Business Week

• WHO update on SARS
• No Insurance coverage for HK, Beijing or Toronto
• Harvard Medical School FAQ
• List of Buildings in HK confirmed with SARS  HK Dept of Health
• SARS alert to US visitors to Canada
• WHO warning on Travel to Toronto (NY Times)
• SARS in Shanghai
• SARS in Toronto
• SARS spread in China
• WHO hoodwinked in Beijing (Time magazine)
• SARS contingency plan

EMAIL circulated - Was it true?   |  Vital info on SARS from A forward science students at Stanford University

Death Rate of SARS in Hong Kong Estimated to be Around 18%     --- meaning that if a person has contacted SARS, that person will have nearly 1/5 chance of dying in the hospital.  

We are a group of graduate students at Stanford University.    Using a Markov Process Model, we estimated that the Death Rate of SARS in Hong Kong should be around 18%, as opposed to the government's claim of 6%.

The Hong Kong government has calculated the SARS death rate by the fraction of death toll over the total number of SARS cases encountered so far. As of April 20, this number is 88 / 1380, which is 6%. However, the total number of cases also includes those who  are currently hospitalized. The above formula assumes that all  hospitalized patients will not die of SARS, and this questionable   assumption leads to an underestimate of the death rate. Because of this, we should not include them in the calculation.

A more appropriate estimate would be the fraction of death toll over the number of people who have either recovered or died of  SARS. This number, as of April 20, is 88 / 497, which is 18% -  three times more than the government's estimate.

Given the above, we think that the 6% figure is very misleading when it should really be 18% instead. We hope to let the general public know the true danger of SARS, and we are wondering if you can help us spread this fact. When people think they have a 90%  chance to recover and get out of the hospital, they may take less precaution. But the truth is, nearly 1 out of 5 can actually die of   SARS.

Note: Our model has been reviewed and validated by professors at Stanford University and Chinese University of Hong Kong. Please  visit www.stanford.edu/~hcpang/SARS.html  for the Stationary Markov Model used, and the raw data gathered from WHO and local  newspapers.

Sam Hui           Dept. of Statistics  Stanford University    hkchuen@stanford.edu
Jimmy Pang     Dept. of Computer Science Stanford University    hcpang@stanford.edu
Bernard Chan     Dept. of Electrical Engineering    Stanford University    berchan@stanford.edu

This week's best quote - from Hong Kong:
"This latest Hong Kong crisis is a hybrid - it combines the uncertainty of handover to China in 1997, the drama of the Asian financial crisis in 1998, and the health concerns of the so-called chicken flu of a couple of years ago, all in one !"  - Jeremy Lee

SARS Economic Deadly Effect

The SARS virus in China is the world's newest, worrisome WMD, or weapon of mass destruction, and one that United Nation inspectors are worried about.

On the weekend, China finally admitted its health authorities had covered up the extent of the contagion that has been exported worldwide. The UN's World Health Organization has sent medical personnel to determine the extent of the epidemic, particularly in overcrowded Shanghai, where 13 million people live and only two cases have been reported.

Nobody believes the official Communist party line, even the revised one, stating SARS has sickened only 1,959 people in China and killed 86.

I would guess these figures are understated by a factor of thousands or tens of thousands. After all, about 1.3 billion people live in China's densely populated cities, towns and farms, virtually without medical care. There are scant supplies of antibiotics, except those available for expatriates and, besides, antibiotics are not that effective on this mutating virus.

This is why, over the weekend, Beijing admitted the cover-up, fired the alleged culprits and stated that its annual, seven-day May Day celebration would be cut to one day. The abbreviation of this cherished national holiday is a measure aimed at preventing China's young, urban dwellers from having enough time to go back to their farms and villages for the week. Last year, 70 million did that. This year, a week-long migration of that magnitude could singlehandedly turn the SARS epidemic into a pandemic.

Because China is the planetary "hot zone" incubating this disease, the concern is that the fallout could end up being as serious as the AIDS crisis and economically more serious than the meltdown of bank failures and currency devastation that occurred five years ago in the region.

