How NZ doctor's diary of death alerted the world

By ANGELA GREGORY and ANDREW LAXON

Tired and worried, Tom Buckley sat down at his hospital computer in Hong Kong and began to type warnings that would shock and inspire his fellow doctors around the world.

"Dear All," the New Zealand-born doctor wrote in an email to about 1500 intensive care specialists from Toronto to Auckland. "We seem to be close to or are the centre of this form of atypical pneumonia ... "

Over the next three weeks Dr Buckley, 48, the acting head of intensive care at Hong Kong's Prince of Wales Hospital, wrote a series of electronic bulletins warning his colleagues.

"I was able to disseminate a lot of information very quickly ... when newspapers, CNN, were not carrying anything. I wanted intensive care specialists around the world to be aware and on their guard," he explained to the Weekend Herald.



One specialist wrote: "Keep it up, Tom. There have been, in the past, valued, heroic representatives in the annals of medicine. I believe you have just joined their ranks."

March 16, 11.40am: "As of yesterday there were 64 patients with 'atypical pneumonia' in the hospital - a large number are staff ... All elective surgery is being cancelled and wards are being closed and evacuated. Masks are worn throughout the hospital. Staff are not going home to children. Please take the warning below seriously. My impression is even with minimal contact with an infected person people have been becoming ill."

March 16, 9.36pm: Dr Randy Wax from Mt Sinai Hospital in Toronto, Canada, confirms the first case of Sars there and criticises attempts by public health officials to downplay the disease. Dr Buckley agrees that public health officials and the health minister in Hong Kong have done the same. "If ICU staff contract this pneumonia then we are well and truly up the creek. If our families do (and I have been very careful to limit contact) heaven help all of us. We are all extremely worried."

March 17: "We now have 87 cases in the hospital (3 more than yesterday). . All staff who've had direct contact with this ward have developed the illness within 4-5 days. Visiting relatives to other patients have developed the illness ... TWO of my nurses are sick." . .

March 18: "We're all wearing gowns, N95 masks, hats, gloves and additional masks with visors for any bedside procedure. I've bought HK's total supply of N100 masks (7) to try them out and have requested our safety officer to investigate suppliers of space suits."



March 19: "Yesterday was a bad day. 7 admissions to ICU. Total of 24. Unfortunately 2 died last night. Yesterday I was truly frightened and the fear was palpable around the hospital."

March 21: "Last night senior nurse rang me to say she was resigning. She is petrified.

"HK Government is downplaying the whole thing presumably due to the economic implications."

March 26: "This is a real rollercoaster ride in terms of emotions. What is even more scary is that: 1. Schools have not been closed; 2. The sevens rugby tournament is still going ahead this weekend; 3. The Rolling Stones are due in HK this weekend.

"Politicians will not take the tough decisions. When they do it will be too late. If this comes to you (and I sincerely hope it does not) it will potentially overwhelm your critical care services."