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Toronto SARS nurses at risk: expert

 

REACTION: Angry and exhausted health-care workers are demanding a safer working environment and more input into the handling of the outbreak of the virus

 

REUTERS , TORONTO

 

The protective gear worn by Toronto nurses treating SARS patients may not be sufficient to prevent them from getting the deadly disease, a respected microbiologist who is helping lead the city's battle against the virus said yesterday.

 

Dr. Donald Low, chief of microbiology at Mount Sinai Hospital, said that there is evidence that some procedures, such as inserting breathing tubes into patients, are extremely risky, and the transmission of the SARS virus can occur even when all precautions are taken.

 

Two of the new SARS cases in the past week occurred in nurses who were inserting breathing tubes into a SARS patient. SARS nurses in Toronto wear, at a minimum, two layers of gloves, a mask and a gown.

 

Health officials meanwhile said yesterday that Toronto's latest SARS outbreak was tapering off, with the number of people in quarantine falling to about 1,000 from about 5,000 on Tuesday.

 

Low made his comment as hundreds of angry and exhausted nurses set up picket lines in front of a suburban hospital and demanded better gear, a safer working environment and more input into the handling of the outbreak.

 

"Clearly, the experience in Toronto is that these people are at an increased risk of acquiring SARS," Low said. "People just don't understand the kind of risk they [nurses] are putting themselves at working in these wards."

 

Low said nurses in SARS units could soon be wearing equipment resembling space suits to protect themselves. One hospital already requires such suits for nurses treating SARS patients, he said.

 

But even space-suit-like gear may not be the best thing to prevent infection, said Dr. Andrew Simor, chief of microbiology at Sunnybrook and Women's College Health Sciences Center in Toronto. "We do not know for sure if that is the answer or not," Simor told a news conference.

 

Recognizing the risk, four hospitals in Toronto have said they will double the pay of nurses working with SARS patients. Senior nurses could get C$66 (US$49) an hour.

 

Yet for some, extra pay is not enough. Doris Grinspun, executive director of the Registered Nurses Association of Ontario, said nurses are overworked, need time to rest and require more training in infection control.

 


"More money alone will do nothing," she said.

 

In an open letter to health-care workers, Ontario Health Minister Tony Clement said, "We are aware of your concerns ... we are taking appropriate steps to help prevent the spread of SARS and other infectious diseases. I want you to know that we are listening, that our government will keep listening to you."

 

But he did not calm the fear nurses have that they might be ordered to work in new SARS wards being created in the city despite new evidence of risk.

Registered respiratory therapist Jacob Krygier displays a protective suit that is worn when performing any high-risk procedure on a SARS patient at his hospital in Toronto.


 

"The cluster is tapering off but we need to be hypervigilant," said Dr. Colin D'Cunha, Ontario's chief medical officer of health. Twenty people are in critical condition, he said, adding that an additional 221 people are being monitored for possible infection.

 

Health officials said no cases were reported from the nearly 1,700 pupils and teachers who went into quarantine at a high school and that five more cases being investigated at a hospital were not SARS. Two possible cases in the town of Parry Sound, north of Toronto, and one in Ottawa also turned out not to be SARS.

Toronto, with 32 SARS deaths, is the only place outside Asia where people have died of the respiratory disease. There were 79 probable and suspected cases of SARS in Toronto yesterday, up from 77 on Tuesday.

 

The disease, which originated in China, has killed 772 people worldwide.

 

 

Is there a pretender to the throne?

 

It is alleged that a secret pact exists between KMT Chairman Lien Chan and PFP Chairman James Soong. If true, the KMT and Lien are clearly paying an arm and a leg for Soong's agreeing to play the No. 2 man on the pan-blue ticket in the next presidential election. In fact, it is hardly an exaggeration to say that Lien is being taken hostage. The question for the KMT is whether it is worth the risk of losing the entire apple orchard over one apple? Voters, however, must ask themselves how much more they can tolerate this kind of under-the-table trading of their welfare and their future in a manner resembling nothing so much as the way vegetables are weighed and sold by the catty after haggling the price in the marketplace.