(The only "hot zone" outside Asia is Toronto, where tourism and business travel has been gutted. Hotels and restaurants are half-empty and health officials scramble to arrest its spread. The disease has hit Toronto hard because of the amount of travel between its enormous Asian immigrant and refugee population and Asia. Some 7,000 have been quarantined and a hospital's SARS unit was closed at the weekend after four nurses contracted the virus.)

This outbreak is bound to affect Canada's economic growth in the short term -- a fact already acceded to by the Bank of Canada. But the consequences could prove much more serious than imaginable.

East Asia is already in serious trouble, as stock markets, business forecasts and economic growth projections fall. Nissan Motor Co., Hyatt Corp. and other companies in China are lowering business expectations. Motorola Inc. scrapped a ceremony in May to announce a $100-million Beijing research centre because overseas guests wouldn't show up.

Hotel occupancy is down to 20% in Singapore and Hong Kong and retail sales have been cut in half in both cities. Cathay Pacific, based in Hong Kong, has cancelled two-fifths of its flights. The Singaporean government unveiled a $130-million aid package for the tourist industry.

Shares of Taiwanese companies with Chinese subsidiaries, such as automaker China Motor Co., fell after the cover-up was acknowledged in China. The benchmark Shanghai A-share index posted its biggest drop in two months, led by tourism-related stocks after the government pared the week-long May Day holiday.

"Investors are dumping companies that count China as a big part of their revenue, fearing the SARS epidemic in China," Eddie Chiu, who manages the NT$4 billion ($115-million) Hitech Fund at First Global Investment Trust Co. in Taipei told Bloomberg News. "Because of China's dishonest record, some people think the actual SARS cases might be 100 times more than it has now reported."

Already some estimate that China's economic growth this year may fall to 7% from last year's 8% as citizens cut spending on travel and entertainment to avoid the disease, said a consultant to the Asian Development Bank's macroeconomic monitoring unit. First-quarter growth was supposedly 9.9%.

City-state Singapore slashed its economic growth rate by half, to no more than 2.5% this year, because of SARS. Malaysia may follow suit and Hong Kong says its growth may be "dampened" as Moody's Investors Service Inc. warned that the territory may lose its A3 credit rating.

But Andy Xie, an economist with Morgan Stanley, was quoted yesterday as saying the economies of Hong Kong, Singapore and Taiwan have not just abruptly stopped growing but have begun shrinking and that Malaysia, Thailand and China itself are next. - Diane Francis   National Post    22 April 2003

WHO warns against travel to Hong Kong & China

A flu-like virus that has killed more than 100 people and infected at least 2,800 worldwide is being spread by travellers.

The outbreak started in southern China late last year before spreading to Hong Kong, Singapore, Vietnam, Canada, Germany and elsewhere in recent weeks.

Deaths have been reported in China, Hong Kong, Vietnam, Canada, Singapore, Thailand and Malaysia.  Below is a list of reported cases.

                   	Cases*    Deaths   Recovered
Quarantined
 China               1,279         53
 Hong Kong             970         27         142     ~1,200
 Singapore             126          9          75        286
 Vietnam                66          4
 United States         148#         0
 Canada                232~        10
Thousands
 Taiwan                 23          0                  1,214
 Thailand                7          2           4          3
 Malaysia                3          1
 Germany                 5          0
 Britain                 5          0
 Italy                   3          0
 France                  4          0
 Brazil                  1          0
 Ireland                 1          0
 Romania                 1          0
 South Africa            1          0
 Spain                   1          0
 Switzerland             1          0
 ______________________________________________________________
Total                2,877        106

* Cases include number of deaths. Figures from mainland China are now included in WHO statistics.

Some 50 people also have been isolated in Vietnam's Ninh Binh province.

# Due to differences in the case definitions, probable cases are reported by all countries except the United States, which is reporting suspect cases under investigation.

~ Canadian figure includes suspected or probable cases.

Singapore has 82 suspected cases.

Case in Spain has not been confirmed.

Sources: World Health Organisation and local health officials.  - Reuters  Yahoo!   9 Apr 2003

SARS fears affecting NY area events

Concerns about the SARS virus are starting to affect events close to home. Law firm Shearman & Sterling, which has four offices in Asia, has canceled its annual partners' conference, scheduled for this weekend in Princeton, N.J., because of health concerns. The firm has also restricted nonessential travel to Asia and Toronto.

