In late April 2003, FRONTLINE/World reporter/producer Renata Simone
crossed paths in New York with noted HIV/AIDS researcher David
Ho. He'd just returned from Taiwan and was planning a trip to
Hong Kong to conduct research on SARS. He invited Simone along.
Simone tells Web editor Douglas Foster, in an interview conducted
just as she came out of a 10-day quarantine (she'd contracted
a simple cold, not SARS, as it turned out), that the invitation
just seemed too good an opportunity to pass up.
How had you gotten to know David Ho?
Reporter/producer Renata Simone, Hong Kong harbor.
I've been following AIDS since 1985, and he's one of the leading
researchers. I'm doing a six-part television history of the
epidemic that starts back in Africa and continues right up to
the present. My choice for the science advisor was David Ho,
because he's so brilliant and he's accessible too. He'd invited
me to a meeting in New York about AIDS in China.
It was at that meeting that he came up to me and said, "I
have to tell you something. Let's talk." He took me over to
the side and said, "You won't believe where I was yesterday
-- Taiwan." The Taiwanese called on him because they were desperate
for advice about SARS. He said there's a real detective story
there, and he started to tell me about the spread of the virus.
He said that he was going back the following week to test an idea
for a treatment. I said right away, without even thinking, "Can
we follow you?"
Who would have thought that a background in AIDS research
would be the right preparation for attacking the SARS problem?
Exactly. The minute the virus was sequenced, and they realized
what kind of virus SARS was, the researchers realized that it
was similar enough to HIV -- in the surface proteins, in the
way it attaches to its target cells -- that they might be able
to use a similar strategy to fight it. So a light bulb went
off as soon as the Canadians were able to generate the whole
When did it dawn on you that you might be putting yourself
at risk to do the story?
Simone with Tsang Kam On (r.), resident of the Amoy Gardens apartment complex.
In the beginning, I thought, "Gee, I've reported on health
issues, I've been in hospitals, I've been around microbes, how
hard can it be?" Then when the lawyer for WGBH came down and
started talking to me about liability and long-term disability
insurance, that was when the facts of SARS hit me emotionally.
SARS has long-term consequences
-- it's not pneumonia, it's a very serious illness. That's when
I felt frightened. Actually the editorial team sat around with
the lawyer in the office and discouraged me from going. So we
decided that we wouldn't do the piece and we went home.
The decision not to go was based on the risk?
Right. I went home, and the next morning I just woke up --
it was one of those things where your eyes pop open and you
have that rare complete thought in the morning. And I just said,
"It's a mistake, we have to go, I have to do this." I thought
that if I clicked onto the AP Wire and found out that the tests
that David was going to do had worked -- and I could have been
in the room when it happened, but didn't go out of fear. The
regret would be so hard. I (went) back in and
lobbied everybody on that Monday and left the next day. So we
had the experience of setting up an international shoot in about
48 hours. We just did it. We traveled light, a couple of bags
and the little camera.
What was it like to arrive in Hong Kong?
It felt very strange. I had never been to Hong Kong before,
so I didn't have anything in my own experience to compare it
to. The airport was absolutely empty except maybe for four or
five people in a long, long hallway with 30 gates. That was
The streets were empty too?
At rush hour there were a few taxicabs and some buses, but
there was really no other traffic. The restaurants were empty.
We were there for six days, and it was so easy to move around,
but also unreal. We shot most of the story of the science in
the laboratory and then it was time to go out to do the Hong
Kong epidemiology -- you know, how did the disease spread, where
did it go, what was the detective story?
Reporter/producer Renata Simone at Amoy Gardens.
What were the steps in unraveling the mystery?
We went to ground zero in Hong Kong -- the Amoy Gardens apartment complex
where more than 320 people became infected and 42 died. I looked
around and noticed the exposed sewage pipes on the outside of
the building. In the end, the detectives on this case, the epidemiologists,
figured out that it was airborne sewage that had carried the
The world learned from that apartment complex that the SARS
virus can survive in feces. So one person came into one building
and was sick. When the sewage from his apartment went outside
of the building, through leaky and cracked PVC pipes, the virus
leaked into the air. Once airborne, it can get carried by wind
and survive on surfaces for up to three days.
So you were standing there looking at this open sewage
-- and you understand at that point that the spread of SARS
doesn't require contact between people?
What unnerved me most was that I could faintly smell the sewage.
I had my mask on, but I was also really frightened.
How did you deal with the fear?
The way a still photographer puts distance between the subject
and himself with the lens. You're doing a job. What I had to
do was follow the story and not dishonor the people who were
living there by exaggerating things. I just thought of it in
a common-sense way. I'm concerned, I'm protecting myself, but
I also need to be respectful to the people who live here.
What was the attitude of the people in that complex toward
There were diametrically opposite reactions. I didn't see
much in between. People would either come up to us and volunteer
things or they would literally jump when they saw the camera
and go walking in the opposite direction. One man invited us
into his apartment. He said, "Do you want to see how it worked?
I'll show you."
What did he show you?
He showed me the bathroom. There are two open drains -- one
in the floor and one in the shower, of course. What happened
was that the effluent from the toilet, before it went into the
sewage pipes on the outside of the complex, was running through
pipes in the floor of the apartment. Little virus particles
were becoming aerosolized, as the public health people say,
and coming out of the drain.
So what about the other half of your detective story? What
was it like, day after day, to be in that research laboratory
in Hong Kong? I don't imagine it's very exciting to watch scientists
looking through microscopes.
