SARS in Toronto!

Nurses General Nursing

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Hey I just saw on the news that a thousand people have been quarentined at a hospital in Toronto!

Do you all know anything about this?

I hope our Toronto members are alright.

Is this virus realy something to be worried about or is it kind of being hyped like the shark attack thing?

Paul

Well, I didn't see a SARS in Beijing thread.

Anyhoo, in the news this a.m., Beijing closed all elementary & secondary schools for the next 2 weeks, in an effort to control

the spread. It said it affects nearly 2 million children. And

parents are being told to keep their children at home and restrict travel.

The Chinese cancelled this years' "May Day" -- "Spring Festival" celebrations. It is their biggest holiday /celebration of the year. People in the cities go home for at least a week. the government wanted everyone to stay put....for city dwellers to not travel to the provinces, which are disease free.

I was planning a trip to the Chinese Embassy in our city with some girlscouts. The parents do not want their kids to go.

And there are 2 Chinese teachers in our school system, to teach ESL classes to 22 Chinese students....parents are nervous about that.

This morning, The World Health Org (WHO) has added Toronto to it's list of places to avoid for unnecessary travel.

The CDC does not as yet issued similar warnng. Personally, I am going by what CDC says and not what WHO says.

Lets hope CDC can overturn what WHO is saying. This is starting to get out of hand and I fear the economic and emotional effects this will have on the people of Toronto, and other communities/cities. let's pray that some one soon gets a handle on this. And too think on top of this it is almost West Nile season.

WHO alert Bull:Doc

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0002.html

WHO edict appealed

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0003.html

WHO the Hell

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0005.html

Some areas badly hurt

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0006.html

Duck,Dude

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0009.html

WHO the heck is WHO

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0028.html

No flights cancelled

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0041.html

Masks at Pearson

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0042.html

Visitors fear flying to TO

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0043.html

Health screen misses 292

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0044.html

Sports world feels ill effects

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0045.html

It's childs play

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0046.html

Tourism industry fights for survival

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0047.html

Pryaing for their return

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0048.html

Condo building a 'lepr colony'

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0049.html

Virus will hurt in pocketbook

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0051.html

THE GUILT (NURSE)

http://www.canoe.ca/TorontoNews/ts.ts-04-24-0053.html

Opposition slams federal handling of SARS outbreak

http://www.canoe.ca/CNEWS/Canada/2003/04/23/71732-cp.html

We were in North Bay just a few hours north of Toronto on tuesday. There is a huge sign of the side of the road that says

"Welcome to the gate way to the North". We heard several people state "This will soon say,'The gate way to the north is now closed due to SARS'.

I think these people are over reacting, I also feel there fear. The smaller communities of the North may be ill equiped to deal with SARS.

On a happier note it is a beautiful day, after 6 cm of snow the sun is shining.

Hope everyone out there is well. To those who are working and dealing with SARS keep up the good work, you are in my thoughts and prayers

I heard on the news yesterday that the virus "seems to be mutating". These guys still don't know for sure what they

are dealing with.....except to say it is in the coronavirus family.

The plan , they said, is to isolate/quarantine everyone and hopefully it will run its course in a few cities/countries and that would be the end of it.

The hard part is getting people to stop traveling.

and spreading it.

Last night on MSNBC the did a real nice article about a nurse that was recovering from SARS. It documented the toll on the patient and the family very well. Some of the things that MSNBC has done has been overwrought and hysteria producing but this was very well done. Let people know about the suffering of healthcare workers that put their life on the line for the public. Another article I read somewhere was about a physician who had to be arrested at a funeral. He was put into forced quaranteen. He was beliegerent and abusive towards the police. He knew damn well he had it but was in complete denial. The behavior they described was typical MD in my experience.

I have been working with SARS patients in the ICU for the last month and we are going to be localizing a unit to deal just with vented SARS patients.

We will not be required to be quarantined, just take isolation precautions so that the area is contained and reduce the risk for other patients and staff.