A host of other global companies have severely restricted travel because of the spread of severe acute respiratory syndrome, which has infected more than 2,000 people and killed about 80 worldwide since November. Insurance giant American International Group Inc. has told its 80,000 employees to limit Asian travel, according to Bloomberg News. Goldman Sachs CEO Henry Paulson postponed a trip to Hong Kong and mainland China this week, and the firm is requiring staffers to seek department approval for travel to Asia. Lehman Brothers has banned nonessential travel to Hong Kong, Singapore, Vietnam, Taiwan and China.

Other firms, such as UBS Warburg, Deutsche Bank and Merrill Lynch, have either instituted quarantines or required doctors' visits for employees returning from some Asian locations.

According to a survey by the Association of Corporate Travel Executives, 70% of business travel managers are curtailing trips to Asia because of the mysterious syndrome.  -  Crain Communications, Inc

YVR passengers don masks to ward off deadly SARS

Worried about a deadly respiratory disease that is spreading around the world, Christine Wong prepared for a flight to Hong Kong from Vancouver Thursday by taking two face-masks to wear during the 10-hour trip.

Six more boxes of the masks intended to protect her against severe acute respiratory syndrome were stowed in her luggage.

"It's very stressful to be going to Asia now," said Wong as she prepared to board her Cathay Pacific flight. "There is the danger everywhere that anyone could give you this disease."

Chen Liujie, on the other hand, breathed in deep gasps of air after arriving home to Vancouver from southern China and happily tossed her mask into an airport garbage can.

Liujie, who said she checked constantly during her flight for symptoms of coughing and high fever in herself and her fellow passengers, said her arrival in Vancouver brought immediate relief.

"I feel like I don't have to worry anymore," Liujie said in Cantonese. "I am not there in Guangzhou any more and the danger has passed. In Canada, the risk of getting this is not as high as in China."

Severe acute respiratory syndrome has already caused three deaths in Ontario and scores of suspected cases in Toronto. In B.C., a 55-year-old man with suspected SARS has been in an insolation ward at Vancouver General Hospital for two weeks.

At Vancouver International Airport Thursday, departing and arriving passengers from Hong Kong and other Asian countries wore masks to ward off any possible transmission of the deadly pneumonia.

"It seems like a wise step to be safe and take these measures," said Oscar Leung as he was about to board his plane to Hong Kong. "I'm not worried so much as careful."

Leung bought four boxes, or about 80 face masks, while in Vancouver, to distribute to family members in Hong Kong.

"They're all sold out over there. So I'm bringing these back for people, because everyone feels safer wearing them."

Levitt-Safety, a medical equipment store in Richmond, has been sold out its standard medical blue model 3M 8210 N95 since Monday.

Sales representative Swen Mahasen said customers have been carting away boxes of the safety masks for the last two weeks.

The model N95 has been the most popular, Mahasen said, because it blocks out 95 per cent of particles in the air.

"The people who are buying them plan to usually buy just a couple of boxes and then they decide maybe they should buy more," Mahasen said.

On Wednesday, a customer came in intending to buy four boxes and took home six. Another wanted to buy six and went home with 11 boxes.

Each box has 20 masks and sells for about $20. Mahasen is expecting another shipment next week.

World-wide, there are now more than 1,300 suspected cases of the disease and there have been 52 deaths, according to the World Health Organization.

The fear of catching SARS, which has no known cure, has some Vancouver residents resorting to herbal remedies, with Chinatown merchants reporting brisk sales of a popular root with the Latin name Radix isatidis, that is boiled into a tea.

Merchant Albert Fok said Banlamgen, literally translated into "board that is blue root" is being purchased in greater quantities than usual by customers.

"People believe that it's good for respiratory problems and to build up immune systems," Fok said. "It's like camomile tea with honey."

In Toronto, where the number of cases of the disease has increased from 11 to 27 since Monday, thousands of people have been quarantined in an attempt to stop it from spreading, but in B.C. the disease has not been confirmed in anyone other than the first patient.

Health Planning Minister Sindi Hawkins told reporters in Victoria that health officials are monitoring 12 B.C. residents who may have SARS.

