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Why flu is nothing to sneeze at

Vijay Verghese, Editor, Smart Travel AsiaHow the Covid-19 virus is reshaping travel and how hotels and airlines in Asia are responding, if coyly, to the challenge with too many heads firmly in the sand. Banal PR spin has been preferred over genuine fixes leaving travellers vulnerable.

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by Vijay Verghese/ Editor

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Empty Cathay Pacific check-in counters at Hong Kong International Airport February 2020

Empty Cathay Pacific check-in counters (Marco Polo) at Hong Kong International Airport late February 2020/ photo: Vijay Verghese

SUPER-SPREADER is a term that gained notoriety and panicked currency during the 2002-2004 Severe Acute Respiratory Syndrome (SARS) outbreak that was largely focused on Hong Kong, neighbouring Guangdong, and Vietnam.

Later determined to have originated from bats, this virulent ‘zoonotic’ coronavirus was a chilling manifestation of a transmission from animals to humans with unknown consequences. Bats have been the prime culprits in a number of zoonosis events from Nipah and the haemorrhagic Ebola to Hendra (in horses), rabies and SARS.

As the Wuhan novel coronavirus – termed Covid-19 by the World Health Organisation – burned out of control in China’s Hubei province inviting draconian quarantines, rumour, travel advisories, military intervention, and travel bans (for China and later Iran, Lombardy and other emerging hot spots as the virus seeped into Europe and even Brazil), the attention of health experts once again turned to bats and super-spreaders. While Italy reeled, by late February San Francisco had declared a state of emergency over coronavirus fears.

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The first recorded SARS super-spreader is believed to have been Zhou Zuofeng. He apparently picked up an unknown respiratory bug in Zhongshan (where a cluster of cases had been reported) and was later brought to a Guangzhou hospital, on 30 January 2003, rapidly passing on the infection to over 30 caregivers and medical professionals. One of those, a Dr Liu, arrived in Hong Kong for a family event and booked into room 911 of the soon-to-be-ostracised Metropole Hotel at 75 Waterloo Road (the hotel was later renamed Metropark Kowloon and Room 911 disappeared without a trace).

{Hotels have coyly retreated into the anodyne – taking ‘all necessary precautions’… ‘following official guidelines’… and ‘closely monitoring the situation’

The hapless Dr Liu was determined to have been the cause of as many as 80 percent of the subsequent Hong Kong SARS cases. From that ill-fated ninth floor the virus travelled with speed and stealth to Hanoi, Toronto and Singapore. That’s when the world woke up to the insidious menace of SARS as the medical fraternity scrambled to find answers.

As David Quammen the author of Spillover – a gripping book on zoonotic events – put it simply, “In late February 2003, SARS got on a plane in Hong Kong and went to Toronto.” A book with deeper insights into the Hong Kong episode is Twenty-First Century Plague – The Story of SARS by veteran journalist Thomas Abraham.

Across Hong Kong harbour, the Metropark Wanchai, which also suffered a minor outbreak and the indignity of a heavily televised quarantine, subsequently changed its name to Kew Green. SARS was energetically effaced from the territory with a zeal worthy of the history-rewriting pharaohs by all who had any remote connection to it. But memories are long.

The search for possible super-spreaders is on again as doctors, epidemiologists, transport operators and governments race to shut down transmission vectors and find a vaccine. This issue was troublingly evident when an explosive South Korean coronavirus outbreak was traced to the reclusive Shincheonji Church of Jesus in Daegu following which all its worship halls were shut down across the country. The locus of the outbreak was determined to be a 61-year-old woman who was estimated to be responsible for over 450 infections. Super-spreaders are back.

Starting with the quarantine of the entire Hubei province (with a population of close to 60 million), the banning of Chinese visitors by several countries, flight cancellations (much of this commercially driven due to low passenger loads), and the cancellation of sports events, religious congregation, and major pilgrimages, our world has been entirely upended. The WHO, rightly, has urged countries to show ‘solidarity’ and avoid any ‘stigmatization’.

