Six months after the severe acute respiratory syndrome (SARS) outbreak in Toronto that killed 44 people, Canadian medical officials face calls from experts for dramatic reforms.
Last week, a federally commissioned panel of infection-control specialists criticised cooperation and data-sharing between infection-control officials during the crisis, and called for a national immunisation strategy and the creation of a national centre modelled on the US Centers for Disease Control and Prevention.
Panel member Allison McGeer, an infection-control specialist from Toronto, said that Canada needs a national agency that will “move science and investment” into infection prevention rather than treatment.
“We need a central or national focal point” for disease prevention and deterrence, Canadian health minister Anne McLellan confirmed; however, she did not set a budget or timeline for the project.
The federal report comes after an Ontario government report that attacked federal officials for ignoring calls from scientists a decade ago to improve national infection control. The province, which administers public health in Toronto, is preparing new provincial guidelines on SARS surveillance.
According to Toronto emergency physician Brian Schwartz, who is vice-chair of Ontario's Scientific Advisory Committee on SARS, which helped craft the new guidelines, they will focus on pinpointing and isolating high-risk patient groups in hospitals and institutions, bolstering public-health education, and reinforcing basic infection-control measures.
The new guidelines will be the fifth to be circulated in Ontario since the SARS outbreak, confirmed David Jensen, a spokesman for the provincial health ministry. Their release was delayed in September after the Ontario Medical Association (OMA), which represents 24 000 doctors in Canada's largest province, criticised propose new measures, including mandatory isolation of all suspected SARS patients and biannual testing of N95 masks on hundreds of thousands of health-care workers.
In hearings at a public inquiry into the SARS disaster, OMA President Larry Erlick said previous sets of directives had been “incoherent at times and completely untenable”.
Erlick noted that an official order closing all but essential services in Ontario hospitals led to a “debacle” in March. And a later directive ordering anyone with SARS-like symptoms in the province to report for emergency care flooded the hospital system.
“We were forced to come up with directives with scant available evidence during the crisis”, said Schwartz, who told the inquiry that Ontario's scientific advisers were barred from access to data on patients during the crisis.