 

Surely, no one bought that phony nonsense about Soong "thinking only of the interests of the country" in his "selfless" decision to "settle" for the vice presidential slot on the ticket. In the last presidential election, Soong garnered more than twice the number of votes that Lien did. Under the circumstances, only a fool would think that the notoriously venal Soong's "sacrifice" came without a price tag.

 

Soong has reportedly been promised the premiership if the alliance ticket wins next year, the top slot on the 2008 ticket and the KMT chairmanship after the two parties merge. If that is the case, Lien is already a lame duck even now, let alone if he wins the election next March.

 

And what about the KMT's own line of succession? Such a deal would eliminate Taipei Mayor Ma Ying-jeou's chance at the presidency until 2012 at the earliest. By then, Ma would be well into his 60s and would be facing a challenge by the next generation of political stars. In addition, there are surely other PFP members with their own political aspirations. Far from wielding the power that should go with their political stature, the middle-aged generation of KMT members will be left with little more than table scraps.

 

As if to confirm the reports of a secret deal, Soong called on five KMT lawmakers on Monday -- as if they were his subordinates -- to discuss KMT Vice Chairman Vincent Siew's decision to head President Chen Shui-bian's economic advisory panel. This was in addition to the loud demands from PFP members that Siew resign his KMT post for accepting the panel post.

 

Then there is the uproar over the Legislative Yuan's decision to delay confirmation of nominees for the Council of Grand Justices. Legislative Yuan speaker Wang Jin-pyng -- another KMT vice chairman -- had advised against postponement, but Lien, at Soong's insistence, caved in, literally putting Wang on the spot.

 

When pressed about the veracity of the alleged secret deal, PFP spokesmen have adopted an ambivalent attitude, which, since denial is so easy, can only suggest that the allegation is true.

 

All these moves were clearly designed to allow Soong to flex his muscles in front of the KMT's members, as well as future grand justices, who would certainly be asked to determine the constitutionality of Soong, if elected, serving simultaneously as vice president and premier.

 

These moves by Soong and the PFP may be clever, but they also show a degree of calculation and manipulation which has left many in the KMT, as well as the general public, feeling very uneasy.

 

 

 

Legislature rejects referendum bill

 

PARTISAN LINES: The pan-blue camp exercised its legislative muscle yesterday, rejecting reviews of the referendum bill and the Judicial Yuan Organization Law

 

By Fiona Lu

STAFF REPORTER

 

Efforts by the TSU caucus to push through a second review of the referendum bill were voted down at the legislature yesterday.

 

Legislative speaker Wang Jin-pyng held an inter-party negotiation session on whether to force a legislative review of the draft, but parties failed to reach a consensus, setting the stage for a vote.

 

With the pan-blue and pan-green camps mobilizing their forces for the vote, the TSU proposal was rejected 98 to 110. At the green camp's insistence, a second vote was held, and the proposal was again turned down, 100 to 107.

 


The rejection of the draft bill means the legislature will not wrap up its handling of the referendum draft this session, which ends today.

 

In another inter-party negotiation, legislators moved to defer the review of proposed revisions to the Judicial Yuan Organization Law. The blue camp forced the delay, saying the judiciary is not ready for the changes.

Legislators from the DPP, KMT and TSU celebrate the passage of legislation governing stipends for senior citizens yesterday.


 

The draft revisions were the result of a finding issued by the Council of Grand Justices on Oct. 5, 2001, that the Judicial Yuan structure violated the constitutional separation of powers and demanded the problem be rectified within two years.

 

Meanwhile, the legislature approved revisions to the statute on subsidies for senior citizens.

 

It also approved three disputed items yesterday afternoon: revisions to the National Security Council Organization Law, revisions to the special regulation on SARS and a special budgetary draft of NT$77.7 billion consisting of budget for public-service employment and another one for public construction projects.

 

The revised statute on seniors subsidies is expected to benefit 210,000 senior citizens as the revision will increase the eligibility of workers and farmers to receive a monthly NT$3,000 pension from the government. The measures go into effect on July 1.

 

Both the ruling and opposition camps endorsed the changes.

 

"We'd like to show our appreciation to the KMT and PFP for their help in securing the revision's approval. The passage ... expands the eligibility of laborers, who have made significant contributions to the country," said TSU legislative whip Chien Lin Whei-jun.

