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Posted on 03/29/2003 4:09:09 AM PST by Lessismore

Ottawa — Fearing the potentially fatal SARS virus had spread to another Toronto area hospital, health officials shut down the facility last night and quarantined the thousands of people who passed through its doors in the past two weeks.

"This is a disappointing and disturbing development," said James Young, Ontario commissioner of public security. "We're facing the same problem all over again."

Dr. Young had fewer answers last night, after telling reporters only five hours earlier he was optimistic that all the measures put in place to contain the outbreak of severe acute respiratory syndrome were slowing its spread.

York Central Hospital in Richmond Hill, north of Toronto, was closed last night after four cases of SARS were discovered there. On Tuesday Scarborough Grace hospital, where the first SARS case was discovered, was closed to new patients. The closings mean patients will remain in both hospitals and visitors are not allowed inside indefinitely.

A quarantine order, which already affects thousands of people who had visited or who work at the 380-bed Scarborough hospital, was expanded to thousands of others who may have passed through 430-bed York Central since March 16.

Dr. Young declined last night to update the number of SARS cases in the province. "That's really way down the list of the things I'm concerned about right now."

Officials were quick to point out that the cases at York Central appear to have been triggered by the transfer of a patient from Scarborough Grace on March 16.

"If this were a stone thrown in the pond, we're still dealing with the ripples of that first stone," Ontario Health Minister Tony Clement said last night. "There's not another stone with another set of ripples."

The patient in intensive care, but not in isolation, at York Central was diagnosed with probable SARS yesterday and staff who worked in intensive care were suspected of having the disease.

Officials also extended restrictions to three more hospitals in the greater Toronto area: North York General Hospital, Southlake Regional Hospital in Newmarket and Markham-Stouffville in Markham.

The Ontario government will convene an emergency summit next week to see what can be done to stem the spread of SARS, Mr. Clement said.

"Clearly this emergency is not over," he said.

Earlier yesterday, however, the number of probable cases in Ontario had jumped to at least 35 yesterday from 28 on Thursday, while suspected cases climbed to at least 31 from 10.

The number of SARS cases changes daily, as people with high fevers or other flu-like systems stream into hospital emergency rooms. In Ontario, three people have died from SARS.

Worldwide there are 1,485 cases of SARS and 53 deaths.

Concern over SARS is not limited to Ontario. Health officials are monitoring people with symptoms similar to SARS in several provinces, including British Columbia and Manitoba.

In Ontario, the epicentre of Canada's SARS crisis, health authorities have taken strong measures to limit the spread, with hospitals in the Toronto area, York region and Simcoe County closed to almost all visitors; the only exceptions are people visiting critically ill patients and parents visiting young children. Also, all volunteer programs and patient transfers between hospitals are suspended. The same regulations will be put in place for the three hospitals north of Toronto.

The number of cases of a mysterious pneumonia outbreak continued to grow as federal officials planned to screen passengers flying out of Toronto for symptoms of the potentially fatal virus.

Health Canada said it is planning to ask passengers flying out of Toronto's Pearson International Airport to screen themselves for symptoms of SARS.

"What we're thinking of is, in fact, providing information to departing passengers, so then they would have to make a decision on whether they were exhibiting symptoms, and then making a decision whether or not to fly," said Paul Gully, Health Canada's senior director-general of population and public health.

Health officials plan to make available an assessment card that will list symptoms of SARS, such as a high fever, shortness of breath or coughing.

This is in response to a World Health Organization recommendation that passenger screening take place in all countries where there has been local transmission of the disease. The affected countries include Canada, China (specifically Guangdong province), Hong Kong, Singapore, Taiwan and Vietnam.

Yesterday, Colin D'Cunha, Ontario's commissioner of public health, urged people to follow the isolation requests from health authorities.

"If you don't follow that request, my colleagues have the tools and may have to resort to legal methods to get you to respect isolation," he said.

No individual has been ordered into mandatory quarantine yet.

Federal Human Resources Minister Jane Stewart said the Employment Insurance Program will be able to help those individuals under quarantine.

Under the Employment Insurance Act, there is a provision that allows for as many as 15 weeks of special benefits when an eligible claimant is unable to work because of illness, injury or quarantine. Claimants will not have to provide a medical certificate immediately and the normal two-week waiting period will be waived for claimants who have received paid sick leave for this situation from their employer.

Doctors are still not sure how people become infected with SARS. The best evidence so far indicates the disease is transmitted by the respiratory droplets released by sick people coughing and sneezing.

Although airline officials have the right to bar any individuals from flying who are suspected of being ill, Isabelle Arthur, a spokeswoman for Air Canada, said it will work closely with Health Canada to put its measures in place.

However, Ms. Arthur said a number of logistical matters need to be worked out first. For example, when passengers fill out forms answering questions about SARS, it is unclear who will review those papers, airline staff or health officials.

Mr. Gully of Health Canada said there are no plans at present to implement the Quarantine Act for those coming into the country. A large upturn in cases from Hong Kong still might prompt Canada to implement the act.

"At the present time, Health Canada does not foresee the need to prevent flights into Canada," Mr. Gully said. "We feel that this would be an extreme measure."

Transport Minister David Collenette agreed, saying that "the airlines and Health Canada have the situation well under control."

With a report from André Picard

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