Dr. Donald Low is blunt when asked about the impact severe acute respiratory syndrome (SARS) has had on health care in Toronto.
“There has been no let-up,” said Low, chief of microbiology at Toronto's Mount Sinai Hospital and one of the lead SARS investigators. “Between 6:30 am and 11 pm you were either dealing with phone calls or faxes or email — it was pretty overwhelming. You literally couldn't take enough time to stop and cook something to eat. There were always 2, 3 or 4 calls waiting — it was quite surreal.”
Low said one of the primary challenges has been trying to manage and allocate health care staff as the illness forced the quarantine of dozens of SARS-exposed workers. “We're literally learning every day how to manage these things,” Low said. “I think during this first phase of the outbreak the primary impact has been borne by health care workers. There are people [with symptoms] who are being taken out [of the workplace] for 4 weeks — that's huge.”
Other workers who were exposed to someone who developed SARS symptoms were forced into 10-day house isolation. Low himself entered quarantine Mar. 25 after being in close contact with a public health worker who later displayed symptoms. He was released Apr. 8 after showing no signs of the illness.
Others haven't been as fortunate. Dr. Allison McGeer, director of infection control at Mount Sinai, was under treatment for SARS in April and was expected to be out of action for at least a month. The disease's impact on health workers has forced the health team to look further afield to replace vital specialists.
“As far as within our science group here, the problem is that local people who might have replaced them have other responsibilities in their own hospitals [because of SARS], so you have to look outside of the city for help,” Low said. “Luckily, we've had people who have been good enough to come in from Halifax to Vancouver.”
Meanwhile, local hospitals had to struggle with the impact of hospital closures on the overall system. For example, the closure of the Scarborough Grace and York Central hospitals was blamed in part for the subsequent closure of the emergency department at nearby Markham-Stouffville Hospital.
“The impact is incredible, because you have to off-load on the nearest hospitals, and that hospital might be having its own difficulties dealing with this already,” Low noted. “So it's a domino effect through the whole health care system.” — Brad Mackay, Toronto
Figure. Sign of the times: SARS clinic at Toronto's Women's College Hospital, Mar. 27, 2003 Photo by: Kevin Frayer / Canapress