The work place was filled with conspicuous silence.  There was little display of emotions behind the masked faces; the usual laughter and conversations were no longer heard.  A slight cough or sneeze sparked off unsociable reactions.  These characterized the early days of SARS in March 2003.

The time of SARS (Severe Acute Respiratory Syndrome) was a time of fear and sorrow.  There was fear during the early days when we knew very little about SARS.  The worst fear is fear of the unknown. Our Chief Executive, whose office is on the fifth floor, was infected, apparently after visiting hospitals. (He was discharged in April fortunately.)  The neighboring department on the same floor lost a colleague to SARS.  She came to the Library to return a book the day before she was admitted to hospital.  Then a few days afterwards, she passed away.  The news was so sudden; "it may happen to us", was the thought that hit us.  We only found out later that she was in the Amoy Gardens cluster.  There was a complex feeling of shock, sadness and trepidation.

It was a time of frustration and stress.  It has been particularly busy for us, trying to capture the latest information on SARS and disseminate it.  We are involved in a lot of literature searching for therapeutic options and preventive regimens in Chinese and Western medicine for fighting SARS.  As an information professional, I felt that this time, it was a real test of our ability, especially since scientists knew little about it, and the world had very scanty knowledge on SARS.

It was a fascinating time.  My initial despair turned into wonderment.  New knowledge was generated, evolved, and turned into action on a daily basis.  A real-life model of the knowledge cycle was in motion.  How this is compared with the hypothetical textbook model of knowledge management warrants a doctoral dissertation.  From March to the present date, researchers and clinicians in Hong Kong have published some 36 articles in international peer-reviewed medical journals.  It is no small feat.  Even now (12 June 2003), we manage to capture new international publications on SARS on a daily basis.

All the skills we have picked up on evidence-based searching and information management were put to good use.  The What's New alert service and the latest literature we have captured and disseminated traveled far and wide.  I got overseas emails from those completely unknown to me thanking me for the information.  I am now fully convinced of the power of being interconnected globally through chained emails and the effectiveness of formal or informal communication through advanced virtual networks.

The pandemic influenza of 1918 took an estimated forty million lives worldwide, including the young and the healthy.  It was only recently that more was known about the reason why it was so fatal.  In comparison, the world lost 790 lives to SARS at the time of writing.  The discovery of the probable cause of SARS took only weeks after its first case was identified in Hong Kong.  It is a great achievement, even with allowance to advanced technologies and electronic communications in this new age.  No matter what some critics may say, they cannot discredit the heroic and arduous work of those who were trying to find out all they could about the disease, and do something to avert and prevent it.

It has been an unprecedented time. Our working life was not the same. During this time, non-clinical meetings and events have been cancelled.  For staff who appeared to be very worried, I had to use my imagination to give them all the assurance I could.  I tried not to cause pressure to my staff, buying them vitamins and fresh fruit, so that they could build up their immunity.  To maintain mine, I tried not to work too late into the evening, nor on the weekends, but it was not an easy thing to do.  I kept thinking to myself,  "The sooner I finish my work, the earlier would clinicians be able to refer to it, the sooner our patients might benefit."  We are luckier than the front-line health care workers who had to face the risk of infection from direct contact with the patients.

It was a time of personal "sacrifices" (though they are miniscule in comparison with those of our health care workers). We did not go out for lunches for weeks.  Many social occasions, together with other aspects of a good life, had to wait.  Mutual concern, a sense of humor and a positive outlook helped us through this difficult time.  Whenever I could, I sent out or helped to forward cartoons and jokes related to SARS (after office hours!) to friends and colleagues to lighten up the day.  In this regard, I found that I needed to exercise restraint and heighten my sensitivity, as humor may be misconstrued as disrespect.  I did not wish to cause unnecessary pain to those in grief.  There was an indescribable atmosphere of a blend between grief for the deceased and celebration of life.

For a lot of people, including myself, it was also a time of rediscovering the self and reassessing our values in life -- balancing family, friends and work.  It might have been a blessing in disguise in many ways.

Recently, the number of SARS cases has subsided to nearly zero.  As with all times good and bad, the time of SARS will pass.  If life is a journey, this is the part of the journey that I will never forget.
 
The following stories were told by health sciences librarians and reflected their own personal thoughts and feelings in the days of SARS.
 

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SARS Reveals the Better Side of Hong Kong
Stella Pong, Assistant Librarian

The mysterious illness - SARS - spread worldwide within a short time while people have little knowledge about it.  SARS have drawn most of my attention since mid-March.

On March 24, after the chief of the Hong Kong Hospital Authority was admitted to hospital with pneumonia-like symptoms, I could feel that the disease has come close and affected my daily lives since then.  In the office, colleagues followed guidelines and took infection control measures: wearing masks; washing hands frequently; cleaning and disinfecting their working areas.

Fear has taken over the community too.  Public facilities, including hospitals, libraries were identified as high-risk areas, whereas health care workers as high risk group.  Surgical masks and alcohol prep pad have become necessities.  All added to my worries.

At the same time, I can see also another picture.  As I go to office every day, I can feel the care of community.  I like spending some time browsing the newly added blessings and appreciation messages to health care workers on display in the lobby of the head office building.  While the whole city focuses on daily new infection figures, there are researchers, scientists and experts working around the clock looking for alternative treatments to contain the virus and save lives.  As an information professional, I had a chance to participate in the search for evidence.  I treasure the opportunity to support health care workers to fight the battle.