 

Chien Lin, however, expressed her regret that "the grant could not be retroactive from January 2002 as was expected due to insufficient finances."

 

For separate legislation on the national pension plan, DPP Legislator Lai Ching-te encouraged the legislature to pass the draft. The legislation will not be reviewed this session.

 

Lai said the pension plan would provide the country with more solid welfare for seniors.

 

KMT Legislator Chiang Yi-wen praised the passage of the seniors plan, which she interpreted as a way for the country to show its respect for the elderly.

 

"The approval identified the country's fulfillment of its responsibility to give impartial care to the elderly while the country is aging," she said.

 

Also postponed was the review of revisions to the Statute Governing the Relations between the People of the Taiwan Area and the Mainland Area.

The first-day legislative assembly made a final decision to postpone the review for proposed revisions to the statute since further negotiations were needed.

 

Still awaiting revision are a budget review for establishing a national human rights memorial hall and another 35 items requested by the TSU for the assembly's reconsideration.

 

A showdown is expected when the legislature wrestles with 50 items scheduled for review today.

 

 

Don't lift advisory on Taiwan: China

 

SARS: Beijing has been pressuring the WHO to keep its travel warning on Taiwan until a similar advisory for China is lifted, according to a Taiwan government source

 

By Melody Chen and Lin Chieh-yu

STAFF REPORTERS

 

China has asked the World Health Organization (WHO) to ignore requests from Taiwan to be removed from the list of places the health body advises people to avoid because of SARS until China is taken off the list, a government source said yesterday.

 

"China not only continues cheating the WHO about the real SARS situation in the country but has also made an all-out effort to block Taiwan's removal from the WHO's travel-warning list before China," the source told the Taipei Times yesterday.

 

He said the real situation in China was out of control, with many provinces still facing a serious threat from the disease.

 

"According to a report from our national security network in China, there is concrete evidence that Beijing is still lying to the international community" about the SARS situation there, the source said.

 

In Datong, Shanxi Province, more than 70 SARS cases have been identified but Beijing has reported only five to the WHO, according to the source.

 

Shenyang, in Liaoning Province, has been sealed off, according to the source, with all schools closed and people prohibited from going outside.

 

He said Beijing had tried its best to conceal the extent of the SARS outbreak there and had interfered with WHO assessments of the situation in Taiwan.

 

"A WHO official has told our Department of Health [DOH] that Beijing asked the WHO not to remove Taiwan from the travel warning list unless China is also removed," the official said.

 

The DOH said it was planning to petition the WHO to be removed from the list today if the number of people in the country still infected with SARS falls below 60.

 

The Center for Disease Control (CDC) yesterday launched an assessment of the 214 probable SARS cases that are still in hospitals to find out whether they are infectious.

 

To be described as no longer infectious, a person with SARS has to be fever-free for two days, have a normal white blood cell and platelet count and demonstrate fewer signs of lung infection and coughing, according to the DOH.

 

DOH Director-general Chen Chien-jen said yesterday if the assessment found fewer than 60 infectious cases, the DOH will ask the WHO to remove the country from its travel recommendations table today.

 

Chen said an area needs to fulfill five conditions to be taken off the travel advisory list.

 

First, there should be no recent reports of internationally exported cases from the area.

 

Second, the area's pattern of outbreak should show a sustained decline.

 

Third, the number of new cases must be below five over five consecutive days.

 

Fourth, all new cases in the past 20 days were only of people who were already identified as contacts of a person with SARS.

 

Fifth, the total number of people who are still infectious is below 60.

 

Chen said he was hopeful his request would be accepted based on the experience of Hong Kong.

 

"By the time Hong Kong sent its application, there were still around 200 SARS patients in its hospitals. These people were convalescing or being treated for other conditions in hospitals," Chen said.

 

The WHO issued the travel advisory on Taiwan on May 8.

 

The number of deaths stood at 81 for the eighth consecutive eighth day yesterday. The number of probable cases fell one to 677.

