaime de Ano Says:

    I think that the action to close HK schools is an appropriate response. One aspect about the security from want school of human security is the need to protect individuals from any threat that prevents people from living in dignity and earning a livelihood (HSC: 2003,5). Being from Australia, we have learnt that quarantine and the control of goods, especially food and other natural products, coming into the country, is vital. In terms of influenza, it is a fundamental concern that this disease may spread onto the Australian mainland. The degree of damage that SARS, influenza, bird flu and other disease to the natural environment and to Australian society would be horrendous. While this is the case for many states in Asia, the current isolation of Australia – in my opinion – creates a sense urgency to find ways of controlling the spread of disease. Indeed, previous Australian governments have gone to great lengths to provide support to Asian governments to fight the spread of disease. This is because the present, highly controlled, environment within Australia creates an appreciation for regulating human activity to reduce the risk of contagious disease being spread.

    Recently, in Australia, we saw the spread of horse flu. The spread of this disease from Japan to Australia caused a major crisis in the horse racing and horse breeding industry, and threw into question the quarantine system currently in place. Perhaps most devastating was the damage done to a large segment of the Australian economy, including jobs lost and families placed in economic hardship.

    In my opinion, the most frightening aspect about the spread of diseases, whether it be diseases impact agricultural goods or livestock or diseases impacting humans, is not the direct impact it has on the afflicted subject. An epidemic has the ability to damage the very foundation of society, that is, it can bring to a halt the various interactions that human beings undertake with one another. Any policy response that illustrates that an outbreak of a disease is being managed and dealt with is commendable, because the primary objective – in my opinion – is the need to control public anxiety about the spread of disease.

  16. Muji Tang Says:

    As a Hong Kong resident, I agree and support with the HKSARG decision on the early closure of kindergarten and primary schools due to the influenza outbreak. I do think that is an appropriate policy to be taken at the right time and that does not show the government is “over-securitizing” the influenza threat.

    As Bessie, Annie and Pretty has mentioned above, the post-SARS fears have made the city and the HKSARG anxious about their health and the possible of the next killing epidemic here. Some people criticized th e government is over-reacted while I think the problem lies more in the suddenness of the policy which makes people think the government is not prepared and systematic in preventing and handling another health crisis here in the city after avian flu outbreak and SARS. Information and details of the outbreak is not transmitted to the public effectively while many people worries the virus has changed and that could be another SARS while at the same time, it was reported there was H5N1 infected poultry in mainland China. It shows the government cannot react systematically and in an organised, not panic way, to give confidence to people here. I am glad that the decision was made but still it was not done very well in the sense that the public is puzzled, more worried, and may send a wrong message overseas that the outbreak has started. Say, my overseas friend asked me whether HKU is closed.

    After all these, although personally I still feel safe in Hong Kong, but I don’t have confidence in the government in handling a health threat. The main obstacle is still be the lack of communication between HKSARG and mainland government in combating any heath threat across the boarder. Hong Kong is too vulnerable to the less desirable public health condition in China. That would be the biggest difficulty for the HKSARG to do a better job. Moreover, I think the government should have learned from the H5N1 and SARS epidemic on how to improve the communication of messages to the world about HK’s situation. While HK has already been famous for her epidemic’s history, HKSARG should be more careful in responding to another health threat. I would say the government improve and change some policies including warning system and statistics in acknowledging the public about what is going on while here I emphasize the importance of transmitting the correct message to the world.

    I think the human security approach can apply to the case in Hong Kong. For the city’s past experience of tackling epidemic, it seems that our city is especially vulnerable to “unknown virus”. HKSARG needs to include health threat when adopting the human security approach. It is because there is a strong link between a stable and healthy society and the sustainable development of the city in social and economic senses. H5N1 and SARS have already demonstrated how health threat can destroy a city by the deaths brought, lack of confidence of locals and lack of confidence from the world.

