Introduction

             The outbreak of infections atypical pneumonia in the recent month caused death of many people in the whole world, and aroused again attention of the medical profession on the virus.  In fact, human beings should draw a lesson from this episode of SARS dissemination and make effort to prevent relapse of the spread of the virus, and at the same time, we should not ignore the combination of TCM and western medical treatment.  

From the medical point of view, atypical pneumonia is only a serious complication of the virus disease during the acute phase.  As a part of the hospitalized patients a year, atypical pneumonia patients are not rare.  According to the government statistics, there are 13480 cases of atypical pneumonia in Hong Kong last year, in which 774 cases required intensive case, 370 cases died, the mortality only 2.7%. 

In fact, it is not the privilege of coronavirus in the production of atypical pneumonia.  In winter and spring seasons of this year, as usual, not a few countries showed spread of epidemic influenza caused by virus and also disease titled “spring pestilence”.  There were also patients died of atypical pneumonia caused by acute virus infection. 

Dr. E. K. Yeoh, Secretary for Health, Welfare and Food, revealed that in Hong Kong, in the atypical pneumonia patients, there were a hundred more cases whose infections source could not be traced back and 60% of them no coronavirus antibodies were found.  This meant that their diseases were caused by other viruses and not coronavirus.  Statistics also indicate that because people put on masks in the recent month, influenza patients are less as compared to last year, but the number of atypical pneumonia patients does not decrease.  This data shows, at least, the so called “super epidemic” coronavirus infection does not cause great increase of atypical pneumonia patients.
　

 Occult property of coronavirus and hepatitis virus

Medical investigations reveal that current virus infections mostly display a chronic course and taking the clinically better studies type B and type C hepatitis as example, after infection by the virus, only a small number of patients show obvious symptoms which can be decidedly diagnosed by physicians as acute or chronic hepatitis.  Data also shows that those having clinical symptoms are in a proportion of 1 to 40, and most of the infected individuals experience a silent course.  But in the past infection long course, there is also existence of progressive hepatic damage, including apparent virus replication and capability of transmitting infection.  Therefore, medical workers should think of the possibility that the spread of coronavirus is in fact similar to hepatitis virus.  It is generally accepted that patients who have acute symptoms like chilliness, high fever, general soreness of body, shortness of breath and heaviness of chest and also positive X-ray findings, may have already been infected by coronavirus in the community.  In fact most people have normal immune ability to coronavirus so that no typical symptoms are shown and they passed a rather mild course of disease. Recently, on Ontario, Canada, 120 patients with positive coronavirus antibodies but no clinical symptoms were found.  This indicates that coronavirus “occult infection” is very common. 

In China and Hong Kong, taking TCM drugs is a common phenomenon in the people, and because they have the chance to receive TCM treatment in the early stage (especially during the time of epidemic), the possibility of developing serious complications of SARS is comparatively low in these places.  This is one reason why the mortality is comparatively high in some countries during influenza epidemic. 
　

Preventive force of TCM in the basic community

The epidemic is under control this time in china mainland and Hong Kong.  It is chiefly due the respect and approval of TCM in the Chinese society; the power of TCM therapy permeates the basis of the society resulting in a great force fighting against epidemics.  Therefore, the chance to develop complications of atypical pneumonia is lower, the course of disease is shorter and the mortality is lowered.  The contribution of TCM should not be unrecognized.  But if the related departments neglect this fact, the reason may only be : the effect of TCM on prevention of disease not fully recognized; or the basic and already-formed TCM therapeutic force in Hong Kong society is neglected.

From the large amount of data recommended, we can see that TCM workers have great confidence in the prevention and treatment of atypical pneumonia and they have actively asked for their participation in the rescuer work of these patients.  If in the elderly stage of the epidemic, the related leading departments could organize the basic force of TCM and wm in time to participate in the prevention and treatment of the disease, the result would be certainly better.  The experience of Guangzhou proved its correctness.