 

 

WHO says SARS outbreak has peaked

 

AFP , BEIJING

 

Asia reported no new SARS cases yesterday as the World Health Organization (WHO) declared the outbreak of the deadly virus had peaked throughout the world and businesses geared up for recovery.

 

News that China, Hong Kong and Taiwan had reported no new cases of SARS came after the WHO noted that no new deaths had been reported on Wednesday for the first time since March 28.

 

The number of fatalities edged higher with China reporting two more, and Hong Kong announced one new fatality.

 

In Canada, the only country outside Asia to suffer SARS deaths, health authorities said a second major outbreak was on the wane.

 

Even the usually cautious WHO was prepared to say SARS was on the run after killing more than 770 out of nearly 8,400 who have caught the pneumonia-like disease, which has wreaked economic havoc in several Asian regions and badly hurt the global travel industry.

 

"We dare to say that the SARS epidemic is over its peak period," Henk Bekedam, chief representative for the WHO in China told a news briefing.

 

"We can see it globally and we can see it in China."

 

China yesterday reported no new cases of SARS and two new deaths in the previous 24 hours, taking the toll to 336 fatalities from 5,329 cases.

 

Hong Kong announced one SARS death, but for the second time since the outbreak was first declared in mid-March, there were no new cases, leaving the number of infections at 1,748 and lifting the toll to 284.

 

Hong Kong's Chief Executive Tung Chee-hwa welcomed a US decision to lift its SARS-related travel advisory for the territory -- two weeks after the WHO took the same step -- as further proof "travel to Hong Kong is safe and life is returning to normal."

 

Mike Rowse, the head of the government's overseas investment body InvestHK, said he expects the first group of business travellers to arrive in Hong Kong later this month and for visits to return to "full gear next month."

 

Several Asian airlines said they were preparing to restore some of the flights they had cut amid plummeting passenger numbers at the height of the outbreak.

 

 

Taiwan in the post-Iraq-war world

 

By Lai I-chung

 

As it turns out, Europe, the US and the Middle East in the post-Iraq world are confronting the resurgence of al-Qaeda terrorism, while much of Asia is busy dealing with the issues of North Korea's nuclear weapons program and the SARS epidemic. It appears the road to Iraqi democracy will be long and bumpy and it remains to be seen how democracy is able to take root in the Middle East. The post-Iraq conflict era is still full of uncertainties.

 

However, there has been something positive in Asia as a result of the Iraqi war. Right after the end of the military conflict, US-China-North Korea multilateral talks were held. The realization of these talks -- in which North Korea agreed to participate despite its repeated demands for bilateral negotiations with the US, and China played host despite its claims that it has no influence on Pyongyang -- did suggest that the result of the Iraqi conflict has played a role in both Pyongyang's and Beijing's decisions. South Korean-US relations also seem to be back on track after a successful summit last month between US President George W. Bush and President Roh Moo-hyun.

 

Though there is no evidence indicating that US-South Korea relations were directly affected by the Iraqi war, the conclusion of this conflict did afford the Bush administration time to pay more attention to Korean Peninsula affairs. Thus it has helped to prepare a better environment to manage the US-South Korean alliance. Furthermore, the US-Japan alliance has also been strengthened in the wake of the war.

 

To sum up, North Korea seems to be more isolated, China has been persuaded to side with the US, the South Korean-US alliance started to swing back and the US-Japan alliance has been strength-ened. The US' position in North-east Asia has been solidified even more.

 

North Korea's informal confession during the May talks that it possessed nuclear weapon only confirms the pre-1994 US intelligence estimate. But it has resulted in several subtle changes in the security architecture of the Korean Peninsula. It has created a crack in China-North Korea relations. Pyongyang's announcement was a public slap in the face to China as it directly contradicted Beijing's repeated appeals for a non-nuclear Korean Peninsula. It also puts China in the international spotlight to see how it backs up its assertion.

 

This "nuclear confession" and the deterioration of China-North Korean relations have led South Korea's leadership to rethink their approach to North Korea and the US. Interestingly, Pyong-yang's nuclear revelation did not really deter the US' hard-line approach, but has resulted in an international environment more inclined to contain Pyongyang than before.

