The War Against SARS
Hong Kong's War Against SARS is progressing satisfactorily and, although not yet won, spread of the disease seems to have been contained and the daily rate of new infections has fallen to single digit numbers.
In this article, OffBeat examines the role played by the Hong Kong Police in Hong Kong's war against an unknown infectious viral disease for which there is no known vaccine or proven side-effects-free treatment.
The potential for disaster did not really emerge until mid-March. It started quite slowly, with a Department of Health (DH) request for help in locating individual contacts of the Metropole Hotel staff and guests, but grew to involve all the staff of Support Wing, Operations Wing, Crime Wing (and its subsequently massively reinforced Major Incident Investigation & Disaster Support System (MIIDSS)), Kowloon East - particularly Sau Mau Ping District (SMPDIST), Ngau Tau Kok Division (NTKDIV), the Emergency Unit, Police Tactical Unit Alpha, Yankee and Zulu Companies - as well as reinforced Regional Missing Persons Units, the Police Negotiation Cadre, and Uniformed Branch officers in all formations.
It has to be remembered that the War Against SARS was not a Police-led operation. Ultimate authority, with legislated regulatory powers, was vested in the Director of Health. The Police could support the DH only insofar as an individual refused to cooperate with or obey the instructions of DH staff.
Early Preparations
In mid-March, Support Wing formed a small group to consider the implications of any request for assistance from the DH. Senior Superintendent Support, Mr Peter Morgan, explained that the Force already held a quantity of protective equipment as a result of its support role for the culling of chickens following earlier outbreaks of Avian flu. Mr Morgan and Senior Inspector (SIP) Field Support (equipment acquisition), Mr Mang Tin-yu; SIP SD (occupational safety and health), Mr Paul Haley, and Police Stores Chief Supplies Officer, Mr Wong Chun-nam, authorised acquisition of additional supplies to ensure that there would be enough protective equipment to meet the worst case scenario. That effort has had to continue and, miraculously, they managed to cope, but only after modifying the usual methods of indenting for stores. Regional Commanders were made responsible for coordinating and endorsing demand.
On March 30, however, the action shifted to Operations Wing. Late that night, Kowloon East Regional Commander Mr Mak Man-poon, Sau Mau Ping District Commander Mr Mike McCully, and Ngau Tau Kok Divisional Commander Mr Gary Field, were informed by Police Headquarters of the Director of Health's decision to place Amoy Gardens in quarantine and the role they would be expected to play in support of that decision.
Extra staff were needed to beef-up Operations Wing permanent staff and, within two days, there were officers drafted in from the Anti-Illegal Immigration Control Centre, Counter-Terrorism and Internal Security Division, and from Key Points and Search Division to provide round the clock manning at the Police Coordination and Monitoring Centre (Police CMC) for Atypical Pneumonia.
The Police CMC, which continued until April 25 before beginning to slowly wind down, provided an unprecedentedly successful platform for information exchanges between the Police, the DH and all other Government departments/ agencies who took part in this War against SARS. It has also helped coordinate the police inputs to the hundreds of multi-agency operations conducted during the height of this war.
The most important of those multi-agency operations was undoubtedly the Multi-Departmental Response Team (MDRT). This was led by the DH but included representatives from the Force and all the Government departments involved that would be responsible for acting on daily reports from Crime Wing's MIIDSS operation that was serving as the SARS Data Records & Analysis Centre.
Quarantine & Isolation
Meanwhile at 6am on March 31, Mr Mike McCully and Mr Gary Field, led officers from EU KE and the Commissioner's Reserve PTU Platoon, Alpha Three, to Amoy Gardens to seal off Block E and assist staff from the Kwun Tong District Office in notifying the residents of the implementation of the isolation order. At that time the intention was to seal off the building for the duration of the incubation period of 10 days. However, though some residents were distressed and some angry, for the most part they cooperated with the authorities.
PTU Alpha Three was later relieved by a platoon from PTU Zulu Company, which became responsible for providing cordon and crowd management duties, as well as escort duties for DH personnel. During the course of the morning the Police Command Post was established and this served as focus for frontline inter-departmental coordination. A regional mobile canteen and tented facilities for use by officers on the ground also arrived. With the cooperation of Amoy Plaza management, secure, sterile washroom facilities were also secured for use by officers on the ground. At the same time, DH, FEHD, Home Affairs Department and the Social Welfare Department established their workstations.
Midway through the first day and up to the subsequent evacuation of Block E, the KE resident PTU Company, Yankee, under the direction of DVC NTKDIV, shouldered responsibility for the maintenance of the integrity of the isolation order, with EU KE escorting residents between Block E and the various hospitals and clinics that had been ear-marked to deal with them.