    In future, I would expect the government can adopt a people-oriented approach in handling public health issue here. The suspension of schools is a good step to start that indicates how the government should re-act in preventing a possible outbreak. However, I am still skeptical about the long-term commitment of HKSARG in preventing HK people from public health threat and ensuring we can get proper medical services. It is because of the lack of a commitment to public health services finance as I observe from the recent consultation paper.

  17. Sandeep Says:

    Personally, I do not feel that the government’s actions were excessive nor were they inappropriate, taking into account two factors for me is very important. The first being that easter holidays were just around the corner, my sister is a kindergarten teacher(how she handles them is beyond me) and she said her kids just missed three days of school because of the closure of the schools. Taking that into account with, secondly, that public emotion was at a low because of the death of the seven year old in hospital.
    In such a situation, despite York Chow’s claims(probably rightfully so) that there was NOT an epidemic coming along, such a precautionary measure to close the schools was probably justified.

    This move does raise two questions for me though, one is the very fact that York Chow said all was well in the morning then the administration took a u-turn to close all schools at night. This suggests to me that maybe York Chow’s comments were a little too rash and did not fall accordingly to the departments holistic views on the matter.

    Secondly, I wonder whether such an action would not prompt paranoia and fear within the general community. Closing ALL the primary and kindergartens is not small thing and was viewed by many as a “serious” move for what was probably a “serious” threat. Take the average person who does not watch the news and was watching TV serials(something we all quite commonly do i think) at around 10-11 pm that night. The sudden ticker flashing at the bottom of the screen would probably set off alarm bells to even the single man who has no care or concern as to what happens in primary schools. Although ultimately this did not happen, it might have been more tactful for the government to make the announcement more orderly perhaps late in the afternoon rather than at a time when most kindergarten students should be in bed.

    York Chow to me took the rather safe than sorry route, and seeing as what happened in 2003 when the government decided to downplay fears, it might have been the right way to go, what I am concerned with is the manner in which the government went about doing it.

    Personally, I have to say that i wasn’t very much concerned with the flu. I do not feel that by closing primary schools and kindergartens the government elevated the situation to a “crisis”, rather to me personally it was more of a “mini-crisis” for children under the age of 12. When the schools were closed in 2003 for SARS, ALL schools were closed so this incident struck me as a mini-problem.

    I don’t feel Hong Kong is particularly susceptible to health infections(Thailand, Cambodia and Vietnam if anything). The fact that we are next to Mainland China does not, I feel, make us more susceptible to any sort of infectious diseases, the very fact that we were at the center of the SARS crisis in fact makes me feel that we might be more ready(I’m reluctant to say prepared) for any infectious disease that hits.

  18. Elaine Chang Says:

    As an exchange student in Hong Kong, I feel that the HKSARG has done a great job in taking measures to provide a sense of security to its residents. However, when I first heard that the government would be shutting down primary and pre-primary schools because 4 kids had died of the flu, I thought the HKSARG had taken the situation to the extreme. There are almost 7 deaths per hour caused by the flu in the USA (http://www.wrongdiagnosis.com/f/flu/deaths.htm) and yet, that is a statistic no one seems to realize (although America may not have the best healthcare system). Granted, I have only been in HK for a couple of months and I would not be able to relate to the fear instilled in the people by the Avian flu or SARS epidemic, but regardless, I did feel there was an over-securitizing of public health when I first heard about the government’s response.

    The precaution taken by the HK government does remind me of the terrorism alert system in America though. As an American, I feel that the alert system is simply a scare tactic to reassure citizens that the government is still taking preventative measures to “fight terrorism” and prevent 9-11 from occurring again. Yet, despite feeling that there is minimal threat, I still do feel safer. By taking these measures, both the HK and US government reaffirms its people’s faith in the government’s ability to protect its citizens.

    Despite the extreme response of the HK government, I think they did the right thing. It is important for a country to take action that will bring awareness and ensure security amongst its citizens. People need to feel that their government is taking precaution and will be able to take proper steps if the epidemic actually became widespread.