But only four of the 12 have any of the flu-like symptoms associated with SARS, and they've been isolated.

The 55-year-old patient's condition was upgraded Thursday from critical to serious, said Vancouver Coastal Health Authority official Viviana Zanocco.

He remains on respiratory support.

The patient, who was taken to VGH shortly after he arrived here after visiting Bali and Hong Kong, stayed on the same hotel floor in Hong Kong as a 78-year-old Toronto woman who has since died. The elderly woman is also believed to have infected her 44-year-old son and a 70-year-old man who was being treated in the hospital where she was treated. Both have since died.

There have been 29 probable cases reported in Canada reported so far, all in Toronto except for one in Ottawa -- a 56-year-old man at Ottawa's Queensway-Carleton Hospital -- and the one in Vancouver.

Currently, federal officials are stationed at Toronto and Vancouver airports to greet passengers on flights from hot zones such as Hong Kong. Thousands of passengers are being handed "yellow cards" advising them to keep a watchful eye out for symptoms of the syndrome and report them to a doctor if they get sick.

The WHO targeted Toronto Thursday as one of the cities were passengers should be checked before boarding flights out of the country.

"If the passengers are sick, health workers will be recommending to the airline that they not board the plane," said Dr. David Heymann, WHO's infectious diseases chief.

The WHO advice -- it can only make recommendations to governments -- is directed at flights leaving cities where the disease is spreading locally: Toronto, Singapore, Hanoi, Hong Kong, Taiwan, Beijing, Shanghai and the Chinese province of Guangdong, where the earliest cases occurred.

Federal authorities "may well consider" banning southeast Asian airline travel into Canada to if the mysterious illness infecting Toronto and other parts of the world continues to spread, a senior Health Canada official said Thursday.

As well, Canadian officials are contemplating screening all international airline passengers leaving Toronto for symptoms of the disease, said Dr. Paul Gully, senior director general of the department's population and public health branch.

A decision to ban airline fights from Asia, where the disease is believed to have originated, would be made by Transport Canada, Gully told a news conference.

Earlier this week, Health Canada warned Canadians not to travel to Singapore, Vietnam, Hong Kong and the Chinese province of Guangdong.

That prompted the International Association of Machinists and Aerospace Workers, district 140, whose members handle baggage and refueling for Air Canada and United Airlines, to ask management to distribute gloves and face masks.

"We're seeing passengers wear them," said union representative Mike Clegg. "Our members have concerns specially those who are dealing with flights from Asia and Toronto."

Clegg said a work stoppage could occur if steps are not taken soon to improve safety for baggage handlers and other workers.

"We have to make sure our members are protected and there are people right now who feel there is a threat to their health."

Air Canada spokeswoman Angela Mah said the airline is monitoring all directives from the World Health Organization and Health Canada.

"What they're telling us there are no additional measures that we need to put in place. Based on the estimates of those two authorities, protective [gear] is not required in the performance of regular duty."

Doctors' offices throughout the Lower Mainland have signs posted advising sick patients to not enter if there are concerns about SARS. Instead patients are being advised to contact their doctor by phone for further instructions.

Meanwhile, the head of Health Canada's national microbiology laboratory in Winnipeg said Thursday scientists there are still trying to solve the puzzle of what virus is responsible for the ailment.

The Winnipeg lab, and others in Europe and Asia, have identified two possible pathogens: human metapneumovirus and a new strain of coronavirus closely related to a coronavirus that causes illness in cows.

"We have made considerable progress and we are now focusing on testing for two agents," Dr. Frank Plummer said. "We don't know if you have to both to have SARS, or if it's one of the viruses causing it and the other is just a passenger. That's going to take a lot more work."

Plummer said lab officials expect to know by early next week how long it will take to develop a rapid diagnostic test to screen suspected cases for the presence of antibodies to the two viruses. Such a tests could be used to screen the thousands of people now voluntarily quarantined in the Toronto area to see if they've actually been exposed to the germs. - Petti Fong       Vancouver Sun      29 March 2003

World Health Organizations officials investigating a deadly outbreak of pneumonia last winter in China said Wednesday they are increasingly convinced it is the same mysterious illness that has since spread to nearly a dozen countries, killing at least 52 people.

