While no minister or department was specifically blamed for what was considered at the time a slow response to the spread of Severe Acute Respiratory Syndrome (SARS), the report suggested a number of changes to the health service, to prevent further epidemics.

The report of a government-commissioned inquiry found that the previously unknown disease had caught the territory off guard.
  
“The committee has not found any individual deemed to be culpable of negligence, lack of diligence or maladministration,” Professor Sian Griffiths, a co-chairman of the expert team tasked with probing the outbreak, said in a statement issued by the government.

The 280-page report, called From Experience to Action, was handed to Chief Executive Tung Chee-hwa on Thursday morning. SARS killed 299 people after it surfaced in Hong Kong in March 2002.

“There were significant shortcomings of system performance during the early phase of the epidemic when little was known about the disease or its cause”

Sir Cyril Chantler,
Co-chairman of the expert team

It spread to the former British colony from the neighbouring province of Guangdong in southern China, and claimed lives in countries from Singapore to Canada. 
  
The disease claimed the lives of 774 across the world and infected about 8098 people, according to revised World Health Organisation figures released last month.

What is more, the disease crimped Asian economies, hurt airlines already reeling from the effects of the 11 September US attacks and sparked global panic.
  
“There were significant shortcomings of system performance during the early phase of the epidemic when little was known about the disease or its cause, some of which were aggravated by key personnel becoming ill with SARS as the epidemic progressed,” Sir Cyril Chantler, the other co-chairman of the committee, said in the statement.

“Many shortcomings were rapidly put right, while others were compensated for by the extraordinary hard work of people at all levels,” he added.

The committee recommended 46 measures to prevent further outbreaks, including the establishment of a centre for disease control, or Centre for Health Protection (CHP).

One of the first victims in Hong Kong was a young man who transmitted the virus to over 100 healthcare workers, patients and visitors

Many commentators expected the study to criticise health secretary Yeoh Eng-kiong, but Tung would not be drawn on whether or not the embattled minister would step down.
  
“As an official he would take responsibility for any wrongdoing,” Tung said. “He has learned from the experience and I think he will make very important contributions” in the future.

One of the first victims in Hong Kong was a young man who transmitted the virus to more than 100 healthcare workers, patients and visitors at the hospital where he was admitted.
   
Many doctors have subsequently slammed the government for failing to shut down the hospital, which quickly became the epicentre of the outbreak in the territory.