  19. Kenny To Says:

    Four students had already been killed because of the influenza and the Hong Kong government (HKSARG) reacted to shut down primary and pre-primary schools two weeks before vacation was scheduled so as to stop any further spread and prevent any possible tragedies. These all seem to be serious and great matter in the society and attracted torrents of comment on whether the government acted properly.

    Main critics come that the government was over reacted, being too sensitive. Schools should not be shut down that quickly and perhaps, they should not be shut down within the whole territory.

    In my opinion, the government action was fully understandable. Learning the lessons from the previous events like SARS, the government is expected to react more quickly and major decision should also be delivered earlier and immediately. Thus, in the recent situation, there are already four children being killed. They government cannot bear the cost brought from any further tragedies. No matter it is one more precious life or the social condemns from citizens and deteriorated government’s reputation and citizens’ confidence towards the government, the government cannot let these happen from a similar event. For me, though it was being criticized for over-reacting, I still support this decision. After learning the previous lessons from Avian bird flu and SARS, you would find that the government, this time, is willing to learn from them and change their practice so as to make a better situation. This actually gave me more confidence on the government. Moreover, since there are already four children dead and life is invaluable, a more rigorous approach is needed to stop the spread immediately.

    Still, there may be some rooms for the government to improve. For example, I think, before shutting down all schools in Hong Kong, an intermediate approach to shut down schools in that community may be adopted so that the government would not be criticized for over-reacting and influencing schools administration in the whole Hong Kong while proving a reasonable mean to stop the spread. Moreover, as what Bessie has suggested, the instant change of the government’s stance should also be prevented so as to deliver a clear and convincing image to the citizens for the disease to prevent the social panic.

    Besides, in the view of ends justify means, the result of the recent government’s decision is probably satisfactory since no further death appeared, there was no panic in the society, at least only appeared for a short period, and there was also not any serious influence on the schools administration. Thus, I do think the government was reacting quite well this time.

    Concerning the impact of the disease on Hong Kong’s international standing and my personal feel, actually, at least in this stage, I don’t think there would be any great impact since the recent situation is only of a small scale and overcome quickly. Unless the government showed no awareness, capacity and capability to prevent, handle or even stop the problem and the similar disease keep appearing frequently, I don’t think there should be great impact to the standing as well as my own security feeling. If it did, I think related persons, states or organizations would be over-reacted that time.

  20. Hui Hiu Ning,Rebecca Says:

    Having had the opportunities to read my fellow course mates’ opinions, I would like to give my comments based upon some of the comments given by them.

    In response to Winson Sau Yin Chu’s comments, I respectfully disagree with Winson that the government’s decision was largely based on public opinion. In fact, on the contrary, his decision was largely the outcome of his meeting with medical and educational experts and microbiology professor Yuen Kwok-yung on the same day when the decision was announced.
    I think there are objective reasons for their decision. The first reason lies in the abrupt deaths of the three children which made the situation distinguishable from previous normal seasonal flu. In times of normal seasonal flu, mostly the chronic patients and the elderly may perish because of complications induced from flu, whereas in the current situation, we have three children lost their lives in such a short period of time. This raises reasonable concern about a possible mutation of the disease which may lead to appalling consquences. Therefore, taking into account the contagious nature and the incubation period of the disease, the Government is justified to take such a swift action to minimize the further spread of flu.

    Even if the Government had been seriously influenced in making their decisions, I do not regard this as irresponsible. I understand your point that in cases requiring high levels of expertise in making sound policies, public opinion may not be a good basis for policy-making. However, I think in most cases and especially in a democratic society, a government is required to take into account the opinions of its people. Also, applying the human security paradigm, one should approach health issues from a people-centred perspective. (Final report of the Commission on Human Security, 2003). Therefore, the provider of human security should also aim at eliminating people’s fear from health insecurity and empower their sense of security and stability.