Armed with the knowledge of SARS and ignorance surrounding the latest zoonotic breakout, reactions have ranged from pragmatic (washing hands regularly) to the bizarre (imbibing rassam, a spicy South Indian lentil stew to kill the virus). What is evident is that the stable doors have been closed after the horse has bolted. The virus is on the loose, a vaccine is at least a year away, genomic mutations may occur, and initial research suggests Covid-19 may not burn out like SARS.

Wuhan has spawned something we may have to live with for a long while. Clearly containment – vigorous or misdirected as the efforts have been as with the ill-starred cruise ship Diamond Princess at Yokohama – is going to have little effect. The world is going to have to move from knee-jerk reactions to mitigation and sensible everyday precautions.

It is entirely possible Covid-19 (earlier known as 2019-nCoV) will become endemic and join the four main coronaviruses currently in circulation that account for as much as 25 percent of colds. While a small percentage of sufferers may develop serious respiratory issues like pneumonia, the new menace appears relatively benign and somewhat manageable with vaccines, education, and healthy habits. As with seasonal flu that thrives in cold dry conditions, this new strain may subside during hot, humid, summer months, offering respite for researchers and exhausted frontline healthcare workers.

While common sense must be a first line of defence, there is no room for complacence. A seasonal flu pandemic simulation last year (by Johns Hopkins, the Bill and Melinda Gates Foundation, and the World Economic Forum) painted a grim picture of a mythical vaccine-resistant coronavirus originating in China that could kill 65 million people in a year. Bear in mind the Spanish flu of 1918 claimed 50 million lives. The 2009 Swine Flu pandemic that swept from Veracruz, Mexico, across North America and the world was a virulent H1N1 strain and no respecter of age, catching the young and fit in its dragnet along with the elderly, but there was little worldwide fuss despite dire WHO pronouncements at the time. Should the current coronavirus be treated differently?

Some facts on the novel coronavirus: thus far while total infections are hard to assess, Covid-19 has had a fatality rate of 2.14% (of diagnosed cases) compared with the current US seasonal winter flu outbreak (0.07%); SARS (9.6%); Swine Flu H1N1 (17.4%); and Mers (34%). To put this in context the CDC (Centers for Disease Control and Prevention) estimates the 2019-2020 US deaths from flu will range between 14,000 and 36,000 out of 26m to 36m infections.

A serious and sustained pandemic will challenge and dramatically impact business practices, stock markets (American Airlines dropped 9.1% and Marriott plunged 7.9% in just one day 25 February), country GNP forecasts, supply chains, schools, population flows (travel and migration), insurance, governance, and political models with more open systems favoured, as the post-Wuhan free-speech petition in China suggests. It is unlikely that petition will gain significant traction within the Chinese Communist Party leadership but it is a portent of social upheavals and ideological scuffles to come.

Yet the lure of feel-good travel persists. A snap poll of Smart Travel Asia’s worldwide readers in January and February showed that while 37 percent plan ‘no travel for now’, as many as 40.7 percent are considering leisure breaks, with 11.1 percent continuing with business travel, 7.4 percent attending meetings and conferences, and 3.7 percent planning travel for destination weddings. Leading the leisure charge are Europeans and Australians, followed by Indians.

While several hotels are on high alert, worryingly this is not the case in resort areas – and even in some high-risk urban centres like Bangkok, or farther afield in India – where procedures remain egregiously lax for fear of alarming guests and losing business. Many hotels contacted by this magazine retreated into the anodyne – taking ‘all necessary precautions’… ‘following official guidelines’… launching ‘preventative measures’… and ‘closely monitoring the situation.’ But behind the PR spin and seeming head-in-the-sand bullheadedness there is a real fear gripping the travel industry.

While safety routines are patchy at the top end, the situation is far worse at wallet-friendly Airbnb establishments and unregulated lodgings. This coronavirus has no interest in the bottom line. It is opportunistic, highly mobile, and on the loose.