The unceasing work done by health care workers, researchers, experts and a caring community  gives me confidence that we can overcome the challenge.

Hong Kong is a great city with great people.
 

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"Reading Therapy"
Mary Ma, Hospital Librarian

One ordinary May afternoon, I received a phone call from a nursing colleague.  I knew this young nurse quite well as she was a regular library user.  After a few seconds of polite conversation, I asked her whether there was anything I could help.  She said she was currently admitted in the SARS ward!  I was shocked as she didn't sound sick or weak -- she sounded her normal bubbly self.

We had a minor outbreak in April in our rehabilitation ward but I never knew that she was one of the patients.  She said she had gone through the worst part of her treatment in the last two weeks and she was now recovering and waiting to go home.  What a relief!  However, she complained that the "waiting-to-go-home" period seemed unbearably long -- she was extremely depressed and she was concerned that the medication she was taking had affected her emotionally.  She wondered if I could find out the adverse effects of the two drugs that she was taking.  I promised that I would send her the relevant articles straight away by internal dispatch and asked after her.

She came back to visit us 10 days after her discharge from the hospital.  She was well, though thinner, and she was happy with what I sent her.   She said the articles were useful in helping her understand her depression and made her feel better.  We received some drinks from her as "thank you" present too.  A happy ending, I suppose.
 

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Slim Fast
Mary Ma, Hospital Librarian

A medical officer was sent to help out in the SARS ward of another hospital in April after the Amoy Gardens outbreak.  He lost 10 pounds after working there for 3 days…

He quarantined himself at our staff quarter and in his rest days came down to the library which was on the same block to check out the latest treatment guidelines and news on SARS using the HA's e-Knowledge Gateway.   When asked why he lost so much weight, he told us that he only had one meal before each shift …

 "It was too dangerous to put on and off the protective clothing so we tried to eat more in one meal to last the day...",  he said.

Poor chap!  I think he is glad that he is now back to work in our hospital.

Written on 10 June 2003 – today, the last lot of SARS patients in our hospital were discharged.
 

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Personal Thoughts on SARS
Angela Wong, Hospital Librarian

Gloom and sadness prevailed when we lost two health care professionals weeks ago.  I could smell the scent of flowers when I returned to work.  The feeling was complicated when you felt the sorrows and knew the blues, but you couldn't do anything.  Some doctors and nurses came to share their grief.  And what I did was to LISTEN.

We did not know the male nurse, the late Mr. Lau Wing Kai, very well, but our staff members at the library counter like the female doctor very much.  They said she was always polite, quiet and nice.  She was very much a "neighbourhood girl".  She was a frequent library user (check her high level of outstanding loans in the INNOPAC circulation module).  She behaved very well in the library -- had never giggled nor used the mobile phone.

There were over a hundred flower baskets placed around the atrium.  You saw patients come to pay respect and you could see many standing to weep and to dry their tears, as the atrium was just down the floor.   Plenty of reporters from local newspapers and mass media came to take photos.   They even took some shots of our library.

We posted SARS guidelines from various sources outside the library.  And the New Territories West Cluster SARS centre had asked us to provide them with full copies.  Many users came to our newspaper clippings corner to follow the news.   Users came to the library more often.  Some even said to me that our place remained the safest place in the hospital.

We set up precautionary measures for our library operations.  Books were cleaned upon return.  The main door was left half open to avoid cross infection through contact with the door handle.   Alcohol spray and tissues were provided near the entrance.  All rubbish bins were replaced by those with lids.  Our staff was supplied with masks, gloves, and gowns.  Some senior doctors were very kind to show their concerns whether we got sufficient protection, as they recognized we contacted clinical staff so frequently.

Recently, the families and clinical colleagues of the two doctors, the late Dr. Tse Yuen Man and her husband, the late Dr. Chan Wai Hing donated over a hundred books to our library.  Many medical staff asked us not to mix these books with our collection, but placed them in a special memorial corner.

There were many personal thoughts at this critical time.   We all came to the library and did our work as usual.   We feel that it is better to keep silent, and concentrate on our work.  Our hospital allowed its staff to be paid cash in lieu of leave; no one in our workplace asked for it, nor had they taken leave for a single day.   I must say that I appreciated this kind of team spirit.

Having been in my current job in this hospital for six years, I share the happiness and the gloom here.  We are part of the hospital.  It is very touching to have such health care professionals in our hospital...
 

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The Days of SARS
Tanny Yip, Hospital Librarian

The days of SARS were dreadful, sad, busy, but warm.

Dreadful: Horrible that every day, we have to face or deal with doctors or nurses who have direct contact with SARS patients. Some of them we knew were confirmed to have SARS afterwards.

Sad: Sad that people around you are sad.  One Orthopaedics and Traumatology doctor told me that he had nightmares every night about performing intubations for SARS patients in the Intensive Care Unit.  Another doctor from the Accident and Emergency told me that in the morning he just diagnosed a SARS patient, who lived in Amoy Gardens.  Many nurses told me that they didn't go home for more than a week.... I could do nothing but only listened to their worries.

Busy: Busy with washing hands, getting updated with SARS news from clinicians and management, sharing the feeling with clinicians, searching SARS information for them...

Warm: Heart-warming when we know that many library users do indeed care about  us. They sent us masks and advised us on how to protect ourselves from SARS in the library environment.  They arranged x-ray for us immediately when we had fever ...