There are two issues of concern for Taiwan in these Korean affairs: the fearthat its interests will be traded in order to obtain China's cooperation and the readjustment of US forward deployment in the region. Since China seems to be under pressure itself, rather than be in a position to be asked to reduce the tensions over North Korea's nuclear weapons, Taiwan's fears of being hurt somehow by US efforts to obtain Chinese cooperation have been significantly reduced.

 

Taiwan's reasons for its other substantial concerns are as follows: The US-Japan alliance and US forward basing in Japan is critically important to this nation's security. Thus Taipei will be very sensitive about the direction the US-South Korean relations because it might affect the US-Japan alliance and the US deployment in Japan. This concern has receded somewhat after the successful Roh-Bush summit in May and Roh's affirmation of the presence of US forces in the South.

 

So far, there is no reason for Taiwan to worry about the Northeast Asia security environment, although we need to maintain a watchful eye. It is very important for Taiwan to have a stable and predictable Northeast Asia as its people are engaged in an all out battle against SARS.

 

However, the above discussion linking Taiwan and the security of the Korean Peninsula bears one distinct feature: the security situation of Taiwan and South Korea is mentioned not by direct linkage but via a third party -- whether it is China or the US-Japan alliance. Both Taiwan and the Korean Peninsula sit in a location where the interests of the continental powers (China and Russia) and maritime powers (US and Japan) overlap and crises in both areas will have global security, political and economic consequences.

 

There should be frequent and common security dialogues between Taiwan and South Korea since both share similar security concerns and their democracies developed at relatively the same time. Therefore, the sorry state of Taiwan-South Korea relations is all the more astonishing. There are many reasons to account for the lack of a common security language, but this issue needs to be addressed in order to establish a balanced, healthy and sustainable relationship between Taipei and Seoul.

 

Another important issue Taiwan should address by taking advantage of this favorable environment is how to implement the political, security and social reform it desperately needs. The SARS epidemic has exposed many governmental weakness, including the national security infrastructure, contingency planning and crisis management. The SARS crisis has presented us with a golden opportunity for reform.

 

The Asia-Pacific region is fast moving from a post-Iraqi conflict period into an era of containing North Korea's nuclear brinksmanship and battling SARS. It depends on how the leaders can transform challenges into opportunities, thus strengthening Taiwan's position in the region and the world. The time for action is now.

 

Lai I-chung is director of foreign policy studies at the Taiwan Thinktank.

 

 

 

 

A mask is more than just a face covering

 

By Lee Shiao-feng

 

I am a mask. I have been worn over the mouth of Professor Lee Shiao-feng for the past two days. The other day a reporter asked Lee: "We have all been wearing masks since the SARS outbreak began. People guard against each other. Is the distance between people growing? Is the feeling of alienation growing?" After hearing this question, I couldn't help but feel sad. The sense of alienation is growing because people wear me?

 

But Lee's answer suddenly made me feel better. "No, my answer is absolutely the opposite. We have seen people wearing masks all over the city. It makes me feel that the Taiwanese are meeting with the virus threat together. It makes me feel that we are all linked together by destiny. Masks have become a symbol of Taiwan fulfilling its destiny as a gemeinschaft," he said.

 

The reporter asked, "Then aren't many people in China and Hong Kong joining our gemeinschaft because they also wear masks?" Lee jokingly said, "This is not gemeinschaft. That would be called the `Chinese SARS Co-prosperity Sphere.' China infected us with SARS. It even infected Singapore, Vietnam and Toronto with SARS. The 21st century is the Chinese people's century, as Chinese people often say."

 

I didn't know that I could be interpreted in multiple ways.

 

As a matter of fact, do you think I like to be worn over people's mouths and noses and alienate people? According to German philosopher Friedrich Nietzsche: "What is great in man is that he is a bridge and not a goal." To be a great mask, I mustn't play the role of a bridge. It would be tragic if we become the bridge between virus and man. We are supposed to help man block and cut off virus.

 

Unfortunately, some people do not understand the meaning of a bridge and always want to hold hegemony over others. Sometimes they even add extra meanings to us.