    Thinking about the other measures the Government should adopt/ should have adopted, I am of the view that the Government should put more effort in implementing middle-and-long-term policies. For instance, the Government should provide free vacinnation to vulnerable populations, including primary school students as suggested by York Chow earlier. Also, the Government should make sure there is a stable supply of vaccines in times of seasonal flu period. Moreover, better coordination and communication with private doctors is necessary to relieve the present burden shouldered by public hospitals.

  21. Pretty Chan Says:

    Regarding Sandeep’s point, I don’t agree that Hong Kong is not particularly susceptible to health infections(Thailand, Cambodia and Vietnam if anything). The effect would be the same if SARS or similar type of disease spread again in HKSAR. The economic and social impact not to mention, but also the human security concern in the Pearl River Delta would become international news.

    Referring to Dr. Cummings, my point on hiv and sars and bird flu are different in the sense that the effect of any epidemic in HK…would be detrimental on its int’l. reputation. I refer the the physical/chemical difference of the two types of diseases. They are naturally different, HIV is sexually transmitted or due to poor medical services, and SARS/bird flu would be more problem based on daily life activities, such as eating chickens, or personal hygiene. I was bringing out the point that they are equally detrimental to international reputation of the state in concern, even though the nature of disease is different.

    For this issue, I think HKSARG’s plan to provide free vaccination for all school children in HK would be another example showing the priority that HKSARG put human security in HK. This would enhance not only the health of individuals, but also the legitimacy of HKSARG in its ability to detect potential harm and implementing preventive measures.

  22. Joshua Burns Says:

    I believe that the response by the HK government was both appropriate and measured. As previously mentioned the density of Hong Kong provides a unique avenue for the rapid transmission of infectious disease. Public schools are particularly susceptible to this action. Children are much less proactive in preventing transmission of disease and are generally more susceptible to strains of common viruses. Moreover, it bears noting that adults engage in more close personal contact with children than with each other. The result is that children (in Hong Kong and globally) are a primary vector for the spread of infectious disease and even parasites like lice.

    In a less dense setting than Hong Kong, I might be inclined to agree that the reaction of the HK authorities could be classified as reactionary. However, density,combined with the aforementioned factors leads me to believe that school closures, particularly at the primary school level are a necessary first line of defense for disease prevention. As to the argument that this round of flu infections did not surpass “normal” levels, it is difficult to define the outcome of the situation if the government had not taken preventative measures. Such is hindsight.

    Another issue of relevance, as it relates to the severity of danger from this flu outbreak versus the degree of response from the government, is preparedness. Here, I relate disease to natural disaster (which it is in a fashion). The best way to be prepared for a natural disaster is to have a plan and to perform periodic drills. Drills for school closures due to disease are certainly disruptive, but nature predictably provides opportunities to rehearse the emergency management measures, just as it did in this case. Again common sense must rule the day here.

    I believe that the problems pointed out in Bessie’s first post, which states the sudden reversal of opinion and the problems caused by a rapid and unplanned closure, illustrate the need for further planning and for guidelines.
    The lessons from SARS brought attention to the need for a rapid response to the threat of infectious disease. This round of school closures illustrates the need, in addition to rapid response, for reliable transmission of information to the public and a means whereby the needs of parents and schools can be addressed even during a mandatory closure. For parents, reliable warning would likely be sufficient, and in a case like this one a single extra day would have made little difference in the overall transmission rate for the flu. For schools, a simple policy change would be sufficient. If it were understood that assignments were to be made during the closure, then the issue would be largely resolved (admittedly this is difficult to manage in the case of poorer families without rapid communication means like email).

    As a final note on the influence of the Human Security paradigm, I would simply like to agree with the many posts by my classmates that this response by the HK government indicates a level of adoption of the paradigm. I believe that rather than damaging the view of HK’s health safety, this response ratifies the credibility of HK’s ability to respond to the issues inherent in the management of a city of this size and density.


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