Bird flu response shows new openness in China

SHANGHAI -- After a new and lethal strain of bird flu emerged in Shanghai two weeks ago, the government of China's bustling financial capital responded with live updates on a Twitter-like microblog. It's a starkly different approach than a decade ago, when Chinese officials silenced reporting as a deadly pneumonia later known as SARS killed dozens in the south.

The contrast shows a new, though still evolving, openness in China that was learned from the SARS debacle, which devastated the government's credibility at home and abroad. It also reflects the demands of a more prosperous and educated citizenry for information and its use of social media to obtain it.

"Publicize information to prevent 'bird flu panic,"' read the headline of a recent front-page commentary in the People's Daily, the ruling Communist Party's newspaper, that urged government departments to release information quickly about an outbreak that has killed 10 and sickened 28 others.

The latest death of a 74-year-old man was reported in Shanghai, where two others also were reported sick. Neighboring Jiangsu province reported two more people infected Thursday.

Though some microbloggers and media are questioning why it took a couple weeks after the first deaths for authorities to announce the new strain of bird flu, international health experts have broadly praised China's response.

The government has said that it takes time for scientists to identify the virus and that such a finding had to be put through several layers of verification before being announced.

The new openness is thanks in part to people like Li Tiantian, founder of Dingxiangyuan, an online medical network popular with Chinese health-care workers. His microblog is among a number of sites that have been tracking the government's response to the new bird flu. "It's evident that the strength of social media can pressure the government to be more open, more transparent," he said from his base in the eastern city of Hangzhou.

Li remembers a time 10 years ago when state media were the public's only source of information. As rumors swirled that a mysterious pneumonia was killing people in Beijing, Li, then a postgraduate student, dismissed the fears as overblown because he saw footage on state television of seemingly carefree foreign tourists arriving in the country's capital.

It took months for Chinese authorities to start acknowledging the true scale of SARS -- but by then it was too late to stop it from spreading worldwide and killing hundreds.

SARS is much deadlier than bird flu, with an ability to spread from person to person that the bird flu virus generally lacks.

Since China reported the first human infections of the new bird flu virus, known as H7N9, on March 31, authorities have had to compete with the online rumor mill. They have also responded to demands spread through microblogs.

After some urged an investigation into a potential link to thousands of pig carcasses found floating in a river, agricultural officials said they tested pig carcass samples and did not find any bird viruses. When others said authorities should help pay the medical bills of those affected, health officials said hospitals were not allowed to turn away patients who could not afford treatment.

Shanghai is also on guard against bird flu in the real world: Signs in apartment compounds warn residents to watch out for the high fevers, breathing difficulties and other symptoms of the virus. At the Ruijin Hospital in the city's tree-lined, former French Concession area, patients with high fevers and other flu-like symptoms are handed disposable thermometers and masks and ushered in through separate entrances.

Breeders of homing pigeons have been prevented from letting their birds fly freely. The sale of live fowl has been suspended, and cages in a wholesale market once stuffed with clucking chickens are now empty save for the rats that roam inside them.

The message seems to be hitting home. Wang Sumin, 61, used to buy live chickens twice a month and slaughter them at home but has stopped purchasing poultry altogether. "We are all very concerned about this problem, after all, there are children and elderly in my family," Wang said as she mounted her scooter to head home from Huhuai market with bulging bags of fresh vegetables.

Fears remain high in a country where deadly viruses have jumped from animals to humans before. "I've been really afraid to shop here since I heard the news that they found the virus in pigeons here," said Cheng Long, 26, a restaurant cook shopping for vegetables at the same market. He now avoids the stray dogs roaming the market in case they have been infected: "I come here every day and can't afford to take any chances. People like us are the first ones to get sick from such diseases."

Health experts have given kudos to Beijing for being forthcoming with information, sharing the H7N9 virus' gene sequencing and samples with the World Health Organization's global research centers and providing timely updates of new infections and deaths. During the SARS outbreak in 2003, some patients were taken out of hospitals in Beijing and driven around the city to keep them out of sight as a visiting team of WHO investigators toured health facilities.

"I think all of us have been very impressed with the Chinese response," said Michael Osterholm, a University of Minnesota infectious-disease expert. "You got to give credit where credit's due."

But old habits die hard. In one case, it is not clear if authorities even informed a patient's relatives about his condition after the virus was discovered. Wu Demao, the father-in-law of Wu Liangliang, one of the first patients -- and at 27, the youngest so far -- to die from the virus, said his family only found out that his son-in-law was one of the first victims of the new virus when friends alerted him to official media reports on March 31. That was more than two weeks after the son-in-law fell sick and died when his lungs failed.

"Even I don't really know what his condition was. The cause of his death was not told to us, even after he died. It was not clear until my friends and relatives told me," Wu said outside his rented apartment in Minhang, a Shanghai suburb, on a recent evening. "We asked if it was SARS or bird flu. The hospital could not answer. They just said it was severe pneumonia." A woman who answered the phone at the No. 5 People's Hospital in Shanghai said it was not the facility's responsibility to notify relatives about the diagnosis.

Wu said his family was being treated like pariahs in their community amid fears about the virus, and that they were asked to leave their pork stall at the neighborhood market because its manager felt the media attention they were attracting was bad for business. Wu and his wife declined to comment further, lamenting: "It's no use. We are just ordinary people, no one will help us."

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Associated Press researcher Fu Ting in Shanghai and AP medical writer Margie Mason in Jakarta, Indonesia, contributed to this report.