What Impact did the 2008 Beijing Olympics have on

Document Sample
What Impact did the 2008 Beijing Olympics have on Powered By Docstoc
					November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
         2008 Beijing Summer Olympics:
             Impact on the Traveller


                   Dr. Susan MacDonald
                    MDCM CCFP DTM&H



November 7, 2008    triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
 China




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
Venue City Locations

                                                                      SHENYANG
                          QINHUANGDUA



                                          BEIJING                            TIANJIN
                                        QINGDAO


                                        SHANGHAI


                                   HONG KONG




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM          Dr. Susan MacDonald
 Population

 • 1/4 of world’s population
 • 5.5 million births Jan 1, 2008
 • 56 ethnic groups
    – Han majority group 1.1 billion (94%)
    – Minority nationalities 160 million (6%)




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  China

  • One party central gov’t
     – Inconsistent links between levels of power
  • Rapid changes in society
     – Doubling of economy since 2002
     – Urban migration
  • Environmental issues
  • Increased inbound and outbound travel




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  New and…Old




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
Old China




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Rural Areas




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Modern China




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Olympic Venues

  • Olympics August 8-24, 2008
  • Paralympics September 6-17, 2008
  • Olympic Torch Relay
     – Mt. Everest on May 8th
  • “Green Olympics”




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Beijing’s New
  Venues
     • National Stadium
       – “Bird’s Nest”
       – 91,000 seats
       – $486 million

     • National Aquatic Centre
       – “Water Cube”
       – Resembles water bubbles
       – 17,000 seats

November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
   Pre- Olympic Concerns


  “China is still inexperienced in providing
    public health services and disease
    prevention and control for major
    international events, which needs
    improving."

            Wang Yu
            Director, Chinese CDC




November 7, 2008      triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Potential Health Concerns

   • Infectious Diseases
      – Risk of pandemic
      – Food and water safety
   • Air pollution and respiratory diseases
   • Motor vehicle accidents
   • Fake medications
   • Lack of clean lavatories

                   Unfamiliar Health Risks

November 7, 2008      triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Potential Health Concerns

          • Safety issues
             • Lack of seatbelts, child booster seats
             • No law for bicycle helmets
             • No child-resistant packaging
          • Hospital care
             • Need for self-care
             • Different expectations for analgesia and
               IV fluids
             • Resistance to take care of foreigners

November 7, 2008      triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Other Health Concerns

  • Security issues
    – July riots in Tibet
    – June - July Olympic Torch protests
  • Mass gathering
    – 2.5 million local Chinese and 600,000
      foreigners expected to attend
  • Natural disasters
    – January ice storms
    – May earthquake in Sichuan

November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Blood Products

• Lack of Rh neg blood products
• 0.3% Han population is Rh negative
   – 5% Uygur ethnic group
   – 1% Mongolian ethnic group
   – 15% Caucasians
• Concerns about safety of other blood
  products




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
   STI’s in China

  Since 1990:
  • Syphilis increased 20-fold
  • Gonorrhea increased 3-fold
  • 10-15% population chronic Hep B carriers
  • HIV rates increasing

                               Chen X-S. Epidemiological Trends of
                               STD’s in China. Sexually Transmitted
                               Diseases 2000, 27(3):138-142



November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
Vaccine Preventable Illnesses
        in 2007

•    Hepatitis B        1,327,225
•    Measles              118,031
•    Hepatitis A           79,349
•    Typhoid               21,254
•    Rabies                 3,399



November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
                   RABIES




November 7, 2008        triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Alarming Events

  • 2003 SARS
     – WHO issued first travel advisory
       against non essential travel to
       Guangdong Province and Hong Kong

  • 2008 Enterovirus 71 Outbreak
     – Over 176,321 children with HFMD
     – 43 deaths
     – Beijing had 1 death on May 11


November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Lesser Known Past Events

  • Toxic IV clindamycin (1 death)
  • Rat poison mistaken as starch (7 deaths)
  • Hepatitis A vaccine (1 death)
  • TCM ginseng herbal injection (6 deaths)
     – Contaminated with bacteria
  • Fake rabies vaccines
     – Both human and dog vaccines
     – May have contributed to rabies deaths


November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
 Counting Down




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  What Measures Were Taken?

