Student recounts successful battle against SARS

When Steve Chan came down with a fever and chills, he thought it was a flu he could recover from in a few days. The initial symptoms weren’t even very bad.

“I didn’t cough, sneeze or have a sore throat,” said the 23-year-old Hong Kong medical student. “There was no muscle pain.”

But Chan still felt unwell after two days, so he visited a private doctor who told him he had influenza.

It was March 9, and Chan settled in for some rest in his dorm room at the Prince of Wales Hospital.

But on March 11, Chan was called by worried school officials, who had seen students and faculty struck by a mystery disease emerging at the hospital and said Chan should be tested more closely.

Chan went straight over, and saw between 40 and 50 medical staff waiting for check-ups.

“I became frightened,” said Chan, who had been examining patients in the hospital’s ward 8A just four days before he became sick.

It turned out Chan and fellow students from the Chinese University of Hong Kong had worked in the ward that suffered a big outbreak of severe acute respiratory syndrome, or SARS, the mystery disease that has sickened more than 2,200 people and killed at least 81 of them, including 17 in Hong Kong.

Chan is among the first group of cases that alerted doctors of a new disease, but he has now recovered fully and been discharged.

When Chan was first admitted to hospital, next to nothing was known about SARS - it didn’t even have a name yet. But one by one, eight of Chan’s classmates and more than 10 teachers as well as dozens of medical workers at Prince of Wales fell ill.

“We had heard rumours that an infectious flu-like disease was spreading at the hospital, but we didn’t know what it was,” said Chan, still pale as he met a reporter in the university canteen, a week after being discharged.

Chan said watching the frontline doctors and nurses who risked their lives each day gave him more appreciation than ever of his life’s calling.

“Before, I didn’t really understand the meaning of studying medicine,” Chan said. “But I saw how health care workers give themselves selflessly to patients. This is the most holistic of all professions.”

By chance, Chan and fellow students landed in the centre of a global health crisis. The Chinese University uses the Prince of Wales as a teaching facility, and that’s where SARS spread rapidly after a Hong Kong “index patient” – a 26-year-old airport worker – was admitted last month.

On the night Chan was summoned to the hospital, doctors checked his blood and performed an oral swab, chest X-ray and nasopharyngeal aspiration test, which can find respiratory viruses or bacteria. Chan said that although there was no clear diagnosis, he appeared to have what several others had caught.

“It was only the X-ray plus other symptoms I had – like fever – and because many people were struck ill at the same time, they knew it was some kind of pneumonia,” Chan said.

Chan can understand why the private doctor didn’t diagnose him correctly at first. Aside from a white patch on his chest X-ray – an indication he might have had pneumonia, all other tests were negative – demonstrating the elusive nature of the disease.

Chan later realised from television news that he had contracted SARS, after medical experts scrambling to unravel the illness gave it that name. Chan said he became quite unsettled by the constant stream of TV reports – and the outbreak going on around him.

“I was very nervous – this was the first time I had been hospitalised,” Chan said. “As I watched the news in our ward and heard about more deaths being reported in Hong Kong, I was a bit frightened, because we didn’t know what was causing the disease. But I had confidence in our medical faculty.”

Some doctors and nurses began looking gaunt, their eyes sunken after days of non-stop work, but they kept spirits high – even as dozens of hospital colleagues were also infected.

“I was quite sad to see that some of the medical workers who took care of us became ill,” said Chan, recalling how he was moved to tears at times. “They joked with us while we were bored and cheered up those who were feeling down. They risked their lives to take care of us.”

Initially, doctors gave Chan antibiotics and an antiviral drug – both of which proved ineffective in fighting the disease.

As of March 15, Chan was still running a temperature of 103F (39.4C) and he found breathing slightly uncomfortable.

On March 16, doctors who were rapidly gaining experience with SARS changed Chan’s medication to a cocktail treatment of the antiviral drug ribavirin and steroids.

Although the World Health Organisation and the US Centres for Disease Control and Prevention say no medication has been proven effective against SARS, Hong Kong doctors have faith in the ribavirin-steroids combination.

Chan is one of many patients who responded well. His fever subsided overnight, his chest X-ray gradually cleared up and he stopped shaking from chills.

Chan said he was fortunate to have suffered relatively minor SARS symptoms, but pointed out some are hit harder.

Some patients’ lungs deteriorate so badly that they need respirators just a few days into the illness, he said. The sickest ones were receiving injections of antibodies obtained from patients who recovered from SARS.

Chan was discharged on March 27, just 11 days after first getting the cocktail treatment. He is now one of 98 people in Hong Kong who have gone home after recovering from SARS.

Hong Kong’s health secretary, Dr Yeoh Eng-kiong, has said about 95% of SARS patients are expected to recover, mostly with help from the ribavirin-steroid treatment, assuming they get quick treatment and aren’t also afflicted with other bad health problems.

The treatment has given Chan side-effects – he is feeling fatigued and anaemic after two and a half weeks in the hospital. Chan also said his level of haemoglobin, oxygen-carrying blood protein, has dropped after taking the drugs.

While he was in hospital, Chan told his parents and younger brother to stay away so they would not get infected.

On the day Chan got out of the hospital, his mother travelled across Hong Kong with home-made soup, but he spent just five minutes with her at a bus stop then broke off the visit.

After suffering through SARS and seeing how badly it can hit some people, he’s going to play it safe and stay alone in his dorm room for another week – and then return to the hospital for another check-up just to be sure the SARS is gone.