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THE SARS EPIDEMIC: BEIJING; Illness's Psychological Impact in China Exceeds Its Actual Numbers

By ERIK ECKHOLM

The threat of infection by the new respiratory illness known as SARS suddenly became virtually the only topic of conversation in this city of 14 million, as reported cases of the disease in Beijing surged by another 105 today, bringing the total to 693.

Migrant workers and college students lined up warily at railroad stations for tickets to their native provinces, while thousands of residents, driven by rumors of possibly draconian quarantines, thronged to grocery stores to stock up on rice and noodles.

The World Health Organization headquarters in Geneva today added Beijing, along with Shanxi Province in China, and Toronto, to its list of places where nonessential travel should be avoided. Previously, only Hong Kong and Guangdong Province in southeast China, where the disease was first detected late last year, had been named.

Health experts warned that hundreds more cases of SARS, or severe acute respiratory syndrome, appeared to be inevitable as the government belatedly struggled to contain an outbreak it had tried to conceal until several days ago.

''Beijing lost the entire month of March in the fight against SARS, and now this is the consequence,'' said Henk Bekedam, chief of the W.H.O. office here, referring to the weeks of official laxity and dissembling as the highly contagious virus invaded the capital city.

''Now they are working very hard on disease control,'' he said in an interview. ''But the disease is more widespread here than we expected, and it's not clear if the end is in sight.''

In one of its most visible countermeasures yet, Beijing today shut down all primary and secondary schools for at least the next two weeks, a step that may have been prudent but which only added to anxiety among a mistrustful public.

A week ago, a W.H.O. team caused concern by suggesting that SARS cases in Beijing might have reached 200, rather than the few dozen officially reported at the time.

Alarm mounted on Sunday, when health officials, pledging a new honesty, reported 339 confirmed cases in the capital. The national health minister and the mayor of Beijing were dismissed in a show of top-level resolve.

Since then, the reported total has climbed to 693. Health experts here say that figure reflects not only the transfer of previously ''suspected'' patients into the ''confirmed'' category, but also a significant rise in new cases. SARS has been fatal in 4 percent to 5 percent of cases.

The tally of both suspected and confirmed cases is still climbing, Mr. Bekedam said. On Monday, the Health Ministry said Beijing had more than 600 suspected cases, but it has not provided such figures for the last two days, adding to the uncertainty.

Mr. Bekedam would not speculate on the ultimate toll, but some health experts predicted that hundreds more cases, at least, would almost certainly appear in the city before new cases could taper off. That would still give the disease a small actual presence in this vast city, but the psychological impact is already huge.

Mr. Bekedam stressed that it was essential for officials to provide more detailed information about which groups are contracting the virus and where the cases are occurring. Such information could be used to help focus control measures, help the public reduce risks and prevent panic.

Today, after rumors spread that commerce into the city might be stopped or that neighborhoods where cases were detected might be quarantined, shoppers raced to grocery stores, stocking up on rice, instant noodles and vegetables. State television tonight tried to reassure people that stores were well stocked and would remain so.

Thousands of provincial businessmen, migrant workers and college students, most of them wearing protective masks, crowded railway stations and rushed onto buses today, feeling they would be safer elsewhere and ignoring official appeals for people to avoid travel that could expose them to the virus and disseminate it around the country.

Over all, China had 2,305 confirmed cases of the disease as of Tuesday evening, the Health Ministry reported today, an increase of 147 over the total reported one day earlier. Ninety-six patients have died.

Guangdong Province still accounts for the bulk of the country's listed cases. But SARS has now been reported in many interior provinces, raising the specter of a wider epidemic.

International experts question the credibility of persistently low totals reported from several poorer regions that have clusters of known SARS cases and scanty, substandard health services to halt the virus's progress.

A W.H.O. team is now investigating conditions in the major city of Shanghai. Only two cases there have been officially reported, but more appear to have been overlooked or concealed, some experts maintain.

The steps toward greater openness about SARS in Beijing have not eased public fears, and many people continue to suspect the government's pronouncements.

The mood was tense today at Beijing's central train station. Nearly everyone outside, including police officers, wore face masks. Small groups of travelers huddled in the plaza outside, trying to avoid spending time in crowded waiting rooms, and ticket lines were long.

Song Yang, a first-year student at the Nationalities University, was heading home to Jilin Province. ''We have no class for the next month, and Beijing is dangerous right now,'' he said.

A construction worker named Li was headed back to Jiangxi Province with his co-workers, all of them still in work uniforms. ''I've been in Beijing for four years now, but I need to go home and wait for this to blow over,'' he said.

This morning, city officials announced that the city's primary and secondary schools would be closed for at least two weeks, affecting 1.7 million students. Officials said the students should study at home, using an improvised online service.

There have been no public reports of children dying from SARS, but parents in many parts of the city kept their children home on Monday.

City officials said that the entrance exams for junior and senior high school might have to be postponed, which could cause major disruptions for families and schools in the months ahead.

The city education department said it was opening the Educational Committee Online School to help students study at home. (The Web address is www.bjedu.gov.cn.) But many schoolchildren do not have computers at home, instead visiting crowded Internet bars where they are more apt to play online games than to download math problems.

Citing the effects of SARS on tourism and business in China, international financial analysts predict that China's economy will stall or contract in the second quarter of 2003, hampering growth throughout East Asia.

Citicorp and J. P. Morgan both are forecasting negative growth in the second quarter, from April through June, in part because of costs related to SARS. But China's economy grew swiftly in the first quarter, and Citicorp, Morgan and others still predict healthy net growth for the year.
 

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