Certainly anyone who is immunosuppressed, pregnant or has a medical condition which makes working in isolation a hazard shouldn't work there, however the college of nurses of ontario mandates that no nurse can refuse to work with sars patients unless they have the above conditions. Having children doesn't exempt you, everyone has someone they love at home whether they are children, elderly parents or others, and nobody wants to be in the position of possibly carring the virus home with them. I have 2 young kids and we have already been through quarantine once because my husband was exposed (he stayed healthy). The trouble is that the isolation protocols must be strickly followed in order for everyone to remain safe. If a core group works with the SARS patients in isolation, there is less likelyhood that mistakes will be made, everyone will develope a level of proficiency which will diminish the risk of inadvertant contamination. I will likely be working in the isolation area and really don't feel any anxiety about it, considering over the last month our isolation techiques have been redeveloped about 10 times, I feel safer now than I did a month ago.

Keep informed about changes, be vigilant about isolation and if you are from outlying areas realize that the media do not always portray information accurately. the toronto sun newspaper which I see a lot of links to, is really almost a rag paper bordering on sensationalism. I know of many instances when that newspaper has caused wrong messages to be given to the public. Usually at the expense of the innocent.

I think the virus is being well maintained and unless something catastrophic occurs that we will see a diminish in new cases over the next few weeks.

My kudos to toronto public health nurses who have been working around the clock and are bone tired - they deserve a lot of credit for the work they are doing in helping to contain the spread of the virus by tracking all the contacts and following up on quarantined people.

This ony is denied to God: the power to undo the past.

Agathon

448-400 B.C.

______________________________________

Denial:

SARS worldwide has put the travel/tourist industry and the healthcare industry into direct conflict with one another.

Very simply: travel and tourism spread SARS.

There is no getting around this simple fact.

This simple truth puts the travel/tourist industry at loggerheads with medical reality. And has led to a lot of official denial internationally.

These is an awful lot of money at stake.

Hong Kong had difficulty facing up to this reality. The Hong Kong airport is said to be either the third busiest or the fifth busiest in the world, depending on what you read. It drives the economy of Hong Kong.

Hong Kong acted like it was it's God-given right to spread SARS throughout the world - until the WHO put in travel advisories.

Only then did Hong Kong begin serious airport screening.

Only then did Hong Kong realize that it actually had a responsibility to do what it could to not spread SARS throughout the world.

The same thing happened in Singapore.

The same thing is happening in China.

The same thing is only now beginning to happen in Toronto, as well.

China in denial:

"There's never been a better time to visit Gunagdong, and tourists are arriving in record numbers."

That from official Chinese government sources just last week (Guandong is the epicentre of the SARS virus). The Health Minister of China was saying similar sorts of things last week - until he was sacked.

Toronto in denial:

"I've never been angrier in my life," Lastman spat out at a news conference in Toronto. "I'm shocked. The medical evidence before us does not support this advisory."

Canadian Physician in denial:

I can no longer find the story, but those of us who read it may recall that a Canadian physician in denial went to a funeral and exposed a lot of people to SARS. He was then very obnoxious and aggressive when Canadian health authorities went after him.

One of the interesting things we are seeing about denial - in both the case of the Canadian physician who exposed people to SARS at the funeral and in the case of Toronto itself - is the tendency to great anger and aggression in attacking the messenger.

They do not defend so much as they go on the attack.

That is what people tend to do when the message is valid and people know that they are in the wrong.

When a position is in itself indefensible, defense cannot work - so the tactic is typically angry obfuscating attack.

The real issue for the WHO in the Toronto situation is not whether or not it is safe to walk the streets of Toronto - it apparently is - but the fact that Canada is continuing to spread the disease to the rest of the world. That Canada is not taking the matter of worldwide spread seriously.

Yes - Toronto HCWs are acting heroically to contain SARS in Toronto. For this they are to be commended.

But simultaneously, the airport is not taking the task of screening passengers - incoming or outgoing - seriously.

Not at all.

There have been at least three reports in the Canadian press over the last week over the laxity of the local airport in regard to the spread of SARS.

If the airport will not take it's responsibilities to the world seriously - then the world has the responsibility to protect itself.

Hence the WHO travel advisory.

Already, Canada has spread SARS to Australia (three Canadian children), The Philippines (a nurse apparently spreading SARS to her family), and to the US (a symptomatic physician in denial returning from Canada and going to work - another physician apparently had to send him home).

Apparently this has a lot to do with the airport being under Federal - not local - control.

