CBC In Depth
Diary: A Canadian in Hong Kong
by Tavis du Preez | May 1, 2003

Overcoming the fear of infection

Pedestrians in Central District with sign in background showing masked face. Chinese characters on sign translate to say: "Salute to all medical workers! No words can show thanks enough."

The now ubiquitous surgical masks were blessedly absent from the faces of all 25 participants in the April 29 meeting of the Hong Kong Philosophy Café. Our timely topic was "The Wearing of Face Masks" and it was obvious to me, even before I heard a word spoken, that a great deal of skepticism regarding the efficacy and benefit of mask wearing would be expressed. Our presenter, a philosophy professor from Hong Kong Baptist University, explained that upon resumption of classes earlier this week, he conformed to the university administration request that Instructors should wear masks and that students must wear masks by strapping one nattily to his forearm. When questioned, none of his students, many of whom had also chosen to put their best faces forward, objected to his choice. I was very keen to hear why the majority of this well-informed crowd shunned the use of the mask while most of the people of Hong Kong consider them to be their best defence against SARS, a correspondingly faceless enemy. By the rising proportion of Hong Kong persons choosing to walk the streets with their own faces hidden, it would appear that the level of concern/fear is rising.

As new daily infection numbers continue to fall, the WHO has suggested that the SARS outbreak has peaked in Asian countries, with the exception of mainland China. But there is still fear in the air. Daily casualties remain high and the communal grief that has been building recently found public expression over the death of an otherwise healthy 38-year-old male nurse who was buried in a special cemetery reserved for civil servants regarded as deserving of the highest honour. Medical workers who have contact with SARS patients are now housed in temporary quarters, apart from their own families, so as not to spread the disease further within the community. During this period, Hong Kong's health minister broke down during a local TV news interview and offered, amid tears, to resign his post and in an unprecedented concession of accountability, Chief Executive Tung Chee-hwa recently admitted that his government should have handled the crisis more effectively from the beginning.

Advertisement for herbal remedy candy (Ninjom) that is portrayed to function as a sort of face mask.

Tung Chee-hwa now states his priority to be the elimination of new cases among health-care workers. Attaining this realistic goal should hopefully restore some confidence here in the ability of the government and the community to overcome the SARS challenge. A large part of the battle here seems to be with self-confidence. Hong Kong had been trying to find a new direction after having suffered a long, terrible economic fall since 1997, but SARS now threatens to jettison whatever spirit that still remains in the heart of this Asian Tiger. One of the few remaining strong sectors of Hong Kong's economy had been tourism, which predictably, has now ground to a virtual standstill. Of course, every crisis presents some opportunity and perhaps some future retailing giant is getting its start now selling masks on a street corner. It has been reported that some amoral opportunists have been making extra money by offering to sterilize pedestrians' bags, purses, etc. and, with nimble fingers, quickly cleaning their customers out of a lot more than mere sundry viruses and spare change. And why not, when bandits' accessories have become street fashion de rigueur?

Such stories relate to the concerns expressed by my new friends at the Hong Kong Philosophy Café What does the en masse wearing of face masks do to the psyche of this city? What, if anything, does it express about the collective consciousness of Hong Kong? If, as some present contended, the wearing of masks is irrational when considered in the light of the statistically very low level of risk, and if masks worn improperly (as they most often are) may actually contribute to disease spreading, then why are so many of us participating in this mass hysteria?

Herbal remedy shop in the Central District MTR (subway) station does a good business.

While some, like myself, were reticent to let go of the idea that wearing a mask is a rational response to the danger of SARS that may actually make us safer, others felt that mask wearing has become a fashion, or perhaps more accurately – a social obligation, which in reality serves more to display the present state of communal fragmentation than it does to protect us from infection. An obviously more existentially oriented French participant saw it to be largely an outward expression of an underlying denial of death. Others suggested that it is an expression of our growing subconscious fear of the dangers of war, famine, and disease that we in the industrialized world had believed, up until Sept. 11, 2001, to have overcome with our wealth and technology. That we are not as obviously concerned by WHO reports of 3,000 children dying daily of preventable malaria as we are over the present total 350 SARS deaths, for example, tends to add some weight to the last proposition.

Regarding the first question, many expressed a concern that masks alienate the wearers from one another, further eroding community bonds at a time when solidarity is sorely needed. One participant observed that masks were never worn at his home, regardless of their various external contacts, because there was trust within his family and they realized greater value in maintaining their relationships than in risking their erosion in order to (possibly) improve their odds against SARS by some probably hardly measurable amount. His perspective suggests that the inappropriate wearing of masks may paradoxically make us more vulnerable to disease by weakening the fabric of community relationship that, when strong, should help to keep us healthy.

Sign in the elevator of my apartment building asking residents to be considerate by always wearing a mask

Awareness of need of solidarity in Hong Kong is expressed through a variety of state-sponsored television commercials promoting Hong Kong to be generating "One Heart, One Mind" as we clean up the city in our communal struggle. A Band Aid style community inspirational effort featuring an eclectic gathering of Hong Kong vocal artists singing "we shall overcome" is played repeatedly on the TV screens of all the buses.

While the daily infection rate is declining, it seems likely that SARS will be with us for some time to come. For our family, continuing to stay imprisoned in our apartment no longer seems to be an option. As horrible as is the idea of catching SARS, our fearful response so far has begun to tear us apart. Depression feels like a real danger for me and we have begun to quarrel over little issues in a way we never have before. Without even a mild fever, I can confidently diagnose myself as having been infected by the SARS outbreak. However easily this dangerous viral infection may spread, the fear of it is far more destructive and infinitely more contagious. We declared our freedom yesterday and travelled by bus to the Central Business district of Hong Kong to take photographs and to enjoy our return to the "land of the living." It seems that many other people must be getting out more again too because the streets seemed to almost as crowded as they were pre-SARS. As my new city home comes to place a higher value on community solidarity, I've made a choice to claw the horrible, hot, wet, bacteria-dripping manacle off my face whenever possible, and get out to "smile on my neighbours" and enjoy the sunshine for as long as I will!

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The SARS (Campbell) Commission

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Ontario Ministry of Health Update on SARS

Vancouver SARS page

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WHO: SARS Outbreak News

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Health Canada SARS site

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Severe Acute Respiratory Syndrome (SARS), Centers for Disease Control and Prevention

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