Environmental Engineering Reference
In-Depth Information
in a way that must be respected. this, of course, became all too clear in the case of
SarS.
From Tinkers to Guardians: The Effect of Canada's Experience at Home
SarS dramatically reinforced the inescapable reality of Marshall Mcluhan's 1964
characterisation of this world as a global village (national advisory committee
2003). It became very clear that germs do not respect borders. In this village, canada
was affected more severely than any other country in the western hemisphere. a total
of 438 people became infected (Health canada 2008); 44 of them died, including
three healthcare workers. the response to the outbreak paralysed a major segment
of ontario's healthcare system for weeks and resulted in more than 25 000 residents of
the greater toronto area being placed in quarantine. the psychosocial effects of
SarS on healthcare workers, patients, and families continue to be assessed even
today. However, this is only the acute human face of SarS. the overall impact
extended further.
When the World Health Organization (wHo) warned against unnecessary travel
to toronto in april 2003, visits to the city plummeted and rock concerts, sporting
events, movie shoots, and conventions were cancelled or relocated. as the naylor
report identified, the estimates, based on the volume of business compared to usual
seasonal activities, suggested that tourism sustained a loss of ca$350 million,
the reduction in airport activity cost ca$220 million, and non-tourism retail sales
were down by ca$380 million in 2003 (national advisory committee 2003, 211).
Ultimately, direct and indirect costs in ontario added up to more than ca$2 billion in
revenues and tourism jobs, and the number of non-residents entering the country fell
by 13 percent, affecting tourism throughout the country. For example, the province
of Quebec was affected, despite not having a single reported case of SarS.
the SarS experience in canada was a failure of both communication and
science. Primarily, the authorities did not know what they needed to know and
therefore could not pass on crucial information. what was the mode of transmission?
No one knew. What was the incubation period? No one knew. And—significantly—
how could authorities reassure people, or explain what they did not know—namely,
that it was a hospital-based disease spread by intimate contact? no one knew. In
short, it was a tremendous failure in terms of what David naylor later called the four
c's: collaboration, cooperation, communication, and the clarity of who does what
when.
as a result of this failure, the authorities were forced to re-evaluate their ability
to share information within a complex federal system—across different levels of
government and among hospitals, healthcare providers, and local public health
offices, and even across provincial borders. In some cases, it was reported that
data sets would not be shared because it was not clear who would be the principal
investigator for that particular study. In other cases, the data were unclear whether
infection started with one patient who went to two hospitals or two patients who went
