Posted on 05/25/2003 7:04:09 AM PDT by per loin
SARS hits St. Mike's
Don't panic, urge health officials
Outbreak still `institutional'
KAREN PALMER The developments yesterday immediately led to more quarantine orders, but public health officials cautioned against panic, and expressed confidence that the latest outbreak remains confined to health care settings. "This is still an institutional outbreak," said Dr. Donald Low, a leading expert in infectious disease and chief of microbiology at Mount Sinai Hospital. "We see cases in close family members and health care workers; beyond that, we haven't seen spread of the disease. "This is not a disease that does well in the community," Low stressed, "because it really isn't that transmittable." Ontario Premier Ernie Eves, who attended a special SARS briefing yesterday, urged calm. "There is no danger to the general population," he said. Public health officials are now investigating 33 potential SARS cases, including seven health care workers. Twenty-five are being treated in hospital; eight others are recovering at home. Toronto also has six other probable SARS patients still recovering from the last outbreak. St. Michael's Hospital closed its neurosurgery and neurotrauma units yesterday after discovering a patient with symptoms of SARS was treated there. The patient had been transferred there on May 15 from St. John's Rehabilitation Hospital, where public health officials found potential SARS cases last week. "This was not an easy decision — our neurosurgical unit is one of the busiest in the province and our trauma unit is one of two in the city," hospital president Jeff Lozon said. "We understand the difficulty this imposes." Some 70 hospital workers at St. Michael's, including nurses and doctors, have been put in quarantine after coming into contact with the patient, who had been transferred from St. John's Rehabilitation Hospital. Five potential cases of SARS were identified at St. John's Rehabilitation Hospital last week. "There's a potential this will grow, but there's also the potential that other cases will drop off the list," chief medical officer of health Dr. Colin D'Cunha said. Anyone who visited the St. Mike's wards between May 15 and May 24 should go into quarantine, call Toronto public health and watch for SARS symptoms. Yet callers to Toronto Public Health yesterday found themselves spending hours on hold or being cut off. "You punch through the voice mail maze and when you get frustrated and hit the 0 button, you get a recording asking you to call back between Monday and Friday, said one caller. Hospital visitors were upset that forms they filled out before entering the hospital weren't used to warn them about the quarantine. Mara Zadnoff, who visited an elderly friend at North York General on Thursday, said she learned she was supposed to be in quarantine by reading the newspaper — after hosting a slumber party for her 10-year-old daughter and seven friends. "That's not containment if you're filling out a form and then not using them," Zadnoff said, noting she would have cancelled the party. "I really think there should have been a phone call, considering they had my name." Zadnoff said she spent most of yesterday afternoon trying to get through — unsuccessfully — to Toronto public health in an effort to clarify her status. "I don't want to be under quarantine if I don't have to," she said. Although the Baycrest Centre is continuing to advertise itself as a SARS-free facility, yesterday it closed one of its seven floors — 3 West and East — after a patient developed a high fever. The patient was immediately transferred to an acute care hospital. "While we are treating this as a probable SARS case," Baycrest said, "there was appropriate protection in place, which is essential in stopping any spread from this one patient." Nancy Webb, Baycrest's director of public affairs, said admissions, transfers and discharges on 3 West and East are frozen, and no visitors are allowed. "We're not closed, it's all precautionary," she said. The facility, Webb added, is simply doing "what public health is telling us to do — be cautious." Doctors cannot officially classify the latest cases as SARS until they know they were either caused by travel to a SARS-endemic area or they can establish a medical link to an existing SARS case. They are still searching for that link, but insist the illness was picked up in the hospital, not in the community. "We've yet to identify where the breach took place," Mount Sinai's Low said yesterday. Public health investigators suspect the outbreak began at North York General Hospital, where a 96-year-old patient developed pneumonia after surgery to repair a broken pelvis. Health officials now suspect the pneumonia was SARS and that it spread to a female patient in her 80s, who was later transferred to St. John's and later died. A 39-year-old health care worker who treated the woman at St. John's is now in critical condition with what doctors believe is SARS. She spread the illness to two other patients she was treating, as well as a 66-year-old visitor. Eves pledged "the entire resources of the province" to the city's latest battle against SARS, vowing yesterday that the province will provide whatever health care workers need. "Cost is not an issue," he said. "Nothing is a question of money here. We are going to provide them with the resources they need." It was welcome news for weary public health workers. Toronto Public Health's hotline was jammed yesterday, and callers were confused by a recorded — and outdated — message saying the hotline was operating only during business hours. "Our hotline has been extremely busy," said Toronto associate medical officer of health Dr. Barbara Yaffe. "We're getting thousands of calls. I'm asking for the public's patience. We're ramping up as fast as we can." About 2,000 people called yesterday to say they had been at North York General, but only about 500 actually went into quarantine, Yaffe said. The rest had passed the incubation period for the illness without signs or symptoms of SARS. Anyone who visited North York General Hospital between May 13 and 23, as well as anyone who visited St. John's Rehabilitation hospital between May 9 and 20, has been asked to go into quarantine and call Toronto public health. Paramedics, homecare workers and Wheel-Trans operators were also affected by the quarantine. Health officials in Toronto spoke with officials at the World Health Organization yesterday and are expected to speak again today. A WHO spokesperson said the organization still wants more information about the possible new outbreak, but for the time being, it will not re-instate a travel advisory against the city. "No change," said Dick Thompson, director of communications.
Hicham Safieddine, Erica Tustin and Star wire services
PUBLIC HEALTH REPORTER
St. Michael's Hospital has closed its neurosurgery and neurotrauma units as a result of the city's latest SARS outbreak, and a new "probable" SARS case has been detected at the Baycrest Centre for Geriatric Care.
With files from Kevin McGran,
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One of the first articles on SARS in Hong Kong was by a medical worker who was hearing rumors about one ward in the hospital where he worked having an outbreak of some new deadly disease, but the hospital would neither deny nor confirm that to its employees. We've seen the debacle in Taiwan's hospitals, China's lying, and now Toronto's sudden discovery of piles of SARS victims. Can we trust the reports we are getting of what is happening here?
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