Medical workers in Taiwan University Medical College and hospitals discovered that although the disease was mild in some SARS patients, but its infections ability was still present and the people infected by these patients might even develop pathlogical changes of pneumonia.  This condition indicates that the existence of coronavirus is an objective evidence.  The critical point is that the disease must be detected early and treated rationally.  When common cold symptoms appear and the patients receive TCM treatment early, the chance of developing atypical pneumonia would be much less and the mortality greatly lowered.

Establishment of anti-epidemic center imminent

High mortality is related to the measures of treatment, and the effectiveness of absolute isolation is discussible, but concentration of patients for therapy can give them the greatest case and most effective treatment.  After being isolated, the patient’s privilege of taking TCM drugs is deprived.  This is a matter of regret.  The medical circles of Hong Kong proposed that the establishment of an infections disease hospital should be carried out as quickly as possible.  A modern city with 7 million citizens attacked once by atypical pneumonia put the directors of the health department in a dilemma.  This is a test in every sense.  For the future possible epidemics, we must prepare well.  Hong Kong, as a cosmopolitan city, should quickly establish the anti-epidemic center and infections disease hospital.

Epidemics occur in the spring, it is closely related to the most and rainly weather.  Stress should be laid on personal hygiene to prevent infection.  Passing into summer, propaganda should be placed on beverage and food hygiene especially on measures to prevent spread of virus and also on the administration of beverage and food hygiene regulations.

The SARS epidemic has its mode and the drop of its climax depends on three factors:

In this epidemic, the critical point is that the coronavirus caused infection of many old people whose bodies were weak or suffering from chronic disease (especially liver disease) so that a high mortality resulted.  In May this year, a report stated chat in Amoy Garden, in 75 patients, 9 were hepatitis B virus carriers, in which 6 had a bad lung function, occupying 67%.  In the remaining 66 non-hepatititis B virus carriers, only 9 had aggravated lung dysfunction, amounting 14%.  In the epidemic period, this kind of patients should be particularly protected; various measures should be undertaken to prevent them from infection and if infected, they should be diagnosed and treated early.

For thousands of years, the Chinese people had discovered that herbal drugs had apparent inhibitory effect on virus pestilential evil, especially in the treatment of some typical virus disease like measles and varicella.  In the past, coronavirus was considered as the primary invader of virus enteritis, but presently, the consideration that the infective path of SARS is chiefly droplet transmission is not without reserve.  We think that the suggestions of beverage and food hygiene, eating cooked food, paying attention to quality of food (especially cold drinks, uncooked food) are more important.  Using the Amoy Garden virus transmission cases as an example, the concept of disease invade through the mouth should certainly not be discarded.  Medical workers are in close contact with patients during the working time, so direct contact infection should also be considered (including would infection).

Obstacles set up by Hong Kong government policy

Treatment with combined TCM and wm is a method used for a very long time and it has accumulated much experience.  The TCM and wm drugs are in the market a long time and can be used at any time, if necessary; this combined method of treatment has been used before and proved effective.  The problem was that the policy of the Hong Kong government did not change in time and it formed a condition of artificial obstruction.  There was a barrier between TCM and western medicine, a “never communicating” situation and refusal of TCM entrance to the hospitals under the medical administration Bureau and prohibition of TCM participation in the treatment of atypical pneumonia early in the epidemic.  Suspected cases of atypical pneumonia were isolated and their privilege of taking TCM drugs were deprived.  This was, indeed, not a good policy.

Nevertheless, create a magnanimous situation, let patients take advantage of TCM wm systemic treatment, develop a condition where TCM and wm can learn from other’s strong points and make up for one’s weaknesses.  The result will surely be higher effectiveness, shorter disease course and lower mortality.  This is certainly a right thing to do.  Recently, the government has begun to put stress on TCM administrative work and this is a good fortune for all citizens.

By WONG Kwok-hung
26 June 2003
Translated by Professor Zheng Hua-En in October 2003       

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