Toronto can do all it can to control SARS - but if the Federal government is not doing what it can at the airport - the world remains at risk from Toronto.

And Toronto remains at risk from the world.

Remember - Hong Kong has been brought to it's knees by ONE case of SARS.

The situation in Toronto is the result of a chain of spread from ONE case of SARS.

Already, Canada has spread at least FIVE cases of SARS to three nations - and doesn't seem to care.

All of Canada's concerns seem to have been directed inward - not toward Canada's responsibilities to the rest of the world.

The situations were similar in Hong Kong and Singapore - until the WHO put out travel advisories.

Only then did they take airport screening and their responsibility not to spread SARS to other nations seriously.

Only now is Canada facing up to its responsibility to follow suit.

Only as a direct result of the WHO travel advisory, wiser Canadian heads are now beginning to surface:

"Obviously, nobody's overjoyed about it, but these are decisions for health-care professionals to make," he said, acknowledging that the decision is "not helpful" for tourism in the province.

Eves said Ontario has been asking the federal government for three weeks now to do more at airports and borders to screen for SARS.

He says it's fine to have information sheets made available to people, as is currently the case, but he also wants screening. >>

That is what the WHO is after.

That is what the WHO travel advisory is all about.

I'm just glad that this could never happen here -

Yours in denial,

Epaminondas

Come to think about it, has anyone seen HappeeWendee? Hope she is allright, just busy.

Canada is not wrong in disputing the WHO's travel advisory, Epaminondas.

The CDC is not supporting their advisory, and if you want to take the time and read and listen to the countless newscasts, you would know that there has not been ONE SINGLE case of SARS in the community that can not be traced back to "ground zero" (ie. the original case that arouse from the person returning from travel to Hong Kong)

Further to that, ALL of the cases of SARS have been hospital based, meaning health care workers who come into contact with SARS pts or their families. There has been a "cluster" in Toronto hospitals, that is well contained and not spreading to the community.

Can I now address the doctor, who after being exposed to SARS during a difficult intubation, went out to a funeral. He was wrong, of course, however his case points out the fact that even though he went out and was in a public place with the public, THERE HAS BEEN NO TRANSMISSION of SARS as a result. He remains in quaranine now. However, it is another example of how , it takes more than passing someone on the street, sitting next to them in a funeral home, etc to contract this virus.

I also take exception to the idea that Canadian health officials are being introspective and not thinking about the world's greater good by protesting the WHO's decision. You have to look at this with science and understand that unless you are flying into Toronto with plans to visit a hospital setting ( and perhaps offer up some personal care, however you would not get into right now anyways) you ARE SAFE. THE CDC is here RIGHT NOW, in our hospitals, helping identify ways of reducing risk to health care workers. Again, I remind you that the CDC is not supporting the WHO's decision.

Please do not accuse countries, health officials of being anything less than honest and outward when it comes to something like this. Yes, China has been wrong in not telling the truth and they have years of being a closed country to overcome. Not true here.

Yours in truth JMP

Saying travel and tourism spread SARS is a statement that at best can be described as ignorant and uninformed. Since the SARS outbreak thousands of tourists have been here and haven't contracted the disease and spread it to their homeland. The case that happened regarding the Phillipines was a health care worker who had been exposed, not a tourist, so I don't see how stopping tourism will stop SARS.

I agree that those at risk and those who have been exposed have no business travelling, but to say that all 16 million or so visitors we get every year are going to spread SARS is ridiculous. We know what type of places are danger zones for SARS (hospitals and homes of those infected). Going to a Blue Jays game or seeing the Lion King is not a high risk event.

Not one community transmission of SARS in 16 days- How is it that Canada is acting irresponsibly. The reason there is so much panic about SARS in toronto is because of irresponsible reporting of facts, and spreading of error ridden information and opinions. The medical community has acted swiftly and tirelessly in containing the spread of a new, poorly understood virus. Blacklisting the city of Toronto is not only unneccesary but an impulsive act not based on scientific evidence. Don't believe it can never happen where you are Epaminondas. I can guarantee most places would not have handled this unexpected crisis as well as Toronto has, this is ground breaking territory so it is very easy to say in retrospect what should have been done. Or that it could have been handled better. When all is known about the situation, let everyone learn from it, rather than place blame because of it.

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