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
by Lim Kit Siang
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
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
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
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"
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