Via The New York Times: Canada Letter: Applying the lessons of an earlier health care disaster. Excerpt:
The SARS virus outbreak in 2003 that infected 375 people in Toronto, killing 44, left behind a widespread physical reminder of that dark time. While they have become often out of order and otherwise neglected in recent years, dispensers for hand sanitizer are still found in most public buildings at their entrances and dotted along their hallways.
The fear that pervaded the Toronto area during SARS resurfaced this week, if to a lesser extent, as the Wuhan coronavirus continued its rapid spread in China and around the world.
Traveling alongside that fear is xenophobia and discrimination against people of Chinese origin or people who simply appear to be from China. The public school board in York Region, north of Toronto, issued a statement effectively rebuking more than 9,000 people who signed a petition demanding that the children in a family recently returned from China be kept from their classes.
As I write this, four cases of coronavirus have been reported in Canada and the anti-Chinese sentiment appears limited. The health care system is working smoothly, and officials have been open about what they’re doing and what’s going on. That’s a marked contrast to SARS, where chaos and mistakes, all cloaked in secrecy, dominated.
The extent of the turmoil in 2003 had dimmed in my memory until I recently read the report from an inquiry Ontario did after the outbreak.
“Our public health and emergency infrastructures were in a sorry state of decay, starved for resources by governments of all three political parties,” Justice Archie Campbell wrote in his final report released in 2006. “The only thing that saved us from a worse disaster was the courage and sacrifice and personal initiative of those who stepped up — the nurses, the doctors, the paramedics and all the others — sometimes at great personal risk, to get us through a crisis that never should have happened.”
Looking back, two things stand out about Toronto’s SARS outbreak. First, hospitals became the place where most people contracted SARS, 72 percent of them. And of the those patients, 45 percent were health care workers who became infected on the job.
Then, after officials believed the crisis had turned the corner — to the point where Health Canada ran advertisements to that effect — they were forced to acknowledge under questioning at a news conference that a second lethal round of infections was underway.
SARS was even less understood than the coronavirus, which is nevertheless surrounded by many unknowns. There was not, among other things, any diagnostic test available for SARS during the outbreak.
“The commission has not heard of any country or any health system that foresaw SARS,” the 2006 inquiry found. “SARS taught us that we must be ready for the unseen.”
As the report repeatedly notes, Canada had an example of the right way to handle outbreaks during SARS. Vancouver’s infection control systems, its well-developed systems for protecting health care workers and its clearly defined hospital protocols for dealing with outbreaks, made it possible for the city to successfully contain its five cases, only one of which involved a health care worker.
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