DAP proposes that Abdullah appoint a special personal representative to the National SARS Inter-Ministerial Committee to ensure that it fully carries out the new Cabinet policy of total openness and transparency on the SARS outbreak without any residue of denial syndrome

Media Statement
by Lim Kit Siang

(Petaling Jaya,  Friday): The Star Page 2 "Comment" by Wong Chun Wai today reported that the Acting Prime Minister, Datuk Seri Abdullah Ahmad Badawi delivered a special message to all his Ministers at the Cabinet meeting on Wednesday - that the government must be transparent about the deadly SARS outbreak.

Abdullah said he would not tolerate any attempt to cover up the matter and that he wanted Malaysians to know the developments of the disease - rejecting the notion that the local press should downplay the SARS outbreak, supposedly to protect the economy. Abdullah also told the Health Minister, Datuk Chua Jui Meng, to go on TV that night to tell Malaysians what steps have been taken to handle SARS.

I will be writing to Abdullah to commend him for his decisive leadership in ending the dangerous three-week denial syndrome of both the Health Minister and the Health director-general, Tan Sri Dr. Mohamad Taha Arif proclaiming that there was "No suspected SARS case" in Malaysia - when the country was told that there were 59 suspect SARS cases with 19 people in quarantine immediately after the Cabinet decision on transparency.

In his first major speech as Acting Prime Minister, Abdullah identified the Malaysian malaise of "First World Infrastructure, Third World Mentality" as the biggest impediment to Malaysian development and progress, and his "no nonsense" approach in insisting on transparency on the SARS outbreak is his first major decision to eradicate the bane of "First World Infrastructure, Third World Mentality" starting from the top, and this bold action should be fully recognized, commended and supported.

Although Abdullah has laid down a new Cabinet policy of transparency on the SARS outbreak, there are disturbing signs that that the denial syndrome to play down the gravity of SARS is quite deeply entrenched in the government. For this reason, DAP proposes that Abdullah should appoint a special personal representative to the National SARS Inter-Ministerial Committee to ensure that it fully carries out the new Cabinet policy of total openness and transparency on the SARS outbreak without any deviation or residue of the denial syndrome.

It is urgent and imperative to ensure that the new policy of transparency on the SARS outbreak to restore government credibility and public confidence is not undermined by any form of rear-guard resistance or "guerrilla tactics" such as to under-report the SARS incidence, which will only start a new round of public doubt and distrust of government facts and figures and the undoing of all the good which Abdullah had initiated at the last Cabinet meeting.

It is not often that I find myself in agreement with an editorial of the New Straits Times, but I have no hesitation in endorsing its description today of Malaysia's response to the SARS outbreak until Abdullah's intervention at the last Cabinet meeting as "quite cavalier". The NST editorial on "Pestilence management" dismissed the short-sighted attempt of the Health Ministry "to keep a lid on the incidence of Severe Acute Respiratory syndrome in this country", with the comment:

"It didn't work because the fear of SARS does not stem from what is known but what is unknown, and trying to eliminate fear of the unknown by keeping people in the dark is like trying to extinguish a fire by dousing it with petrol. The fear has spread faster than the disease."

I am aghast however by the editorial's terribly uninformed and unscientific definition of "suspected" and "probable" SARS cases as follows: "suspected" (i.e. a cough & cold) and "probable" (persisting for several days) - three weeks after the global SARS outbreak which had claimed 80 lives and infected 2,300 people across 18 countries, apparently now reaching South America. A British journalist who arrived in Brazil to cover Sunday's Brazilian Grand Prix may have contracted the disease and be the first case in Latin America. The 42-year-old woman had been in Malaysia to cover the Formula One Grand Prix and had passed through Singapore and London en route to Brazil.

The NST classification of SARS "suspect" and "probable" cases are completely at variance with the World Health Organisation (WHO) case definition. But the Health Ministry also flouts the WHO case definition, where a "suspected" SARS case is one which meets the three criteria of firstly, high fever (more than 38C, 100.4 F); secondly, one or more respiratory symptoms including cough, shortness of breath, difficulty breathing and thirdly, recent history of travel to a SARS-infected area or close contact with a person who has been diagnosed with SARS in the past 10 days.

It becomes a WHO "probable" case when there is a chest X-ray findings of pneumonia or Respiratory Distress Syndrome. As WHO has said repeatedly, "Chest X-rays showing distinctive features of SARS are presently the main tool for distinguishing suspected from probable cases". (WHO SARS mult-country outbreak - Update 8 - 24.8.2003)

All the cases in Malaysia announced after the Cabinet meeting, i.e. 65 cases as of yesterday, would fall under the WHO definition of "probable" cases, as they would involve patients meeting all the four WHO criteria of high fever, respiratory symptoms, recent history of travel to SARS-infected area or contact with SARS patient in the past ten days, together with X-ray changes.

When Chua and Mohamad Taha said in the past two days that there are only "suspect" but no "probable" SARS cases, they are not following the WHO case definitions.

Both Chua and Mohamad Taha should explain why they are denying that there is any single "probable" SARS case, when doctors in their notification to the health authorities submit separate lists of "suspected" and "probable" cases?

What Chua and Mohamad Taha had done are to announce cases which meet the WHO definition of "probable" SARS cases as "suspected" cases, while ignoring the WHO-defined "suspected SARS cases" altogether.

Yesterday, I said that the number of WHO defined "suspected" SARS cases in Malaysia would far exceed the Health Ministry's "suspected" cases (which should properly be classified as "probable" cases according to WHO case definitions) by two to three times.

I have now been advised that the actual figure of the WHO defined "suspected" SARS cases could be even higher, as to reach four times the figure, or over 200 cases when taken into account the 65 "probable" (by WHO definition) cases announced by Chua and Mohamad Taha yesterday.

If so, Malaysia would overtake Singapore as the world's third country with the largest number of SARS suspect and probable cases - with China having 1,190 cases, Hong Kong 734 cases and Singapore 100 cases.

Malaysians, however, are prepared for the worst news but they want the unvarnished true so that they could properly protect themselves. NST editorial hit the nail on the head when it said:

"…immeasurably more damage may be done to the authorities' credibility by a policy of stonewaill denial than in being open and honest about the threat and what is being done about it. In these matters, we should have learned from the Nipah virus experience of just four years ago, a good way to avoid hysteria is to tell people the truth."

The special personal representative Abdullah should appoint to the national SARS Inter-Ministerial Committee, headed by Chua and comprising top civil servants from the Home Ministry, Immigration Department, police, Transport Ministry, Information Ministry, Education Ministry, Culture, Arts and Tourism Ministry, National Unity and Social Development Ministry, Human Resources Ministry, Malaysian Medical Association, Association of Private Hospitals of Malaysia and Private Practitioners Association should have the unique brief of ensuring that there would be no residue of the denial syndrome in the new policy of open and transparent policy on the SARS outbreak and to eliminate any rear-guard action to stonewall and to continue to deny all information about the deadly outbreak to the public.


* Lim Kit Siang, DAP National Chairman