When, some days later, it was decided to evacuate all residents, KE was faced with another logistical challenge. Moving several hundred people, each with baggage containing their valuables, from Block E to the designated isolation centres, needed absolute professionalism and immense patience. Constraints on space and headroom in the immediate vicinity meant that large buses could not be used and because smaller buses were used, it was difficult to load them because of the need to keep family groups together. Eventually, however, the move was completed successfully.
Once the evacuation was completed, all PTU duties were withdrawn and SMPDIST was given the responsibility for the maintenance of the isolation order and the subsequent return of the residents, seeing the operation through to its eventual successful conclusion. What followed was the cleansing of all public areas and, after that, of all individual flats and the undertaking of various tests and investigations to determine how the virus had spread through the building. This process entailed residents' representatives, under escort by CAS, to be brought from the isolation camps to witness the disinfecting of their individual units. Before this could be done, however, Crime KE, and RMPU KE, were given the task of tracking down those residents who had moved out of Block E prior to the implementation of the isolation order. They succeeded in securing the return to Block E of all but four households, the residents of which were not in Hong Kong, but whose verbal consent was obtained to gain entry to their units, to undertake the cleansing work.
There we must leave KE and the hardworking, gallant officers of Regional Headquarters, SMPDIST and NTKDIV to look at what had been happening elsewhere in Hong Kong. The infection rate continued at a high level for the first part of April but then began to slide. Why was that so? While the likely virus had been identified, and it was certain that infection usually required close personal contact with a carrier or victim identified under 'presumptuous diagnosis', or exceptionally, as with Amoy Gardens Block E, through faulty sewage installations, there was still no vaccine or treatment free from side-effects.
Tracing SARS Patients' Contacts
The answer can be found in the Crime Wing MIIDSS Centre. In late March, when the Force first offered to use MIIDSS to record and analyse the personal data of all SARS victims and the contacts they could recall, there was no understanding within the DH of what such a database and subsequent analyses could offer.
Detective Chief Inspector, Mr Alan Chan, was responsible for briefing the DH hierarchy and he finally convinced them towards the end of March.
After a few days, when Mr Chan had secured the joint DH/Police information forms completed by SARS victims, MIIDSS began to produce results.
The secret behind the power of MIIDSS lies in Force development of a basic system imported from the United Kingdom. Hong Kong has a unique environment, however, and it became clear that there was a need for accurately identifying a specific address which can be given in written or spoken Cantonese and Mandarin, by the Chinese or English version of the address and whether or not the addresses are faultlessly reproduced or rendered with English or Chinese homonyms.
The Force achieved this breakthrough and it led to the well-known success of a number of law enforcement operations, including the Garley Building fire. From the SARS data input, the MIIDSS Centre was able to produce maps showing the geographical location of 'clusters' of SARS victims. It was also able to show the import of any particular cluster and alert the MDRT to the possible need for environmental cleansing operations to prevent more examples of the Amoy Gardens Block E disaster.
At its peak, the MIIDSS Centre, usually operated by Mr Chan and four or five other staff, employed as many as 77 people. These were officers and civilians seconded from all parts of Crime Wing and beyond. There was also a DH medical officer and nurses to help officers to question victims more closely, and make follow-up calls to people with whom they had had contact.
"We had three basic questions to ask," said Mr Chan. "The three Ws were: Who did you contact? When did you contact them? Where did you contact them?
"Every victim," explained Mr Chan, "will have had regular close contact with an average of four family members, four work colleagues and another four 'leisure contacts'. No human brain could have handled all the implications of even a single victim's contacts, let alone the dozens being handled by frontline medical staff working in shifts. With the wide variation in addresses given, the likelihood of any one person identifying links was remote.
"We have been able to do it because of the excellence of our in-house designed MIIDSS, well-trained staff and the complete cooperation of the frontline medical officers."
The Force has been complimented by the World Health Organisation and received enquiries from disaster, law enforcement and medical authorities in North America and Europe.
Mr Chan concluded: "Most importantly we have been able to show, once again, that the Force is serving the community in a professional and caring manner."
In a subsequent article OffBeat will recount the experiences of a cross-section of frontline officers directly involved in the effort to control SARS.
Chief Executive Mr Tung Chee Hwa visits the Crime Wing MIIDSS Centre
Amoy Gardens Block E residents back from designated isolation camps
DCIP Mr Alan Chan gives a briefing on analysed SARS data
Director of Health Dr Margaret Chan visited the joint Police/DH team in tracking SARS contacts and posed with a bevy of indexers