JAMES MCCARTEN
Canadian Press
Saturday, April 19, 2003
TORONTO (CP) - SARS claimed a 99-year-old man as its 14th victim and left Canada's largest trauma unit isolated and closed to new patients Saturday amid warnings that the virus is taking a heavier toll on younger, otherwise healthy patients.
The latest victim, whose identity was not released, died Friday, six days after a 73-year-old woman became Canada's 13th SARS fatality. No other details were immediately available.
Word of the death came at the halfway mark of a holiday weekend billed as critical in the fight against SARS and amid a stark warning that healthy young people are not as safe as was once thought.
Toronto's outbreak is mirroring that of Hong Kong, where youth and vitality no longer guarantee survival, said Dr. Andrew Simor, the head of microbiology at Sunnybrook and Women's College Health Sciences Centre.
"The experience in Hong Kong has been a larger number of younger adults getting very severe illness, sometimes fatal," Simor told a hastily assembled news conference Saturday.
"We are beginning to see that in Toronto as well."
Simor did not say any younger adults had yet succumbed to the disease, which continues to have a fatality rate of about five per cent. But several members of a religious group who were first exposed to SARS two weeks ago are in critical condition, he noted.
"A number of those individuals were younger people without other underlying disease, and a number of them are now critically ill. So our experience is mirroring what has been reported from Hong Kong."
Sunnybrook ratcheted up its level of protection Saturday, closing its critical care, cardiovascular intensive care and SARS units for 10 days as a precaution after four staff members began showing symptoms.
The workers, doctors and nurses both, were exposed last Sunday during a four-hour intubation, a procedure that involves inserting a tube in a patient's airway to facilitate breathing, said Dr. Mary Vearncombe, the hospital's head of infection prevention and control.
The procedure proved difficult and the patient in question turned out to be a so-called "super-spreader" - someone far more infectious than a typical patient might be, Vearncombe said.
As a result, the four suspect cases joined Ontario's list of SARS patients, while eight other staff members, most of whom had contact with the same patient, were "under investigation," she added.
The closure will tax Sunnybrook, which has treated half of Ontario's SARS caseload to date and managed much of the city's surgical and urgent care needs, said hospital president and chief executive Leo Steven.
"It's a huge burden on the system," Steven said. "This is going to be a major blow to us for 10 days, primarily for the patients who need the help."
Discussions were ongoing with the province to determine where Sunnybrook's patients will go; emergency patients who arrive at the hospital's doors will be taken by waiting ambulance to a hospital that can handle them, Steven said.
Public health authorities asked anyone who visited Sunnybrook's critical care and cardiovascular intensive care units on Thursday and Friday to isolate themselves as a precaution and to watch for symptoms.
The number of visitors was estimated to be "very small," the department said in a release.
Saturday's developments marked the first of what those at the forefront of the battle against SARS had billed as a make-or-break weekend in the fight to prevent the spread of the disease.
There's no better place to have an exposure than at a hospital, where the virus can be readily contained, said Simor, who added that the outbreak hasn't changed much - for better or worse - in the last few days.
"Sure, this has been a setback, but I don't think it's an insurmountable one," he said. "I would not say that it's out of control, but ...the next few days and the next week is really going to be telling."
Containing Toronto's outbreak is one thing, Vearncombe said. Keeping the disease out of Canada is another matter entirely.
"This disease is going to be with us, and we're going to have to remain vigilant," she said.
"I have some level of optimism that we can contain it in Toronto; I have no optimism that we can contain it in developing areas of the world like mainland China, so we will continue to import cases."
Ontario reported 249 probable and suspect SARS cases Saturday, two fewer than Thursday. The province did not issue a caseload update Friday.
Health Canada did not report an updated cross-county caseload Saturday and advised on its Web site that no update would be coming on Sunday, either.
On Friday, the agency reported 304 probable and suspect cases in six provinces.
The World Health Organization reported 86 new cases Saturday, bringing the global total to more than 3,500. To date, 182 people have died.
