China has promised full co-operation with the WHO after the country’s early attempts to hide the epidemic were exposed. But, despite a propaganda campaign calling for greater transparency, many officials continue to attempt cover-ups.

China has almost 5,000 cases now and, if Sars spreads in the countryside, where modern medical facilities are not available, the epidemic may become impossible to contain.

At the Infectious Disease Hospital in Baoding, in Hebei Province, staff began preparing for a WHO visit yesterday after notification from the Government. Police and security agents were on guard while staff undertook last-minute construction measures.

One entrance had recently been refurbished, covering redbrick walls with white marble and gold letters bearing the hospital’s name. Keen to impress the WHO with their anti-virus efforts, staff spent the morning installing new room dividers and partitions. They also filled the hospital forecourt with brand-new cars and ambulances. Later, hospital workers were instructed to raise a banner over the main entrance saying: “We must be victorious in the hard battle against Sars.”

As the WHO team arrived, staff and police at the main gate donned face masks; staff at the back of the building remained maskless. WHO representatives were asked to have their temperature checked, a procedure afforded nobody else all day.

Hours earlier, dozens of smaller clinics in Baoding were suddenly closed. A doctor at one of the centres said: “The local government gave the order to close all the small clinics the day before.”

The measure may be aimed at preventing the WHO from inspecting less well equipped facilities. Shops along the streets near the seven-storey Infectious Disease Hospital were also closed, possibly to isolate the visiting delegation.

The WHO has made rural China its focus in the fight against Sars, saying that the anti-virus campaign had reached a crucial stage. The WHO experts visiting Hebei, a province of 67 million people neighbouring Beijing, were assessing the region’s readiness to cope with the epidemic.

Yesterday’s trip is the first that the WHO has conducted with China’s Health Ministry and will be followed by visits to the southern Guangxi region and central Henan Province. None of these has reported large numbers of infections, although Hebei has seen its infection rate double to more than 100 in barely a week.

“Visiting Hebei makes a lot of sense,” James Maguire, a WHO official, said. “It is next to Beijing, there are a relatively small number of cases, but we want to see if the numbers are accurate. The floating population, the migrant workers, are another real cause of concern. It’s very much a priority to keep Sars away from them.”

Mr Maguire said that the fear was that the millions of returning migrant workers would carry the disease out of Sars-affected areas and into the countryside. He said the epidemic was in danger of exploding if not checked. “We don’t know if we are already at this point or not, but if we are not already there, we are very, very close,” he said.

Communist Party officials in the province have also advised staff to bow instead of shaking hands, which doctors fear might be a way of passing on Sars. “It’s really a suggestion more than an order,” a member of the provincial publicity team said, “but we want to do everything possible to stop the spread of the disease.”

• Medical workers were attacked and an ambulance overturned as villagers in a suburb of Shuiquangou, in northern China, reacted to a rumour that their local clinic was to be turned into a hospital for treating Sars patients. More than 160 police and troops were called in to suppress the riot.

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