The committee includes renowned experts from Hong Kong, Mainland China, the United States, United Kingdom, and Australia, selected for their wide range of relevant experience. Dr. Koplan, who is former director of the Centers for Disease Control and Prevention (CDC), and Dr. Harvey Fineberg, president of the Institute of Medicine (IOM) of the National Academy of Sciences, are the only two U.S. members on the committee.
"This report is not only valuable for the Hong Kong government and public health community for managing and controlling future outbreaks, it also contains many valuable lessons for the United States and the entire international community," Dr. Koplan said. "Our experience with SARS certainly helped us more clearly identify many of the challenges we will face in future outbreaks and better prepare ourselves to face these difficulties efficiently."
Although the SARS Expert Committee Report to the Government of Hong Kong concluded that Hong Kong handled the SARS epidemic well in many respects, it also noted significant shortcomings in the country's health system during the epidemic's early stages, when little was known about the disease and when health workers themselves became ill.
"All nations, particularly in this age of easy and frequent global travel, are vulnerable to the formidable threats of emerging infectious diseases," Dr. Koplan warns. "We can be assured that either SARS or another equally vicious disease will present itself in the future and we would be well advised to make the changes in our surveillance and healthcare systems that will allow us to deal with diseases effectively. The Hong Kong government is to be commended for addressing these issues head on."
Dr. Koplan regularly serves as a consultant to the World Bank and the WHO on public health programs. He has worked in Finland on cardiovascular programs, consulted on infectious and chronic disease issues in China for more than 20 years, and designed efforts to prevent chronic disease in Hungary. In 1984 he led the U.S. team investigating the Bhopal chemical disaster in India. He serves on the Global Health Board of the Institute of Medicine.
The committee's 46 recommendations were grouped within 12 strategic themes, some of which centered on restructuring parts of the Hong Kong health system, such as better coordination and communication between the hospital authority and the health department. Others stressed the need for strengthening surveillance mechanisms throughout the entire health care community, including prompt and routine reporting of suspicious diagnoses. Contingency planning, site-specific plans within the public and private sectors, and a clear chain of command in case of emergency also were cited as high priorities. Inadequate surge capacity in hospitals and the public health system were noted as major problems during the SARS epidemic, and the committee recommended improvements in hospital facilities and clinical skills. Close collaboration with the entire international community was stressed as a key factor in dealing with emerging diseases, in addition to communication with the public to establish a level of trust. The committee also recommended the establishment of a CDC-like unit, termed a Center for Health Protection, with particular focus on surveillance, outbreak identification and control, and epidemiologic capacity.
"As the U.S. prepares itself for the possibility of a future SARS-like outbreak, we should focus on these very same issues, particularly hospital capacity, effective communication and collaboration within our public health system, infection control within healthcare facilities and increased surveillance procedures," said Dr. Koplan.
The entire report of the Hong Kong SARS Expert Committee may be viewed on the committee's website at http://www.SARS-expertcom.gov.HK