  • Massive changes with modernization
    – Focused on improved healthcare, public
      health, transportation, security and
      communication
  • Mobilization of resources
    – 42 billion dollars
    – 1 million volunteers




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Improvements in Healthcare

  • 22 official Olympic hospitals in Beijing
     – 1,350 infectious disease beds
  • 50 infectious diseases labs
     – 6 for SARS and 16 for Avian flu

  • Nationwide electronic network to report
    epidemics
     – Mandatory reporting of 3 classes of
       infectious diseases

November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Public Health Measures

  • Air pollution controls
     – Banned cars, closed factories,
       desulfurization projects
  • No smoking laws
  • 24 hr water inspections
  • Improved food standards
  • 500 designated drug stores
     – 24 hr monitoring near 500
       hotels and tourist spots

November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Other Initiatives

  • Traffic and security controls
  • 3 special protest zones
  • “Sanitization” of Beijing with etiquette
    training
     – Queuing
     – Not spitting in public
  • Elimination of “Chinglish”
  • Migrants sent home


November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
   “Health Risks in Travelers to China: The
   GeoSentinel Experience and Implications for
   the 2008 Beijing Olympics”

• Travellers to China from 1998 - 2007 in the GeoSentinel
  Surveillance Network
• Provided evidence base for recommendations for Bjg
  Olympics
• During travel: Respiratory illness and injuries common
• After travel: Diarrhea and dog bites common



                   Davis X., MacDonald S. et al.
                   Am. J. Trop. Med. Hyg., 79(1), 2008, pp. 4-8


November 7, 2008           triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Impact on the Traveller
      • Both positive and negative
      • Modernization in many cities
        – Less development in most regions
          especially rural
      • No epidemics or mass disasters
        – Tragic, apparently random fatal attack
          on US traveller
      • Cleaner air, water and food
        – More “blue sky days”
      • Easier communication

November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Olympic Surprises

  • World records
    – 5 world records including men’s marathon
    – 16 Olympic records
  • Air pollution generally under control


             The 2008 Beijing Olympics were… “truly exceptional Games”

                                                             IOC President Jacques Rogge




November 7, 2008             triennial conference – TRAVEL MEDICINE SYMPOSIUM    Dr. Susan MacDonald
  Opening China’s Internal Borders

  • Increasing openness globally
     – Since 2004, non-Chinese companies can
       apply for in-bound tourist license
     – World Expo in 2010 in Shanghai
  • National gov’t admission of partial blame for
    “Tainted Milk” scandal




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Negative Impact

  • Change of visa rules with little explanation
  • Increased official checks for travel documents
     – Especially expats, business travellers
     – Included Chinese from outside Beijing
  • Foreign visitors decreased from predicted
     – Decreased by 12.5% in May compared to 2007




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Foreign Visitors During Olympic
  Period

  • August visits decreased by 7%
  • September visits decreased by 23%
  • Chinese visitors also decreased
    – by 41% in Aug and 15% in Sept




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Cultural Changes

  • Loss of hutongs
  • Migrants sent home
  • Closure of street markets and food stalls
     – Banning of salads, many food imports




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Post Olympics Travel

  • Many internal Chinese travellers on Oct 1
    National Day
     – 5.4 million train passengers
     – 557,300 air travellers
     – 53.2 million road travellers
  • 920,000 visitors to 21 Beijing tourist sites
     – 60% increase over 2007




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Are the Pre-Olympic Changes
  Sustainable?

       Less inspectors…

                                                              A return to
                                                              old habits...




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM      Dr. Susan MacDonald
  A Return to Life As Usual

  • Construction 24 hrs daily
  • Motor vehicles back on the road
    – Some license plate-based car restrictions
  • Queuing is out-of-favour again
  • Spitting is in favour again
  • More food scandals: “Tainted milk and
    melamine”




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Beijing Pollution




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Air Pollution Levels

  • Pre Olympics a serious concern
  • During Olympics remarkably acceptable
  • Post Olympics somewhat improved but
    variable levels
     – Higher than WHO recommended standards




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
        “The Public Health programs associated with
        Beijing hosting the 2008 Olympic and
        Paralympic Games should not be limited to
        the six weeks during which the competitions
        take place.”

                                               Hans Troedsson
                                              WHO Representative



November 7, 2008    triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  Diversity




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
            Most Popular Travel
                 Regions
  • Major destinations
     – Beijing, Xi’An, Shanghai, Hong Kong
  • Increasing tourism in Yunnan, Inner
    Mongolia, Silk Road, Tibet
     – Remote and urban areas
  • “Opening China’s internal borders”




November 7, 2008    triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
A Chinese Saying

   On Saturday October 25, 2008, Chinese Premier
   Wen Jiabao promised to toughen supervision to
                 “The Sky is High
   ensure food security after the recent milk powder
                           and
                       scandal.
              The Emperor is Far Away…”
  "Not only relevant companies were responsible for
   the scandal, but the government should also be
        held responsible for lax supervision."




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  And Yet



                   Melamine Tainted Eggs
                         are found

                            Hong Kong October 26, 2008




November 7, 2008      triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
  London 2012




November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald
November 7, 2008   triennial conference – TRAVEL MEDICINE SYMPOSIUM   Dr. Susan MacDonald