Chinese authorities said the disease has killed at least 34 people in China since November - 31 in the south and three in Beijing. Hundreds have been infected. Previously, they said only five had died in southern Guangdong province.

World health officials later said the symptoms of the Chinese illness are consistent with those for severe acute respiratory syndrome, or SARS, which has sickened nearly 500 people and killed 18 elsewhere - 10 in Hong Kong, four in Vietnam, three in Canada and one in Singapore.

A second person suspected of having the disease died in Singapore late Wednesday, officials said, and all schools were ordered shut as a health precaution. More than 700 people in the city-state have been ordered to stay home under quarantine or face fines.

In Canada, public health officials have quarantined at least 25 people and their households in Toronto, and one school in the city's east end was closed after three students came down with high fevers. The number of probable cases in Ontario has jumped from 10 to 18.

"Everything we've seen so far indicates it's the same disease," said Dr. Meirion Evans, a member of a WHO team that has studied the cases in southern China, but not yet those in Beijing.

"We're getting a more complete picture," Evans said. "It's certainly been one of the objectives of the mission to clarify whether the outbreak in China was the same disease as what's been seen outside of China.

"It's not good news for the patients, but it's helpful in our understanding of the disease."

The WHO has called on Beijing to be more co-operative.

Taiwan also urged China on Wednesday to be more forthcoming.

"Because the mainland is not sharing information, the source of the contagion has not been clear and the period of risk for the outbreak has been lengthened," said a report from Taiwan's Mainland Affairs Council, which handles the island's relations with rival China. "This hasn't helped us protect ourselves from an epidemic."

Singapore's closure of schools, from day care centres to junior colleges, will keep a half-million students temporarily out of class.

"On purely medical grounds, there are currently no strong reasons for closing all schools," said Teo Chee Hean, Singapore's education minister.

"However, principals and general practitioners have reported that parents continue to be concerned about the risk to their children in schools."

In Hong Kong, where numerous citizens are going about town in masks, media reported that about 60 schools have been closed as a precaution.

The Hong Kong Education and Manpower Bureau would confirm only five closures - after eight students were infected by sick relatives or health care workers - but officials acknowledged some schools were closing at their own initiative.

The disease is believed to have spread to Singapore, Vietnam and Canada by people who caught it while spending time last month on the ninth floor of the Metropole Hotel in Hong Kong, where an infected mainland Chinese medical professor was a guest.

The South China Morning Post in Hong Kong reported early Wednesday that the professor had been treating atypical pneumonia patients in the mainland before he came to Hong Kong. The professor died here in early March.

Chinese officials said previously that 305 people were sickened in the atypical pneumonia outbreak.

But a spokeswoman for the Guangzhou city government, who identified herself only by the surname Ye, said Wednesday that 792 cases of atypical pneumonia were reported in the province by the end of February, with 680 in the capital Guangzhou.

Ye said 31 people in Guangdong had died by the end of February. Three others died in Beijing this month, the city said Wednesday.

Hoping to avoid any SARS cases in the Philippines, officials in Manila on Wednesday urged travellers from countries hit by the disease to stay at home for a week in voluntary quarantine. Foreign Secretary Blas Ople also cautioned Filipinos to limit travel to countries with known cases of SARS.

Tens of thousands of Filipinos work in Hong Kong and Singapore, many as domestic helpers.

Philippine officials also convinced the parents of a Filipina maid, Adela Dalingay, who is believed to have died of SARS this week in Hong Kong, to have her remains cremated to avoid difficulties of transporting the body home, Ople said. No official cause of her death has been given.  - 26 March 2003    Canadian Press   Associated Press   AUDRA ANG

HONG KONG  - As Asia struggles to beat back the spread of SARS, Canadian authorities identified a new cluster of cases among mourners who went to a victim's funeral and U.S. experts said the just revealed genetic code for the disease doesn't explain how it started or how to stop it.

The U.S. Center for Disease Control and Prevention said gene sequencing will help create accurate diagnostic tests and increases the chance that a drug or vaccine will be found to defeat the virus, but that could take weeks or even months in some cases. The World Health Organization said least 144 people have died of severe acute respiratory syndrome, which has infected more than 3,000. Most victims have been in Asia.