Science can be boring. But the scientists who work with David
Ho [Dr. Richard Kao, Dr. Leo L.M. Poon and Dr. LinQi Zhang] -- he calls
them the Three Amigos -- are young and excited and smart. They
told me this was the biggest experiment of their lives. They
looked forward to every morning. We'd get there at 6:30am in
the morning with our camera and they would already be there
after leaving past midnight every night. They came in talking
about their dreams. They'd say, "Last night I dreamed that we
pulled out the plates, the cultures, and we forgot to add the
virus." Anxiety dreams, excitement dreams, aspiration dreams.
I felt all my hopes go with them too.
Hong Kong's public health director, Dr. Margaret Chan (l.), with Simone.
Tell me about that amazing moment when they got positive
It's Saturday morning, they've been waiting for three days.
They'd expected to get results in 24 hours. You can just feel
the frustration. David Ho has been called to Taiwan, so the
young researchers are on their own. They stand outside, and
they're talking about how nervous they are. They're wringing
their hands inside their rubber gloves and fiddling with their
masks. I ask them why they're so nervous. They say, "Because
so much rides on this. It's not just science. This is about
people's lives. This is why we are virologists."
We go in with them, and they methodically check the results.
One of them looks in the microscope, the other one takes down
the results. They start using code words. They say, "Something
interesting." It's the tone of voice and the urgency in the
voice rather than the language that tells me this is really
good news. Then they say, "These readings are consistent!" And
finally they say, "Number two looks very interesting" and "Excellent!"
What was it that they were seeing exactly?
What they saw was that the cells that were combined only with
the virus were dead, but that the pools of cells combined with
the virus and the experimental peptide were healthy.
The results were that clear-cut?
They were basically looking for life and death and that's
what they saw. When there was a peptide preparation combined
with everything, the cells were alive. They tested
12 peptides and several different concentrations of each. They ran
more than 100 assays. Five of the peptides at
specific concentrations definitely had a protective effect.
So that was real success.
Is this a definitive step toward a treatment for SARS?
Production assistant Olga Wong and Simone at Amoy
The next steps are make-or-break. They're going to test it
in rhesus monkeys and then they're going to test it in people.
They're optimistic though. They have a realistic sense of optimism
because these peptides are modeled directly on the drugs that
are already approved for AIDS and proven to be nontoxic.
SARS seems to threaten adults much more than children.
Is that because so much of the damage caused by exposure to
the virus is actually a result of the behavior of the infected
person's own immune system?
Right. In fact, a priest who became infected when he went
to visit a parishioner in the hospital came home and, before
he knew he was sick, he infected his wife. The two of them became
sick, but the children didn't get it. He has two little boys
under 12 and they didn't get sick. That's even though they were
in the same household, sharing utensils and towels and things.
Both he and his wife survived?
Yes, they're in good health.
Compared with other epidemics you've covered, like HIV,
for example, SARS is something of a piker -- maybe 8,240 cases
by the end of May, 745 deaths, and none of those in the United
States. What's the broader significance?
This shows us the dark side of globalism. Maybe years ago
it didn't matter to somebody in Minneapolis that somebody in
Guangdong Province in China had a new virus. But now it does.
When you look over the history of flu viruses and really lethal
flu pandemics, most of them have come out of Guangdong. Hong
Kong is really the gateway, then, for those diseases, those
emerging diseases -- which then go all over the world by air
travel. A thousand flights a day, 100,000 people.
What is it about Guangdong Province that turned it into
such a viral petri dish?
Reporter/producer Renata Simone, Guangdong, Mainland China
People live close together. Not only do they live close together,
but they also live close to their animals. Then there's the
fact that the custom is to sell live animals in markets. That
means slaughtering takes place in the midst of daily life, it's
not segregated off in slaughter houses where conditions can
be controlled and separated from everything else. This happens
right in the middle of everyday life. There's blood spurting
everywhere. So not only do viruses have a chance to get into
the environment and into people's immediate surroundings, but
they also have a chance to combine from animal to animal and
animal to human, and it's those combinations that create the
conditions for new viruses. The climate is the last factor -- in the
subtropics, it never freezes, so the viruses thrive.
As you got more deeply into reporting on the science of
the story and understood it better yourself, what was your appraisal
of the daily coverage of SARS?
I was worried about the sensationalism. There were some pieces
that presented SARS like the archetypal airborne killer from
Mars that's going to wipe out the planet. That worried me because
when I talked to the scientists they said that's not what this
one is. But they did say let's use this as a lesson because
we might get one of those kind of cases in the future.
I had a couple of other reactions too. As somebody who has
covered AIDS so much, I felt, well, sad. AIDS has affected over
60 million people. More than 24 million people have died. As
you said before, even up to the end of May we're talking much
smaller numbers of deaths from SARS -- under 1,000 people.
Look at the whole continent of Africa and the way AIDS is
surging through Asia and Russia. So I felt tremendously sad
that here was this was firestorm of an epidemic -- I mean that
both in the sense that it's damaging and in the sense that it's
attracting so much attention. Part of me wanted to say, "Hey,
look over here, there's this other thing, let's not forget about
Is SARS a kind of wake-up call in terms of future infectious
Absolutely. We're so lucky to have had something come at us
that's not even as infectious as the flu, for example. That's
why SARS hasn't caused a global health disaster. This experience
can show us where the weaknesses are in our public health system.
We ought to use SARS as fair warning to try to get our system
prepared -- because if the past is a record, we will see another
lethal infectious disease emerge from that corner of the world.
Back to top