They had identified a likely source for the infection. But could it account for both Man-kei and her cousin? Or had Man-kei caught the virus and then passed it to her cousin while they were frolicking on their grandmother’s carpet? Could the virus already be spreading from one person to another? Neither Chan nor Fukuda nor anyone else could ever rule that out.
Hong Kong at Christmas was a city under siege. People were flooding emergency rooms to be tested for the virus. Even medical personnel were calling in sick, fearful they’d been infected. Drug prices had spiked, and panicked calls were overwhelming the health department’s hotlines. Though only a handful of sick chickens had been discovered in the city’s live markets, poultry sales had plummeted, and restaurants were banishing popular Cantonese chicken delicacies from their menus. On Christmas Eve alone, three more suspected human cases had been announced. Now the first of the seasonal flu cases were also surfacing.
There was no holiday break that year for the six members of the CDC team. Fukuda had never before missed a Christmas with his wife and daughters. So the health department arranged a Christmas Day lunch cruise for their CDC guests. But they couldn’t escape the oppressive mood. Word came that four more suspected cases had been identified, the highest one-day total so far.
“I don’t know whether this disease will stop or spread,” Fukuda once again told reporters two days later. He was appearing at a press conference on Saturday, December 27, with Chan and Hong Kong’s agriculture chief, Lessie Wei. There were now about twenty confirmed or suspected cases. The press was demanding to know what more the government would do to stem the crisis. Since poultry were thought to be responsible for most of the outbreaks, would officials have them killed? Chicken hawkers had already been ordered to clean and disinfect their cages. On Christmas Eve, Hong Kong had barred all imports of chicken from mainland China, the primary source of the city’s poultry and a possible origin of the infection. “I feel at this point in time,” Chan responded, “the measures are sufficient.”
The call that changed everything came that night at two in the morning on Sunday, December 28. Chan was at home in bed. It was the agriculture department. There had been a die-off of chickens at Cheung Sha Wan, the city’s main wholesale poultry market. About fifty birds from a batch of three hundred in a single stall had abruptly fallen over dead with swollen chests and necks, internal bleeding, and other symptoms of avian flu. And there was more bad news. A week earlier, a similar outbreak had occurred at a farm in the New Territories. The disease had moved gradually along a row of cages, claiming its victims. The test results had just come back positive for bird flu.
Chan couldn’t fall back asleep. “What is going on?” she wondered. Only days before, city inspectors had toured Hong Kong’s farms and reported that there were no outbreaks. “Margaret,” she told herself, “the size of the problem is bigger than what it appears.”
She didn’t have proof of a widespread poultry outbreak. But if there was one, it could finally explain the unrelenting series of human cases. She thought about the holding pens, nicknamed “chicken hotels,” where Hong Kong’s birds were kept overnight. As demand for poultry had dropped, retailers in the city’s live markets found they couldn’t sell many of their chickens. At the end of each day, birds from various stalls and markets were gathered together before being distributed again for sale in the morning. Chan’s technical advisors had told her this system was perfect for disseminating disease throughout the markets. “Enough is enough,” she thought.
After a long wait for sunrise, she contacted researchers at Hong Kong University. They had begun sampling poultry in the city’s markets just before Christmas. Most of the test results had yet to come back. Chan urged them to take as many specimens as possible and to hurry up. She was about to recommend drastic action but didn’t yet have the scientific evidence to support it. “When you are ahead of the curve in dealing with new and emerging infections, science is always lagging behind,” she later explained. But despite the uncertainty, she wouldn’t wait. “Don’t be afraid to make major decisions,” she told herself. “Don’t be afraid to be wrong.”
Chan spoke that morning with her boss, Chief Secretary Anson Chan, who ran the Hong Kong administration. They scheduled an emergency meeting for later in the day. As health director, Chan would tell her that all the chickens in Hong Kong had to go. But there was no guarantee the city’s political leaders would sanction such a costly measure. “I am prepared, if they don’t accept that, to resign,” she thought. “I will resign, because if the environment does not allow me to do my job to protect the people, then that is the proper action to take.”
Chan’s driver ferried her up to the Peak, the highest point on Hong Kong island and home to a white colonial villa called Victoria House. Once a taipan’s summer retreat, it was now the official residence of the chief secretary.
Chan and agriculture director Lessie Wei briefed the chief secretary on the latest poultry outbreaks. Hong Kong had already closed its borders to imports from China, yet the poultry infections persisted. If the disease continued to circulate among birds, Chan explained, the public health threat would mount, especially if the virus mutated or reassorted. That’s why all 1.2 million chickens in Hong Kong had to be culled. About three hundred thousand ducks and geese that were kept in close contact with the chickens would also have to go.
The chief secretary cautioned that the economic implications were huge. A mass slaughter could severely harm the livelihoods of countless chicken farmers and traders.
“People will not like it,” Chan admitted, “especially when it affects their vested interests.”
The chief secretary continued to press. The poultry sector would demand the government pay compensation. The bill could be tremendous.
“Yes, it’s going to cost money,” Chan agreed.
“What if we don’t solve the problem after killing all of the chickens?” the chief secretary asked.
“Then we need to go after all the ducks and geese,” Chan said.
“And what if we still don’t solve the problem again?”
“I’ll be accountable,” Chan answered. If she needlessly put Hong Kong through the trauma of a mass slaughter, she’d accept the consequences. “I’ll deliver my head on a platter. I’ll resign.”
Finally, the chief secretary accepted Chan’s recommendation. She agreed to take it to Hong Kong’s leader, Chief Executive Tung Chee-hwa.
Within hours, Chan announced that Hong Kong would kill every last chicken. The slaughter would start the following afternoon. They were all to be gone within a day.
From the start, it was clear the slaughter would not go as planned. The government pressed 2,200 public employees into the operation, giving them masks, canisters of carbon dioxide, and orders to gas the birds to death. But these were dogcatchers, park rangers, and other civil servants with no experience in killing birds and unsure even where to find all of Hong Kong’s farms. Day laborers were hired as reinforcements, and even some market traders joined the effort, slitting the throats and snapping the necks of their birds. The result was literally bloody chaos. The chickens clawed and scratched and scampered for safety. Flies swarmed. Farmers resisted. By the end of the first day, less than a fifth of the chickens targeted had been slaughtered, and many of those remained unburied. Television showed plastic garbage bags of carcasses heaped high while stray animals and vermin scavenged through the carnage, spreading fear of contagion. Nearly a week into the slaughter, fugitive chickens still roamed the streets.
Many traders and laborers in the city’s nearly one thousand poultry markets were incensed. On the third day of the slaughter, New Year’s Eve, Chan accompanied Chief Executive Tung to the Cheung Sha Wan wholesale market, an expanse of weathered stalls with rusting corrugated metal roofs in an old industrial quarter of Kowloon. They walked through the parking lot, crowded most other mornings with small trucks heavy with poultry, and toured sheds crammed with wood and bamboo cages, now empty but still caked with droppings. The chickens had gone silent. Instead about two hundred market employees confronted the officials, shouting objections and waving placards with slogans scrawled in red paint.
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