Alan Sipress - The Fatal Strain

“I can see what many people cannot see,” he told me. He had always been a bit of a Jeremiah. “For me as a scientist, my record and reputation are fully acceptable to the scientific community. So why do I keep working so hard?”

He paused and reached across the table to pour me a cup of traditional Oolong tea from a white ceramic pot.

He resumed. “The flu virus is not easy to track down. I am building up information so I can know where and how a pandemic might happen. I want to tell the world we can create a different future.” He was on his pulpit, urging humanity to prepare for the inevitable mutation of the virus and adopt economic and political reforms that would stem its spread. These should include restructuring farms, markets, and trade and improving how disease is monitored. Most important, he preached, was candor in disclosing outbreaks when they occur. “If not, who will be the losers? The whole globe.”

Guan shifted on the edge of his chair and told me he envied Al Gore. As a former U.S. vice president, Gore could find the financing to make his film An Inconvenient Truth about the threat of global warming. Guan had been finding it hard to make his own exhortation heard.

“We are all sitting at the same table,” he continued. “We share the same benefits, share the tea. Globalization is good for promoting civilization. But if you’re part of globalization, you need to take responsibility. If not, it will damage not only one country but many, many countries.”

Guan himself had come to epitomize the age of globalization. From Jiangxi, where he grew up reading in the courtyard with chickens for companions, this country boy had worked his way to Tennessee to study with the dean of all influenza researchers and then found a perch at Hong Kong’s most exclusive university. There, he was quickly promoted to professor, awarded his own laboratory, and installed in a corner office on the fifth floor of the Faculty of Medicine with a spectacular hillside view of the western approaches to Victoria Harbor and Lantau Island beyond. When he breaks for a cigarette, he stares out the floor-to-ceiling picture windows, watching the procession of freighters and the setting sun burning into the mist. He travels the world, lecturing and consulting. Shortly before my last visit to see him, he had flown to my home city of Washington for a meeting with U.S. health officials, sending me a message by BlackBerry when his airplane landed but departing again before we could meet. Just three days after he’d set out from Hong Kong, he was home again. “Fifty hours in transit,” he told me afterward, somewhat bemused. The pace had left him little time for Jiangxi. Though he sent money home to support his brothers and sisters, he could only spare five days a year for his aging, melancholy mother. “I’m so sorry, mother,” he told her. “For 360 days a year I belong to the world.”

This globalized age offers untold firepower for fighting disease. It was via the Internet, for example, that some of the earliest rumors about SARS in southern China found their way to WHO, and the intense scrutiny of global media made it untenable for Beijing to keep the secret indefinitely. The agency’s virtual lab network wired together the world’s leading scientists as never before. Public health officials, even in poor, far-flung corners of the world like Mongolia and Vietnam, were quick to learn how to recognize, treat, and contain the disease with guidance from foreign reinforcements.

Yet for all the advances of this era, someone still has to grab the bird and swab its underside. There is no substitute for the grunt work of influenza field research.

Guan had continued to expand the sampling program that he launched with the lab at Shantou University Medical College. By 2005 he had about eighty people working for him, quietly collecting specimens every week from poultry and wild birds in seven provinces of southern China and Hong Kong. He had tapped into an old-boy network that dated as far back as Jiangxi, locally recruiting what he called his band of heroes. “They’re very brave,” he said. It wasn’t just the health risk. Most had some background in veterinary studies or health care, so they knew how to take proper samples and protect themselves from infection. It was also politics. The Chinese government was wary of this outside meddling and at times tried to block it. But using the cultural smarts he’d developed as a boy, Guan helped win his staff access to poultry markets across the vast belly of China even as officials grew increasingly uncomfortable with the extent of infection his program was uncovering. He demurred when I pressed him for more details. “This is a kind of top-secret weapon, a top-secret system.”

The logistics of maintaining this network were almost beyond Guan’s ability. The financial burden of paying the staff was tremendous. “They are working for the good of China, working for the good of Hong Kong, working for the rest of the world,” he kept telling himself. But the sampling of more than two hundred thousand birds over nearly a decade yielded an unrivalled library of ever-mutating influenza viruses. It came to represent the most comprehensive accounting of the pandemic threat, in essence an early-warning system for the world.

Guan told me in late 2007 that his research showed the virus was now smoldering in poultry across much of Asia, waiting to flare up. China had ordered a massive campaign to vaccinate chickens against bird flu, as had Vietnam and Indonesia. While this had helped curtail poultry outbreaks in many places and reduced the overall level of infection in birds, the practice had not eliminated the pathogen altogether. Birds were still spreading it but without overt symptoms. “The virus is covered up,” he warned. “We’re giving the virus a chance. Now the virus can travel freely and undetectably and easily be transmitted.”

Many in government and media had mistaken silence for peace.

“Because we don’t have a pandemic today,” he said, “don’t accuse of us of crying wolf.”

Guan had been at his apartment watching television on Boxing Day 2003 when his wife called. Though the day after Christmas was a legal holiday in Hong Kong, she had gone in to work, where she’d heard a disturbing report. After a half-year hiatus, there was a new suspected case of SARS in China.

Guan was not surprised. The Chinese government had reopened the wild-game markets months earlier despite his objections. The world’s concern over the disease had waned but not Guan’s. He had continued sampling wild animals. He had even expanded his effort beyond Shenzhen to cover other markets across Guangdong province. His findings were alarming. Not only was he discovering the SARS Coronavirus in most of the civets he tested; he was also turning up evidence of infection in a wider range of species than before. When he learned in December that a Chinese television producer had been hospitalized with the disease and been put into isolation, Guan knew what he’d have to do.

A week later, he met with senior Guangdong health officials at a Guangzhou hotel to argue his case. The civets had to be slaughtered. Guan was emotional, perhaps too emotional. The officials were skeptical of his judgment and resisted such a radical recommendation. The trade in wild animals was worth at least $100 million a year to the provincial economy. But when Guan had them compare the genetic signature of the virus from the ailing journalist with the one he had isolated from civets, they were stunned to see that the two were practically identical.

Later that day, the governor of Guangdong ordered that all civets on the farms and in the markets of the province be culled. Though three more human cases would surface in Guangdong that month, the outbreak would be rapidly contained. WHO credited Guan for helping preempt a second SARS epidemic.