Introduction

The Health Care System in Hong Kong was completely unprepared for the outbreak of severe acute respiratory syndrome (SARS) which occurred in March 2003. It challenged the entire medical system resulting in the temporary closure of emergency departments (EDs) (Figure 2.1) and hospitals. In the early stages, the illness affected an unusually high proportion of health care workers. The health care system was faced with many difficult issues including how and where to screen the hospital workforce and local community, and who should take responsibility for this screening task?

Emergency medicine is a systems-based, primary care speciality with skills and training to screen large populations of patients but its primary brief is to deal with acutely ill patients and not to provide a public health service. However, in the acute crisis brought about by the SARS outbreak, it was appropriate for the ED to take short-term responsibility to coordinate screening, as there were no other facilities available immediately.

This chapter reviews the challenges and responses involved in initiating and developing a SARS-screening clinic in an ED of a University Hospital in Hong Kong. While clinical features aid the assessment of patients suspected of having SARS, radiography supplemented by high-resolution computerized tomography (HRCT) is the cornerstone of SARS assessment.