So how are hotels, airlines, and countries handling this?

At the Four Seasons Hotel Shenzhen antibacterial hand sanitizers are freely available. In accordance with local government directives, the hotel has also closed its spa, swimming pool and gym. All guests have a daily temperature check and also when they leave or return to the premises. Hotel restaurants are only for in-house guests and as of mid February the hotel had stopped accepting fresh room or banquet bookings.

Urban Resort Concepts that runs the swish PuXuan in Beijing and the PuLi in Shanghai has instituted daily room disinfecting. Staff are monitored daily. All guests undergo temperature checks and are required to declare recent travel history. Says CEO Markus Engel, “In the event of a suspected case, the guest will be kept isolated in the room, the entire floor will be cleared and designated medical personnel called.” In addition housekeeping will be frozen and necessities served by staff in protective gear.

Grand Hyatt Hong Kong has temperature checks at all entrances and regular deep cleaning in the rooms, a habit mirrored at premium city hotels like the Mandarin Oriental,  The Murray, and JW Marriott. In the absence of swift or meaningful government action, Hong Kong residents have been queuing for elusive masks, toilet rolls and wipes, often only available at usurious rates on the black market. Hotels, however, have moved fast to stock up on hygiene items.

Hyatt has reassuringly tough protocols in place across Asia, including Bangkok where at the Hyatt Regency and Grand Hyatt Erawan, all guests have temperatures checked at the entrance. In Bangkok as in Phuket and Koh Samui several hotels late February were content with temperature monitoring at the airport though some said they would offer facemasks and hand sanitiser upon request.

The Siam Kempinski Hotel Bangkok and Shangri-La Hotel Bangkok are two that insist on temperature checks at the entrance for all guests, visitors and staff, a practice dodged by many luxury properties including those under the usually hyper-cautious American mega-brand Marriott. Doubtless this will change as the crisis escalates. At The Okura Prestige Bangkok in addition to upgraded hygiene there is the sensible exhortation to wash hands frequently and avoid touching the eyes, nose and mouth.

In Chiang Mai where the exposure to Chinese visitors is higher, hotels like Shangri-la and Dhara Dhevi have a full raft of measures in place including temperature checks for all. Yet, in Pattaya, another favoured escape for China groups, both the Hilton and Dusit public relations departments declined to offer any information at all.

Mandarin Oriental properties in the region now ask guests for health declarations at check-in, offer hand sanitizers in public areas, and have doubled cleaning shifts.

Taiwan has a 14-day quarantine in place for visitors from China, Hong Kong, Macau and South Korea and upscale addresses like Regent Taipei have temperature checks for all guests and staff. The Regent Taipei keeps just two exits open (out of five) to regulate inflow of visitors and is acquiring airport-style thermal cameras to reduce stop-and-check inconvenience to guests. The W Taipei monitors guests at check-in while boutique hotels Quote and Proverbs (from Gloria) also run temperature scans at entry points. Gloria Residence is refreshingly upfront with clear online guidelines for Covid-19 policies.

Singapore’s iconic Fullerton Hotel has instituted temperature scans as has The St Regis Singapore (unlike its Bangkok counterpart). The Philippines stopped issuing visas on arrival for Chinese visitors late January 2020 (the fast-track policy was launched in 2017 to open the travel spigot). A ban was in place for South Korea end February though Taiwan was off the list. Amorita Resort in Bohol asks for temperature checks only in the case of visitors from China or those who have recently travelled to China and display symptoms while the uber-luxe Amanpulo on secluded Pamalican Island does temperature scans for all arriving guests before they enter the hotel lounge. In Manila procedures are watchful if unstressed. At Raffles Makati expect a nurse on duty at all times and a doctor 7am to 12 noon.