Public health officials reported no change in the status of a northeast Toronto condominium complex where four SARS cases - one of which had no apparent link to the original outbreak - erupted last week.
On Thursday, health authorities said they were confident the case did not represent the oft-discussed worst-case scenario of sporadic community infection, where the disease becomes impossible to control.
In the day's only good news, York Central Hospital - one of two hard hit in the early days of the outbreak - reopened its emergency and maternity wards, the start of what it called a "gradual re-opening" of its services.
In coming weeks, the hospital would resume elected surgery and "selected outpatient services," giving priority to cancer patients and other serious illnesses, according to a release.
Visitors to the hospital remained restricted to birth partners, family of critically ill patients and parents of children in hospital.
In Montreal, Stella Riggi was among a group of a few dozen new Quebec parents who returned from China late Friday night with their newly adopted babies.
Riggi said the purpose of her trip made the decision to go to China an easy one.
"Considering the nature of my trip, I had no apprehension," said Riggi, who waited 20 months for the adoption to go through.
"There were worries, for sure, but it's not as if I was going on vacation. I had a specific reason, I was going to get a child. When you're giving birth, no matter the circumstances, you're giving birth."
Riggi said she wore a mask whenever she was out in public while in Beijing and she used a sterilization system to wash her hands "intensely."
Also in Montreal, some 450 people who attended a financial services conference remained in quarantine after a Toronto attendee came down with the disease upon returning home last week.
In other developments Saturday:
- Hong Kong reported a record 12 deaths in a single day from SARS while it tried to calm its 6.8 million residents and international companies with a cleanup campaign.
- Singapore's prime minister, Goh Chok Tong, said SARS could become the worst economic crisis the city-state has ever faced. He also announced tough new measures to try to contain SARS, including prison sentences for people who defy quarantine orders.
"SARS will knock you backward, it may even kill you, but I can tell you SARS can kill the economy, and all of us will be killed by the collapsing economy," he said.
Canadian Press
Saturday, April 19, 2003
TORONTO (CP) - SARS claimed a 99-year-old man as its 14th victim and left Canada's largest trauma unit isolated and closed to new patients Saturday amid warnings that the virus is taking a heavier toll on younger, otherwise healthy patients.
The latest victim, whose identity was not released, died Friday, six days after a 73-year-old woman became Canada's 13th SARS fatality. No other details were immediately available.
Word of the death came at the halfway mark of a holiday weekend billed as critical in the fight against SARS and amid a stark warning that healthy young people are not as safe as was once thought.
Toronto's outbreak is mirroring that of Hong Kong, where youth and vitality no longer guarantee survival, said Dr. Andrew Simor, the head of microbiology at Sunnybrook and Women's College Health Sciences Centre.
"The experience in Hong Kong has been a larger number of younger adults getting very severe illness, sometimes fatal," Simor told a hastily assembled news conference Saturday.
"We are beginning to see that in Toronto as well."
Simor did not say any younger adults had yet succumbed to the disease, which continues to have a fatality rate of about five per cent. But several members of a religious group who were first exposed to SARS two weeks ago are in critical condition, he noted.
"A number of those individuals were younger people without other underlying disease, and a number of them are now critically ill. So our experience is mirroring what has been reported from Hong Kong."
Sunnybrook ratcheted up its level of protection Saturday, closing its critical care, cardiovascular intensive care and SARS units for 10 days as a precaution after four staff members began showing symptoms.
The workers, doctors and nurses both, were exposed last Sunday during a four-hour intubation, a procedure that involves inserting a tube in a patient's airway to facilitate breathing, said Dr. Mary Vearncombe, the hospital's head of infection prevention and control.
The procedure proved difficult and the patient in question turned out to be a so-called "super-spreader" - someone far more infectious than a typical patient might be, Vearncombe said.
As a result, the four suspect cases joined Ontario's list of SARS patients, while eight other staff members, most of whom had contact with the same patient, were "under investigation," she added.
