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  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?
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  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 
                  genetic sequence. 
                 
 
When did it dawn on you that you might be putting yourself 
                  at risk to do the story?
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  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 
                  truly eerie. 
                 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?
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  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 
                  virus. 
                  Airborne sewage? 
  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 
                  you? 
  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.
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  Hong Kong's public health director, Dr. Margaret Chan (l.), with Simone.
 |   Tell me about that amazing moment when they got positive 
                  results. 
  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?
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  Production assistant Olga Wong and Simone at Amoy 
Gardens.
 |   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?
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  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 
                  AIDS." 
                  Is SARS a kind of wake-up call in terms of future infectious 
                  diseases? 
  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. 
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