In hardest-hit China, WHO investigators were seeking permission Tuesday to visit military hospitals in Beijing that are rumoured to hold unreported cases.

SARS is thought to have started in southern Guangdong province last November, but its extent in China only became known recently. Chinese officials have been accused of underreporting the crisis, which Premier Wen Jiabao last weekend described as "grave."

He ordered passengers on airlines, trains and boats be screened and on Tuesday state media said buses, taxis and other public facilities would be disinfected.

Mainland China has reported 64 deaths, Hong Kong 47, Canada 13 and Singapore 12, including two suspected fatalities. Vietnam has had five deaths, Thailand two and Malaysia one.

In Canada, health officials said they had linked 31 possible SARS cases including members of a religious community and two physicians who attended the April 1 funeral of a victim of the pneumonia-like disease.

Dr. Sheela Basrur, the chief medical officer of health in Toronto, said some of the cases had previously been identified.

Toronto, Canada's largest city located 100 kilometres from the U.S. border, is the epicentre of the largest SARS outbreak outside of Asia.

During the weekend Canadian researchers published the entire genetic sequence of the new type of coronavirus believed to be the cause of SARS. The U.S. Center for Disease Control and Prevention released similar information on Monday.

The centre's director Julie Gerberding described the breakthrough as "unprecedented in the history of science. But it is not the magic bullet for dealing with SARS."

It does not provide any simple answers to questions about the disease, including whether it came from animals, such as chickens and pigs.

The gene sequencing will help create accurate diagnostic tests and increases the chance that a drug or vaccine will be found to defeat the virus, but it's something that could take weeks or even months in some cases, she said.

In Hong Kong, doctors from one badly hit hospital denied accusations that poor infection controls may have worsened the crisis there.

In a letter published in a newspaper, more than 100 doctors and medical professors at Prince of Wales Hospital called the allegations "hostile" and "very damaging to the morale of the frontline staff," which could end up affecting patients.

Questions about how well the hospitals reacted to SARS appeared in two recent articles by popular radio talk-show host Albert Cheng and the dean of medicine at the University of Hong Kong, Professor Lam Shiu-kum.

Lam suggested the Hong Kong's outbreak could have been prevented if Prince of Wales staff had been more alert.

In Kuala Lumpur, the Sun newspaper warned that Malaysia could lose around 200 million ringgit ($53 million US) a month in tourism revenues because of tough new anti-SARS visa rules. Last week the government announced new entry regulations and revoked visa-free travel for tourists from Hong Kong, China, Taiwan, Canada and Vietnam.

The outbreak of SARS has crippled Asia's vital tourism industry, with many people cancelling plans to travel in the region and airlines reducing flights.

In Taiwan, the government offered to reduce aircraft landing and other charges to help cash-strapped airlines.

In Singapore, the government told companies badly affected by SARS to cut salaries rather than lay off workers.

Prime Minister Goh Chok Tong recently warned that the country's full-year growth forecast may be revised down because of the war in Iraq and the spread of SARS. Last month, the government warned that unemployment could exceed previous predictions of 5.5 per cent for the first half of 2003, rising to a 17-year high.  - Margaret Wong    Canadian Press   Associated Press     15 Apr 2003

HUMOUR | recent EMAIL

War may have just broken out in Iraq, and a contagious pneumonia is on the loose, but Hong Kong people can't seem to get enough of their beloved designer labels. On Saturday, Louis Vuitton in Hong Kong released a limited edition atypical pneumonia mask, specially for the Hong Kong market, in super-soft Connolly leather with a monogrammed sterling silver clasp. This luxurious and unfeasibly comfortable mask comes with a matching protective case to allow its users to store it away safely in their Kelly bags without contaminating their shatoosh shawls. At a retail price of HK$1,800 (approximately US$230), one would have expected these to be more of a publicity stunt than a serious retail proposition, but by Saturday lunchtime, all 88 limited edition masks had been sold.

