SARS Was Deadly in Canada. Is the Country Ready for Coronavirus?


Canada Letter is a weekly newsletter from our Canada bureau, written by Canadian correspondent Ian Austen. Sign up to get it by email.

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.

ImageHospital staff at St. Michael’s Hospital in Toronto during the SARS outbreak in April 2003.
Credit…Andrew Wallace/Reuters

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.

[Read: As Coronavirus Spreads, So Does Anti-Chinese Sentiment]

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.

The coronavirus, so far, isn’t as virulent as SARS, and the number of admissions related to it here remains relatively low.

“When I compare this to what I experienced as an emergency physician during SARS, this is a different situation and a better situation,” Dr. Daniel Kollek, a professor of emergency medicine at McMaster University in Hamilton told me. “I think we are more ready.”

The changes over the last 17 years include better training, better systems for identifying infected patients and more hospital rooms with air filtering equipment. Additionally, clear and consistent updates and instructions from health authorities are now being given promptly to doctors, nurses and hospital administrators.

Canada does still lag, Dr. Kollek said, in planning for handling large-scale emergencies. Among other things, he said, in an era when many hospitals are regularly running at or beyond capacity, there is still no way to discharge patients who are not as seriously ill to free up beds during a crisis. He also said that large-scale health crises could be better handled by initially assessing patients outside of hospitals.

Times journalists from around the world, including me, are following the coronavirus situation as it develops.

Among the results of that is a regularly updated map of infections worldwide and a constantly revised briefing. You can find the most recent live briefing via the link at the top of every article we’ve published related to the outbreak, including the map.

[Read: Coronavirus Map: Tracking the Spread of the Outbreak]

Our correspondents based in China and Hong Kong have, of course, been following developments there closely.

Steven Lee Myers visited the shadowy world of Chinese markets that illegally sell live wildlife. As with SARS, coronavirus appears to have jumped from animals to humans through the consumption of wildlife, which, he writes, is “driven as much by the desire to flaunt wealth as by a mix of superstition and belief about the health benefits of wildlife.”

[Read: China’s Omnivorous Markets Are in the Eye of a Lethal Outbreak Once Again]

The wildlife delicacy that appears to have distributed the coronavirus to people is bats. James Gorman, a Times Science writer, explains that bats have a unique ability among mammals to carry many viruses with no ill effects to themselves.

[Read: How Do Bats Live With So Many Viruses?]

Finally, the question on many of our minds: Where is this outbreak headed? Knvul Sheikh, Derek Watkins, Jin Wu and Mika Gröndahl have looked at six factors that will direct the course of the outbreak.

[Read: How Bad Will the Coronavirus Outbreak Get? Here Are 6 Key Factors]

Trans Canada

  • When Rhona Wurtele and her identical twin, Rhoda, were 5 years old, their father strapped skis on them before sending them downhill in Montreal’s Westmount neighborhood. Rhona died last month at age 97. In her obituary, Richard Goldstein write that the “Flying Twins” went on to become the pioneers of women’s skiing in Canada.

  • As Parliament began considering the new trade deal that will replace NAFTA this week, President Trump signed it into American law in Washington. Ana Swanson and Jim Tankersley looked into the key changes it will bring.

  • The fashion sensation, or at least the most exclusive bit of fashion, at the Sundance Film Festival was a special edition jacket from Canada Goose.

  • Prince Harry and his wife, Meghan, have renounced British taxpayer money as they embark on their new lives as non-royals and part-time residents of Canada. But, as Benjamin Mueller reports, their multimillion-dollar income, while ostensibly private, will come from “a generous mix of public giveaways: medieval landholdings passed from one male heir to the next, sweeping tax relief, indemnity from some laws and exemptions from others, ownership of long stretches of coastline and all the treasure buried in Cornwall.”

  • Travel’s popular 36 Hours series visited Whistler where the high level of the skiing is paired with similarly high prices.

  • Shaun the Sheep and the world of Mossy Bottom Farm are among the offerings streaming this month in Canada on Netflix.

A native of Windsor, Ontario, Ian Austen was educated in Toronto, lives in Ottawa and has reported about Canada for The New York Times for the past 16 years. Follow him on Twitter at @ianrausten.

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