Tue, Jun 03, 2003 page2

• Disease expert respected

  • By Melody Chen / STAFF REPORTER
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  Colleagues and friends of Chang Shang-chwen (張上淳), chief of the infectious disease department at National Taiwan University Hos-pital, describe him as "a trustworthy person."

  Since the outbreak of SARS, Chang -- who handled the nation's first SARS case -- has frequently appeared on TV and newspapers since the outbreak of SARS.

  The first generation of the country's SARS cases infected very few people because the hospital speedily implemented strict isolation measures, health officials said.

  When Taiwan sank into a panic over SARS, President Chen Shui-bian (陳水扁) invited Chang -- along with Chen Chien-jen (陳建仁), a leading epidemiologist and now the director-general of the Department of Health -- to explain the disease to the public.

  Chang and Chen Shui-bian's televised speeches aimed to calm the public's fear of the epidemic and subsequent hysteria.

  Since the university hospital has handled between 70 and 80 SARS patients, Chang is perhaps more familiar with the disease than any other physician in the country.

  The hospital has drawn acclaim for its early successes and for its contribution to the containment of the SARS epidemic.

  But Chang said that he should not be the only one to receive glory for the hospital's triumph in battling the virus.

  "It is a team effort," he said.

  Chang, born in 1956, obtained his doctorate at National Taiwan University's Institute of Clinical Medicine in 1992 and is now a professor of internal medicine at the university's College of Medicine.

  Chang's colleagues and friends say he has been under massive pressure since outbreak of the disease.

  Chen Yee-chun (陳宜君), an infectious disease specialist in Chang's department, described her superior as a careful and circumspect person.

  According to Chen Yee-chun, the infectious disease department was not the only unit involved in treating SARS patients. Many other units have participated in the battle against the disease, she said. Negotiations and coordination between the units, therefore, became an essential part in the hospital's fight against SARS -- and Chang has been the mediator and coordinator between the units.

  In addition, Chen Yee-chun said, Chang has participated in clinical treatment, done research on the disease and held press conferences to explain to the public what's been going on at the hospital.

  "In handling all these numerous things, Chang gave people a sense of trust. He is really a trustworthy person," Chen Yee-chun said.

  Communication between the department's infectious specialists has been good, Chen Yee-chun said. "That was why the whole team could be quickly mobilized when we detected our SARS case was infected by an unknown virus."

  The country's first SARS case, a China-based Taiwanese businessman surnamed Chin (勤), was admitted to the hospital on March 8. Several days later, his wife was also sent to the hospital.

  On March 14, Chang became alarmed when reading a news report Hong Kong's outbreak of a mysterious pneumonia. That same day, he demanded that the couple's isolation be upgraded to biosafety level 3.

  Chen Yee-chun said Chang, sensitive to any information about the new disease, also passed a message to her when attending a conference on March 17.

  "He instructed me to start arrangements [to combat the disease] and collect information. We asked for help from anyone who might be able to contribute to treating the illness," Chen Yee-chun said.

  Fighting the good fight has taken its toll on the high-profile physician.

  Chang has lost about 5kg since SARS outbreak, said Hsieh Szu-min (謝思民), another infectious disease specialist in Chang's department.

  That might not be unusual, since the pressure and workload caused by the outbreak have caused the department's doctors to work without a break for several months.

  "For these months, we have never had so-called off hours. We needed to be on-call 24 hours a day and always on standby," Hsieh said.

  Before the SARS outbreak, the department handled a range of infectious diseases from tuberculosis to AIDS and was responsible for the hospital's infection control.

  "SARS is an emerging disease. It posed a challenge to clinical treatment and has had a great psychological impact on society. When the first case was brought to us, we went into a highly vigilant battle-like state immediately," Hsieh said.

  New strategies and measures needed to be in place to confront the disease.

  "Suddenly we had so many things to do. Each one of us took the workloads of several people," Hsieh said.

  Chang, as leader of the medical team, took the brunt of the terrible pressure.

  "In the hospital, he had to stabilize our hearts. At the same time, he also had to face the media," Hsieh said.

  In the past few months, many rumors have hovered over the hospital like dark clouds. For example, one newspaper reported that the hospital had shut down air conditioning to save costs, thus causing viruses to circulate around the hospital.

  The hospital has since held several press conferences to dismiss those kind of rumors. Chang has been present for the hospital's every SARS-related press conference.

  The good news, Hsieh said, is that the pressure on the department's doctors has lightened slightly as the epidemic has been waning.
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