Across town in the sprawling Gucci boutique, the company spokesperson said that they would be shortly releasing a designer mask as an addition to their summer 2003 accessories range. She declined to mention details, except to say that it would of course be in black and would incorporate the Gucci buckle. A Hong Kong tai-tai (the local equivalent of ladies-who-lunch) in the store at that time said that she was eagerly awaiting its release and had put herself down on the waiting list, adding "Everyone knows that black is the new Burberry".

Burberry, meanwhile, has not as yet brought out a mask and says that it has no immediate plans to do so, but fake Burberry masks can already be found across the border in the Chinese city of Shenzhen, where Hong Kong people and visiting tourists go for day trips to stock up on fake goods. For just RMB10 (US$1.25), one can get a surgical mask with a Burberry check trim and some functional yet rather fetching beige elastic earloops. This correspondent bought a box of twenty, and was given a free "men's hold-all", which despite its uncanny resemblance to a toiletries bag appears to be hugely popular with the local menfolk.

All this consumerism may appear to be frivolous, especially in times such as these, but it does emphasize the breathtaking speed at which the fashion industry reacts to the latest news and trends. Mainstream and luxury goods retailers are increasingly capitalizing on current affairs in order to come up with killer fads. And where else to do this than in a city full of fashionistas: as a Hong Kong advertising executive put it, "When you have a cutting edge, never-seen-before virus, you've got to fight it with a cutting edge, never-seen-before mask. Designer masks for designer viruses".

Back at Louis Vuitton, a tai-tai who had bought two of the limited edition masks - presumably one for herself and one for her husband - wandered back into the store yesterday to say how much she loved her new mask and how jealous the other members of her lunch group were. Before speaking she of course had to unclasp the Louis Vuitton Connolly leather mask that she was wearing... and then reached down to unclasp the second Louis Vuitton Connolly leather mask that her pet poodle Benzie was wearing.

Atypical masks for atypical pneumonia in an atypically unique city.

Does your business have a SARS contingency plan?

Think of your company's SARS contingency plan like a fire drill. It's good for everyone to know what to do

The last time most businesses thought about contingency planning was probably after the Sept. 11, 2001, tragedy, when it became important to install security measures to protect buildings and occupants.

SARS -- severe acute respiratory syndrome -- calls for businesses to put a different type of contingency plan in place. Urgently. Think of your company's contingency plan as a fire drill. While you may never have a fire, it is good for everyone to know what to do if there is one.

Our hospitals and health care institutions have rapidly developed and executed plans to cope with the tremendous strains that SARS is putting on them. However, SARS is not just a public health issue. It concerns every organization because SARS is about people. And SARS is as much about psychological concerns as it is about physiological.

Although contingency plans are usually found in larger companies, I believe small companies often have much more to lose than the big guys if contingency plans are not in place. Business managers need to ask the following questions:

1. Do we have contingency plans for other emergencies? Can we adapt them for SARS? Are there gaps?

2. Do we have locations where large numbers of employees work in close proximity with each other? Are we clear about who will make decisions about closure and quarantine?

3. Are we ready to provide timely, authoritative and up-to-date information to our employees and managers, the public and the media at all stages?

Examine the experience of Ontario Power Generation in dealing with SARS. Contingency planning is a well-understood discipline at OPG because of its role in generating electricity for the province of Ontario. OPG assembled a senior co-ordinating committee under an executive vice-president to monitor the situation, develop appropriate action plans and co-ordinate employee communications. This committee, led by the human resources (HR) department, includes representatives from operations, employee wellness, the chief physician, procurement and employee communications.

- Special protocols were developed for daily reporting, enhanced hygiene and business travel.

- Protective masks were procured and made available to OPG emergency response teams and medical staff.

- For critical groups such as nuclear plant operators, business-specific contingency plans were put in place in the event a person needed to be quarantined.

- When it discovered that 40 OPG employees at a social event were exposed to a guest who subsequently was confirmed to have SARS, OPG immediately asked all 40 to go into voluntary quarantine with full pay.

- OPG issues daily updates on World Health Organization and Toronto Public Health reports, the situation at OPG and its response to SARS to employees and contractors at all locations. Additional updates are provided to supervisors and managers, suppliers and other business associates as required.

- Actions have been implemented to raise awareness related to personal hygiene and improved cleaning of common areas.