Indonesia was quick to ban all travel to and from China to curb any knock-on risk from the almost 2m tourists in 2019. Bali is a major recipient of this traffic. Flights have been reduced sharply and China-originating crews may not be allowed to disembark. A local African Swine Flu outbreak (affecting pigs) appears to be abating but pork has to be government certified with a few luxury hotels opting for imported pork. While the island is largely in denial claiming business as usual despite dwindling guests, some resorts have reacted sharply with at least one luxury Nusa Dua address turning away booked Chinese guests. A few hotels instituted temperature scans when news of the virus first broke but this is not current practice and queries on ‘temperature checks’ may elicit extreme puzzlement at five-star hotels – including American chains and large conference hotels. Australians, Europeans, Middle Easterners and Indians continue to visit though airport transits (in cities like Singapore) are cited as a concern.

In the sunny Maldives things are decidedly more relaxed. With flights from China suspended and a ban on Chinese visitors and China transiting passengers since 3 February, resorts believe the health screening at Male Airport is a sufficient bulwark. The swish Conrad Maldives does not demand temperature scans of its guests and nor does Six Senses Laamu. This is par for the course here.

At the InterContinental Danang Sun Peninsula Resort, Vietnam, heightened hygiene standards involve increased frequency of cleaning while at Accor hotels, group policies include “flexible cancellations or modifications for any travellers from Greater China to any Accor destination.” Asia-Pacific members of loyalty programme World of Hyatt will also see more flexibility in the form of extensions to their tier status (with the expiration date moved back to 28 February, 2022) as well as benefits and upgrades as the travel downturn bites.

Airlines meanwhile are replacing HEPA (high efficiency particulate air) micro filters with greater frequency and introducing rigorous disinfection routines. Garuda, which grounded an aircraft that had carried a Chinese passenger (who later tested positive for Covid-19) from Bali to Shanghai on 28 January, is working on contact tracing – a tediously imperfect art – to track co-passengers and others on the island who may be at risk. The Chinese visitor had travelled to Bali from Wuhan a week earlier. And later in February Korean Air revealed one of its cabin attendants had been stricken by the flu. These will not be isolated events.

Airlines have been hard hit. Citing ‘flight reductions’ Cathay Pacific announced that from 17 February three of its Marco Polo lounges at Hong Kong International Airport were closed indefinitely. It has relaxed regulations covering rebooking and rerouting for certain periods and stopped issuing online boarding passes for certain regions due to fast changing airport entry restrictions. Beleaguered cash-strapped Hong Kong Airlines has cut staff and dropped inflight service (including duvets and pillows in business class, magazines, and more) on certain flights, effectively replacing its premium promise with budget carrier service.

Singapore Airlines has reassured KrisFlyers that post flight all surfaces and devices (like trays, headphones and entertainment screens) undergo ‘rigorous’ cleaning and the cabin air is replenished every two to three minutes (the standard for most modern aircraft).

Philipine Airlines has stopped its flights to China, Hong Kong and Macau till 28 March with detailed updates on its website.

Following the quarantine tumult and return to a new normal it is arguable that five-star and luxury properties (long losing business in the online stampede for cheap beds) will return to fashion as ‘safe’ havens with trusted, verifiable protocols. While price is a powerful incentive and bargain hunting has become something of an online pastime, health is now a premium commodity that travellers may be unwilling to gamble with.

It is also possible that in the foreseeable future temperature scans at hotels will become de rigueur in much the manner that airport security checks, however intrusive and irksome, are niggles that passengers now take in their stride.

If anything, the current Covid-19 outbreak has revealed how unprepared governments are for a full-scale pandemic despite painful test runs with SARS and Swine Flu. It has spotlighted how out of touch and insular hotel PR has become and how ill-equipped the travel industry is to report facts or come up with practical solutions, this at a time when good timely information is of the essence. It is time for governments, national health centres and the hospitality industry to come together to fashion universal protocols to put travellers at ease and dispel rumours. It is in everyone’s interest to do so. This is the way to protect the bottom line.

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