The closure will tax Sunnybrook, which has treated half of Ontario's SARS caseload to date and managed much of the city's surgical and urgent care needs, said hospital president and chief executive Leo Steven.
"It's a huge burden on the system," Steven said. "This is going to be a major blow to us for 10 days, primarily for the patients who need the help."
Discussions were ongoing with the province to determine where Sunnybrook's patients will go; emergency patients who arrive at the hospital's doors will be taken by waiting ambulance to a hospital that can handle them, Steven said.
Public health authorities asked anyone who visited Sunnybrook's critical care and cardiovascular intensive care units on Thursday and Friday to isolate themselves as a precaution and to watch for symptoms.
The number of visitors was estimated to be "very small," the department said in a release.
Saturday's developments marked the first of what those at the forefront of the battle against SARS had billed as a make-or-break weekend in the fight to prevent the spread of the disease.
There's no better place to have an exposure than at a hospital, where the virus can be readily contained, said Simor, who added that the outbreak hasn't changed much - for better or worse - in the last few days.
"Sure, this has been a setback, but I don't think it's an insurmountable one," he said. "I would not say that it's out of control, but ...the next few days and the next week is really going to be telling."
Containing Toronto's outbreak is one thing, Vearncombe said. Keeping the disease out of Canada is another matter entirely.
"This disease is going to be with us, and we're going to have to remain vigilant," she said.
"I have some level of optimism that we can contain it in Toronto; I have no optimism that we can contain it in developing areas of the world like mainland China, so we will continue to import cases."
Ontario reported 249 probable and suspect SARS cases Saturday, two fewer than Thursday. The province did not issue a caseload update Friday.
Health Canada did not report an updated cross-county caseload Saturday and advised on its Web site that no update would be coming on Sunday, either.
On Friday, the agency reported 304 probable and suspect cases in six provinces.
The World Health Organization reported 86 new cases Saturday, bringing the global total to more than 3,500. To date, 182 people have died.
Public health officials reported no change in the status of a northeast Toronto condominium complex where four SARS cases - one of which had no apparent link to the original outbreak - erupted last week.
On Thursday, health authorities said they were confident the case did not represent the oft-discussed worst-case scenario of sporadic community infection, where the disease becomes impossible to control.
In the day's only good news, York Central Hospital - one of two hard hit in the early days of the outbreak - reopened its emergency and maternity wards, the start of what it called a "gradual re-opening" of its services.
In coming weeks, the hospital would resume elected surgery and "selected outpatient services," giving priority to cancer patients and other serious illnesses, according to a release.
Visitors to the hospital remained restricted to birth partners, family of critically ill patients and parents of children in hospital.
In Montreal, Stella Riggi was among a group of a few dozen new Quebec parents who returned from China late Friday night with their newly adopted babies.
Riggi said the purpose of her trip made the decision to go to China an easy one.
"Considering the nature of my trip, I had no apprehension," said Riggi, who waited 20 months for the adoption to go through.
"There were worries, for sure, but it's not as if I was going on vacation. I had a specific reason, I was going to get a child. When you're giving birth, no matter the circumstances, you're giving birth."
Riggi said she wore a mask whenever she was out in public while in Beijing and she used a sterilization system to wash her hands "intensely."
Also in Montreal, some 450 people who attended a financial services conference remained in quarantine after a Toronto attendee came down with the disease upon returning home last week.
In other developments Saturday:
- Hong Kong reported a record 12 deaths in a single day from SARS while it tried to calm its 6.8 million residents and international companies with a cleanup campaign.
- Singapore's prime minister, Goh Chok Tong, said SARS could become the worst economic crisis the city-state has ever faced. He also announced tough new measures to try to contain SARS, including prison sentences for people who defy quarantine orders.
"SARS will knock you backward, it may even kill you, but I can tell you SARS can kill the economy, and all of us will be killed by the collapsing economy," he said.