Here is a chief executive's guide to the essential steps in SARS contingency planning.

PUT TOGETHER A CONTINGENCY TEAM Create a small task force of three to six key individuals to create the plan. Remember to include HR in the team. Decide whether you will lead it or delegate. Ask the team to create a skeleton plan in 24 hours and fill in the details later.

ESTABLISH A SINGLE POINT OF CONTACT FOR MEDICAL INFORMATION If you do not have a chief physician or medical officer, retain a reliable and readily accessible medical consultant.

IDENTIFY YOUR VULNERABILITIES Start with the worst case and work your way down. Do you have a core essential service that must be maintained? Do you have paramedical resources or occupational health nurses to provide advice to employees? Do you have large factories? Call centres? Distribution facilities? What are the points of contact of employees with the public? Do you have employees who travel to (or are returning from) suspect destinations? Try to figure out what can go wrong with SARS and then work out plans and policies to cope with each situation. How would you cope with large numbers of people ill, at home and in hospital, or dying? Specify under what circumstances a facility will be closed, who makes the decision, how the decision is communicated and whether employees are compensated.

DETERMINE A PROTOCOL FOR SENDING EMPLOYEES TO QUARANTINE How will you determine who should go home and who can stay at work? Who has the authority to approve dismissals, quarantines or quarantine periods.

DETERMINE A PROTOCOL FOR TRAVELLING, COMPANY EVENTS AND OTHER ACTIVITIES Do you have employees travelling from one site to another? Does this travel pose a risk to employees at another site or put them at risk?

DETERMINE HOW YOU WILL KEEP OPERATING Establish plans for an alternative work site during the emergency, including records, staff, and support such as telephone and computer equipment. Can employees work from home? Can they operate during quarantine? What activities are essential and what can be postponed to free resources for the essential? Should we be sending home now a "clean crew" that can be called upon if necessary?

ESTABLISH THE CHAIN OF COMMAND What decisions will the chief executive make personally? What should happen if the CEO is unavailable? The chain of command for SARS- related decisions should be clear, with alternate decision makers for key positions.

PURCHASE EQUIPMENT AND SUPPLIES Determine whether you need supplies of masks, gowns or other protective gear at some locations for some employees. Remember that even the parking lot attendants may have to be protected. Develop a rational plan for distribution that ensures employees and the public are protected but does not alarm them or waste supplies you may need later.

INFECTION CONTROL AND HYGIENE PRACTICES Does your company have equipment that potentially could spread the virus (such as shared microphones or headsets). Should you step up cleaning of washroom facilities? Should you remind employees about how the disease is spread and the personal hygiene practices they should be following? Should you provide extra precautions (waterless hand sanitizer, alcohol wipes)?

DEVELOP A COMMUNICATIONS PROGRAM It is essential to communicate relentlessly throughout any crisis. Daily communication is not too frequent. Even when you have nothing new to say, it is important to keep the channels of communications open and functioning. Telling your employees there are no new cases of SARS or quarantines is as important as communicating that you have a contingency plan.

UPDATE YOUR ROSTERS You probably have lists of the names of employees at all locations, but they may not be up to date. Disconnected phone numbers or outdated e-mail addresses will not be any good on an emergency roster. Include alternative ways people can communicate with each other. Include home phone numbers, pager numbers, non-work e-mail addresses, and cellphone numbers. You might also want to set up a formal phone tree that can be activated should you need to get in touch with your employees quickly.

SWEAT THE DETAILS Once the basic contingency plan is in place, it is time to revise, review and enhance it to make sure details that were overlooked in the first round are addressed.

The time-consuming process of developing a full-blown contingency plan can have unexpected benefits. It forces your people to focus on the most critical aspects of your business. It can be a good complement to the annual strategic planning process as well as to efforts to improve operational effectiveness. If you approach contingency planning the same way as other organization-wide activities, it can contribute to the all-important development of an integrated point of view. Integrative thinking is a hallmark of firms that thrive in turbulent times.

Joseph D'Cruz is Academic Director of the Health Leadership Program at the Rotman School of Management, University of Toronto. He can be reached at dcruz@rotman. utoronto.ca     - National Post     28 April 2003

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