The current Severe Acute Respiratory Syndrome or SARS epidemic is a wake-up call for everyone. We are not isolated in our cozy little spot in the world. In 1973 I attended the International Congress of Nurses in Mexico City. At that time there was a Canadian nurse-journalist there, whose first name was Charlotte – her last name escapes me now, but her words still ring clear in my memory. She tried to get her message across to everyone and anyone who would listen. It was this: “The world is less than 24 hours from your doorstep. With modern planes, diseases we never even heard of could be on our own doorsteps tomorrow and we are not prepared!” At the time, I knew the lady was right. To continue her argument one step further, she also made a point of saying that medical schools on this continent did not include tropical diseases and the diseases of third world countries in their curriculum, therefore our medical personnel were not prepared for the onslaught of many diseases, that were endemic in other parts of the world, when they arrived here. This lady’s thinking was remarkably astute and much advanced for the time. Fortunately, in North America, we now have Centres for Disease Control that identify and track diseases throughout the world, then advise healthcare professionals dealing with unusual disease outbreaks. The world is now seeing Charlotte’s 24-hour theory coming true. We will see how well prepared we are to meet the reality of this new global disease.
Having worked as a health care professional in one of my former incarnations, I am more than aware of what is happening at the present time. SARS is either going to be contained with the co-operation of the population in the affected areas, and with the controls that have to be put into place, or we have the potential for a pandemic over which, through no fault of their own, the world health professionals will have no control. We are fortunate front line health professionals in Ontario and British Columbia have been so diligent and dedicated and have dealt with SARS intelligently. People cannot afford to hide their heads in the sand and ignore possible symptoms. The self-imposed quarantines are only as good as the conscience of those who need to be quarantined. The two health professionals who broke the rules in Toronto made that painfully obvious. It makes me think of releasing a bag of feathers in a windstorm then trying to put each feather back into the bag. On the whole, Canadian health professionals cannot be faulted. They have been working hard and diligently to get a handle on this situation since patients first began to appear with a puzzling set of symptoms, looking for help. Those working to help the victims of this disease, while taking personal risks, are true heroes in my eyes.
Personally, I applaud Crystal Cruises for taking the lead in announcing new restrictions regarding potential passengers from SARS infected areas. Just think of what a dilemma cruise ships are faced with. All cruise companies are very aware they need to address this new situation and have moved to initiate new policies to deal with the threat until SARS is brought under global control. There is screening being done prior to boarding.
Malaysia soon took the initiative to temporarily close its borders to people from infected countries, Canada included. Some of their neighboring countries were affected. That showed their insight into the situation and their unselfish attitude, considering tourism is their number one industry. The country is to be commended for its prompt action. The Canadian government could take a lesson on prompt action! Because of the measures that have been taken to control SARS in this country, Malaysia lifted that closure against Canadians on Thursday, April 17th, however, that may be a fluctuating move depending on how this situation evolves.
Canadian airports should have promptly begun taking temperatures and interviewing passengers before departures in any area that had fresh SARS cases – and currently in Canada that included Toronto and Vancouver. The World Health Organization got into the act because there were cases reported to have been exported from Toronto. Also any plane coming to this country from infected areas should not accept passengers with temperatures above 38 degrees C. Several years ago, when I was with a group traveling to Israel, the people at El Al set up several podiums in the airport, near the line-up of passengers waiting to check-in. El Al security people came out and called each of us individually over to interview. I left that interview reassured that those people were putting all the safeguards at their disposal to use. Why couldn’t a similar procedure have been promptly put into place in our airports? Our government said it was too expensive to take temperatures, so they just handed out bulletins. Well, I think it was too expensive not to initiate that step and to sit there moaning about the loss of tourist dollars. Tourists will return to Canada when they feel confident that the disease has been brought under control. Politicians should have stopped trying to tell people, “Toronto is safe,” when the WHO was saying, “Beware of Toronto!” I received several press releases from Hong Kong recently. In them they state that Hong Kong has a problem and they proceed to give a factual and up-to-date report on what they are doing about it. That is a much more realistic and effective response. They deal with the facts and leave us to consider the implications of safety in Hong Kong. When they tell us it is safe in Hong Kong, I, for one, will believe them. I hope Toronto will use a similar tactic in letting the world know that because of our heroic health care professionals, SARS has been contained and the further spread of the disease has been halted in Canada.
I live in the Greater Vancouver area and observed the situation here in BC as it evolved. The Royal Columbian Hospital closed one floor while it sat out the incubation period for the contacts there. Two more Fraser Valley hospitals reported new cases which were promptly isolated. A search was immediately initiated to quarantine the passengers of a plane that arrived in BC with some passengers thought to be infected with the SARS virus. Fortunately the disease was quickly brought under control here. Hospitals are being proactive instead of reactive. Their plans are in place and daily measures are being taken, throughout the area, to co-operate in containing all reported cases immediately. Good communication between the various hospitals is a key component of their strategy. However, it still comes down to each individual recognizing his or her own symptoms, seeking appropriate help and respecting the necessary quarantines to control this disease. We must all err on the side of caution.
I have clear memories of the polio epidemics that used to occur in North America, summer after summer. The sources could not be traced and there was no magic bullet to cure the disease. People were warned not to go to places where groups of people congregated, not to go to public beaches or theatres, to stay out of crowds. Quarantines were put into place. We all breathed a sigh of relief when polio vaccine was discovered. We’ve become very complacent about infectious diseases since antibiotics came into general use. As they are discovering with SARS, those so-called wonder drugs are not so effective with various mutations that are appearing in this century. SARS will not go away as long as a powder keg of infection rumbles ominously in China! Our government needs to wake up to the potential of this disease and put a realistic federal policy into place to deal with this threat to the health of its citizens.
Each of us must personally take responsibility for our own well-being and that of other people by recognizing symptoms as soon as possible and respecting both restrictions and quarantines. The old adage about short-term pain for long-term gain is probably very true here. If it means that we’ve got to stay close to home for a short period of time, so be it. Tourism may take a hit in the short term but will rebound if this thing gets under prompt control. While people need not panic, they do need to recognize the seriousness of this disease and that it is essential for every person to take reasonable precautions and to follow the recommendations of health professionals.
Article by M. Maxine George
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