He and fellow researcher Malik Peiris also continued to stalk the strain into the Mai Po Marshes of the New Territories. There the mudflats and mangroves offered a refuge unique in Hong Kong for hundreds of species of wild birds. The scientists drove up before dawn. It was a cold, damp morning. Though they were wrapped in heavy coats, the chill penetrated Guan’s bones. He pushed a small boat into the dark water, mud soaking his sneakers, and then rowed across the narrow inlet. He came ashore on Duck Island, a sliver of land that fittingly boasted more than twenty species of ducks. It was too hard to catch these birds. So for an hour and a half, Guan scoured the ground for their droppings. Live virus would be lurking inside.
The specimens collected from scores of birds in Hong Kong suggested that the mystery outbreak in Guangong’s hospitals was H5N1. But by February 2004, Guan and his fellow microbiologists realized there was no substitute for actual human samples. Someone would have to go to Guangzhou to get them.
“Why not Yi?” Webster asked. “It’s not everyone who’s going to want to go into that room and risk his life.” Guan was impetuous and courageous, and it was obvious to him that this was his moment.
When Guan arrived at the Guangzhou Institute of Respiratory Diseases, he told the director, Nanshan Zhong, that the pathogen was most probably influenza. “It is possible this is the early stage of a pandemic. If we don’t deal with it carefully, this will be a disaster,” Guan warned.
To contain it, medical experts had to determine precisely what it was. Guangzhou didn’t have the necessary lab facilities, Guan concluded, but Hong Kong did. Zhong concurred.
With the vials stashed in his satchel, Guan hailed a taxi outside the institute gate on the afternoon of February 11 and set off into rush-hour traffic. He wanted to make the 6:30 P.M. express train to Hong Kong. If he did, he could turn over the cache of vials to his lab staff in time for them to begin the process of culturing the virus samples that very night. Guangzhou East Railway Station was teeming with travelers. The cavernous hall echoed with the announcement of trains departing for destinations in the Chinese hinterland. Guan headed toward the terminal for the Kowloon-Canton Railway, which would whisk him to Hong Kong. Police officers, some alone, some in pairs, meandered through the crowd. Guan avoided eye contact.
He ascended the escalator. At the top were the immigration counters. Guan liked to tell himself it was all one country, Hong Kong and the mainland. That was, after all, the official Chinese government line. And by that logic, he wasn’t smuggling the samples abroad. But in many practical ways, China still treated its border with Hong Kong as an international frontier. Guan showed his passport to the blue-uniformed immigration officer, who waved him through. When he reached customs and saw the X-ray machine, he momentarily considered looking for another way around. Then he thought better. “If you try to avoid that,” he told himself, “there will be more trouble.” He placed his satchel on the belt. Seconds passed before it reappeared on the far side. The white-uniformed customs officer didn’t say a word. Guan retrieved his bag and continued toward the waiting room.
There were families with large suitcases, and businessmen returning home after a day trip to their factories and suppliers. They were already queuing up when the train was announced. Guan joined the line. An immigration officer was conducting a final passport inspection. “The quieter you are, the safer you are,” Guan reminded himself. Usually he was a dervish of activity, a fast-walking, fast-talking impresario of scientific notions who pressed his theories, passions, and grievances on listeners in a shotgun spray of sentences, a chronically restless soul who found it nearly impossible to remain seated or stand still unless, of course, he was smoking a cigarette out an open window. Yet in his plain gray suit, inexpensive haircut, and large, silver-framed aviator glasses, he could melt into the undifferentiated mass of commuters if he could just feign the right air of indifference.
“The more you keep quiet,” he repeated to himself, “the safer you are.” The immigration officer asked for Guan’s passport. He flicked his cigarette to the floor and produced the document from his jacket with an affected look of weary annoyance. The officer returned the passport and moved on.
Finally the line moved. The passengers filed downstairs to the red tile railway platform and onto the train. Guan claimed his seat. He placed the satchel carefully on the overhead rack. Then he took out his cell phone and called his lab. “Are you ready?” he asked. “The samples are on their way.”
But as they were analyzed over the coming days, the samples stumped Guan and his fellow researchers. The virus wasn’t H5N1. It wasn’t flu at all. It would later be identified as SARS, and that was fortunate. Because in the age of globalization, flu would have been much worse.
Half a year after the SARS epidemic had subsided and life had returned to Hong Kong’s deserted streets, the city’s legislative council would conduct an inquiry in January 2004 into the government’s handling of the crisis. The outbreak had killed 299 people in Hong Kong alone. Nearly six times that number had been infected. Amid stinging criticism, Hong Kong’s secretary of health, welfare, and food and the chairman of the hospital authority would lose their jobs.
Margaret Chan, the city’s health director who had so ably steered Hong Kong through the bird flu outbreaks of 1997, had also skippered its emergency response to SARS. As she testified before the legislative council, she broke into tears. “We tried to do our best,” she assured the members before being overcome by emotion, forcing them to briefly suspend the hearing. During her testimony, Chan told the council she had tried several times in early 2003 to confirm the press reports of an epidemic brewing in neighboring Guangdong province. On February 11, 2003, the very day that Guan was making his clandestine run to the Guangzhou institute, Chan and one of her departmental consultants had repeatedly phoned health officials in Guangdong about the rumors. No one answered their calls. “Usually, with other infectious diseases, there was no problem with communication,” she testified. She added that a Guangdong official later told her “there was a legal requirement for infectious diseases at that time, that infectious diseases were classified as state secrets. That is why they cannot share the information.”
The council went on to censure Chan, who by that time had resigned from the health department for a post at WHO in Geneva. She was faulted in part for leaving Hong Kong vulnerable “in that she did not attach sufficient importance to ‘soft intelligence’ on the [acute pneumonia] epidemic in Guangdong.” The report suggested she could have dispatched a team to the mainland to investigate.
Ultimately, it was a doctor named Liu Jianlun who had brought the disease to Hong Kong’s attention. Liu was a retired kidney specialist from southern China. At age sixty-four, he still worked part-time in an outpatient clinic at a hospital in Guangzhou. It was this hospital that first treated one of the earliest victims, a forty-four-year-old seafood seller from the suburbs who came in January 30, 2003, with a severe cough and fever. This patient stayed only two days before being transferred to another hospital. But in that remarkably brief time, he infected at least ninety-six other people, including ninety health-care workers.
Liu himself started feeling sick two weeks later. He worried that he had contracted whatever horrible illness was besieging his hospital. But his chest X-rays looked clear. So he dosed himself with antibiotics and set out with his wife on a three-hour bus ride for a nephew’s wedding in Hong Kong. When they arrived, he felt well enough to go shopping and enjoy a long lunch with relatives. Late that afternoon, on February 21, Liu and his wife checked in to their room on the ninth floor of the Metropole, a three-star hotel in Kowloon with a large swimming pool on the roof and a karaoke bar in the basement. Their room was what marketers call cozy, with two single beds and a pale olive carpet. From the window of room 911, they could see a Shell service station, an Esso service station, a YMCA guesthouse, and beyond, one of the most congested quarters in all Hong Kong.
Long before the term
Liu would become Hong Kong’s first case. Before he died, he told the doctors and nurses caring for him about the disease raging in his own hospital.
The Singaporean hotel guests returned home, where they were all hospitalized, and one, the woman on the
