Apr. 13, 2003 - HONG KONG -- China reported two deaths yesterday from a new strain of atypical pneumonia in a remote northern region, thousands of miles from the southern province where the disease originated. The 10 cases reported in Inner Mongolia lent credence to accusations that, even as authorities delayed publicizing the illness and downplayed its seriousness, it was spreading across the country and -- via air travelers -- around the world. 

In Hong Kong, which after China is the area hardest hit by severe acute respiratory syndrome, or SARS, health officials reported three more deaths yesterday and 49 new infections, bringing the total in the former British colony of 6.4 million to 1,108 confirmed cases, including 35 deaths. 

Officials in China have reported 1,300 infections among the 1.3 billion populace, including 60 deaths. But prominent government doctors said the true number is far higher, based on the number of cases they have seen in Beijing's hospitals alone. Although the disease surfaced in China in November, authorities did not report the outbreak publicly until February. 

Most of the dead were elderly or chronically ill, but two of the latest Hong Kong victims were patients in their 30s with no known long-term diseases. Authorities said that the two were already quite sick when hospitalized. Worldwide, about 3,000 people have been infected by SARS, an illness characterized by high fever, dry cough, and breathing difficulties. So far, there have been 121 deaths in 20 countries, according to the World Health Organization and yesterday's updates. 

The United States has the fourth-largest number of cases with 166, though there have been no deaths yet. Nine cases have been reported in Massachusetts. The fatality rate of SARS is around 4 percent, making it far less deadly than ordinary pneumonia. But the sudden arrival of a new disease and unanswered questions about its origin and transmission have stoked anxiety globally, spurring more calls to the US Centers for Disease Control and Prevention than the anthrax scare in late 2001. 

China's communist government appears to have concealed the scope and seriousness of the outbreak in an effort to prevent panic and instability, and to shield the country's reputation. Beijing recently agreed to release infection rates to the World Health Organization. The WHO has issued its first-ever travel advisory, warning against visiting southern China and Hong Kong, and the agency plans to maintain the global alert for at least a month while it monitors the situation. 

Beijing will host the 2008 Summer Olympics, and the government worked hard to win that bid as well as other prestigious events, all the while strengthening its surging base of international investment. A number of international conferences and celebrities have canceled upcoming events in China, but government media have not admitted that SARS is spurring the cancellations, leaving the public in the dark about the anxiety over the disease. Chinese authorities insist the illness is under control and continue to downplay the risks of infection. 

By contrast, in Hong Kong, as one local newspaper said yesterday, fear of atypical pneumonia is spreading faster than the disease itself. A far more open local government and a free press have inundated the public with information, and 80 percent of residents are wearing surgical masks, according to a new survey. Schools have closed, and those who could have fled the city. Others are working at home and avoiding public places, giving the ordinarily cheek-by-jowl city a deserted, ghostly feel. Locally based airline Cathay Pacific is considering grounding its fleet next month as its passenger base evaporates, according to Reuters. That move would seriously damage economic confidence in Hong Kong. 

With the business pall spreading over this travel and financial hub of Southeast Asia, Hong Kong residents are blaming the mainland and local governments for not revealing the crisis sooner or taking strong preventive measures immediately. In Singapore, where health authorities imposed strict quarantines, the disease has spread at a slower rate. 

"My brother and my friends work in China, and they alerted us to this outbreak long ago, so we all know the actual number of those suffering from the virus or carrying it is far beyond the official announcements," said Carmen Tsui, a 31-year-old secretary. Tsui said her boss, who is on assignment in China, "feels so nervous and insecure because the Chinese government is keeping the facts secret," so people there are not taking precautions to stop its spread. 

Only in the last week has China's official media begun reporting on the outbreak, and even then mainly to announce positive developments. Unlike in Hong Kong, where the government has held daily news conferences and encouraged hand-washing, mask-wearing, and careful hygiene, the press in China on Thursday published recipes for traditional herbal remedies, but did not mention washing one's hands, a basic disease-prevention measure. 

"The Chinese government is dishonest. They cover up everything, because they are afraid people won't come in the future," but their coverup has had deadly results, said Juliana Leung, a 60-year-old housewife in Hong Kong. "No one there wears a mask, and there's no proper education, so how can the disease be controlled?" Well-read residents of Beijing and Shanghai said that, because of the void in reporting on SARS within China's media and the Internet blocks on foreign news, they had no idea the disease had caused international alarm or that it had spread through China. Authorities said on Friday that nine foreign residents of Shanghai, including two Americans, are under hospital care for suspected SARS. 

Infectious-disease specialists believe that the illness stems from coronavirus, a relative of the common cold, but they have not determined precisely how it spreads nor have they developed a vaccine. The strain may have begun as an animal virus and jumped to humans. It first appeared in southern Guangdong Province and was spread here in late February. 

The blow to Hong Kong, still suffering the effects of the 1997 Asian financial crisis, is palpable. About 10,000 small businesses could shut down in the face of canceled trade fairs and postponements of orders due to SARS, according to the local Small and Medium Enterprise Association. 

Tourism, a key sector of the economy, will lose hundreds of millions of dollars in revenue if arrivals drop 30 percent to 50 percent, as industry analysts estimate. Airlines have slashed schedules by 30 percent. Major carriers said they will cut back even more and may be forced to lay off staff. Hotel occupancy has plunged, according to the tourism board. 

International concern is growing. Malaysia and Panama have announced they will bar visitors from Hong Kong and China, and Thailand has begun checking travelers arriving from Hong Kong and China for fever. 

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(c) 2003, The Boston Globe. Distributed by Knight Ridder/Tribune Business News.