 

For example, on Sept. 26, 1988, more than 30 social groups wore masks and protested against the Civic Societies Organization Law which was instituted by the KMT to prohibit the use of the name "Taiwan" in group titles. And on Dec. 28, 1988, Hakka friends wore masks and protested against the Broadcasting and Television Law for restricting native-language programs. They even had a photo of Sun Yat-sen covered with one of my kind. At that time, masks stood for the KMT's restrictions on the Taiwanese consciousness,native languages and culture. Masks were the symbol of some wicked laws such as the two laws just mentioned, thereby becoming a sign of KMT dictatorship.

 

Do KMT Chairman Lien Chan and PFP Chairman James Soong, two of the partners in crime, still remember this part of history? After a Lien-Soong ticket for next year was agreed upon, didn't Soong say he wants to be "responsible for history?"

 

What is done cannot be undone, but the future is in our hands. It is not too late for them to be responsible for history, to repent their mistakes. However, it is hard to tell from their recent actions that these members of the old guard want to start over with a clean slate.

 

For example, because China infected Taiwan with SARS and prevented this country from entering the World Health Assembly, President Chen Shui-bian hoped for a referendum to solidify public opinion so as to voice the people's will to join the World Health Organization. However, the pan-blue camp is still opposing and making things difficult for a referendum law in every possible way.

 

It is so contradictory for Soong to oppose the people's right to a referendum. How clever it is for Soong to say one thing but practice another. Soong's mouth cannot be covered by any kind of masks. I would consider myself in very bad straits if I were to come across this kind of mouth.

 

Lee Shiao-feng is a professor at Shih Hsin University.

 

 

Kungliao residents want a referendum as the nuclear issue heats up politically

 

By Chiu Yu-tzu

STAFF REPORTER

 

"We don't know if the government wants the north coast to be crowded by tourists to boost economic development or abandoned by people for the sake of nuclear safety."Lai Wei-chieh, secretary-general of the Green Citizen Action Alliance

 

Anti-nuclear residents of Kungliao township, Taipei County, where the Fourth Nuclear Power Plant is located, said yesterday that the future of the controversial construction should be decided by people living nearby.

 

The discussion around a referendum on the future of the plant has been heating up in political circles with the approach of the next presidential election. Since September last year, former DPP chairman Lin Yi-hsiung and his anti-nuclear partners have held 35 walking campaigns to push the DPP-dominant government to hold a national plebiscite on the future of the controversial plant by the next presidential election.

 

Only by doing so, Lin believes, people will possibly be convinced that the ruling party is determined to fulfill its political platform -- phasing out the country's nuclear power plants.

 

To heat up the referendum issue, Lin's 36th walking campaign will be launched in Kungliao tomorrow.

 

At a meeting on the discussion about existing supervision mechanisms applied to the controversial plant held by the Ministry of Economic Affairs yesterday, anti-nuclear Kungliao residents said that the locals' destiny should not be decided by others.

 

The meeting is one of preparatory meetings for a National Nuclear-free Homeland Conference being held on June 16.

 

"A referendum can't be processed without legal basis," said Minister without Portfolio Hsu Chih-hsiung, who chaired the meeting.

 

Hsu said that the referendum issue would be listed on the agenda of the national conference. Other topics include strategies to phase out nuclear energy, the decommission of existing nuclear power plants, the adoption of renewable energy, the disposal of nuclear waste and the future of the Fourth Nuclear Power Plant.

 

In addition, Hsu said, the subject needed to be clearly described before the referendum was held.

 

Lai Wei-chieh, secretary-general of the Green Citizen Action Alliance, said yesterday that the government lacked integrated plans on the development of the north coast, where many popular tourist spots and the controversial plant are located.

 

"We get confused because we don't know if the government wants the north coast to be crowded by tourists to boost economic development, or abandoned by people for the sake of nuclear safety," Lai said.

 

As yesterday marked the 31st anniversary of World Environment Day, Lai said the government's performance on protecting the environment seemed ironic if the plant project is clearly reviewed.

 

Lai said the construction of the plant has caused too much negative environmental impact, such as the loss of beautiful Fulung Beach nearby.

 

According to Kungliao residents, the construction of a wharf being built for the plant had caused not only the loss of 3km of beach but also irrrevocably changed their way of life.

 


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