Case Analysis: “Emergency Response System Under Stress: Public Health Doctors Fight To Contain Sars In Toronto (A, B)”

As some of the major problems of emergency response in the Toronto SARS crisis, the following can be mentioned:

Though Health Canada knew about the spreading of an atypical pneumonia in Asia, and despite the massive arrival at Toronto airport of passengers coming from the Far East, no measures were adopted to monitor these arriving passengers or to alert the medical service about the risk of having to treat patient with the mentioned disease. (VARLEY, 2005)

Not having the proper information, Scarborough-Grace Emergency after being sought by Tse Chi Kwai - a 43 year-old man that in just a few days had lost his mother of what was primarily diagnosed as flue -; whose symptoms were fever, shakiness, difficulty to breath and cough; proceeded with his hospitalization in the emergency area, nearby many other patients. Furthermore, demonstrating Toronto’s lack of preparedness to deal with the new disease, Mr.Kwai’s difficulty to breathe was relieved by the usage of BiPAP, lately recognized as responsible for spreading the infectious virus more severely. (VARLEY, 2005)

By that time, though the disease had not still been given a name and though its actual gravity was not entirely known, medical care professionals should have been alerted of the possibility of facing patients infected, and to treat any suspect cases with all the precautions involved in a highly contagious disease, for example isolating the patient.

Facing SARS, Toronto’s emergency medical system proceeded without the necessary precaution; once its professional didn’t even consider the possibility to be in contact with a dangerous and unknown infectious disease.

The lack of information, other the endangering other patients that sought for medial care, also put at risk the heath of doctors, nurses and other medical assistants. Used to treating infectious diseases without the proper protection equipment, such as gloves, goggles, gown and masks, the medical staff treated Tse, and other patients infected with SARS, without any precaution. The mentioned careless procedure contributed for the infection of many medical professionals, and the consequent spread of the disease in Toronto.

While in the middle of the SARS crisis, it became clear that there was a considerable confusion about who was, indeed responsible for overcoming the crises and what was the exact attribution of each department involved. The low synergy between the Toronto Public Health (THP) and the Ontario Public Health Department, contributed to a poor job of tracking possibly SARS infected people and the uncontrolled diffusion of the disease.

Enhancing the absence of leadership, most of the local, provincial and federal politicians did not get involved with the crisis. (VARLEY, 2005)

Considering that according to the laws of Canada, THP was responsible for controlling infectious diseases inside Toronto’s borders and according to Ontario’s law requirements THP had to assign to each medical facility, personnel with the attribution of participating in the internal infectious control committee, managing вЂ" additionally вЂ" the tracking of diseases that potentially threaten the public health. Unfortunately, because THP didn’t supervise infection control in the hospitals and other medical facilities, it had a low interaction with medical staff, and that fact contributed significantly to making very difficult THP’s job of identifying SARS cases. (VARLEY, 2005)

With the evolution of the SARS crisis, the competent authorities declared the situation an emergency, activating the Provincial Operations Center (POC), and assigning as its co-managers Colin D’Cunha and Jim Young. (VARLEY, 2005)

The co-managing came to show its self as a trouble in communication and decision making process.

Facing the lack of expertise on Ontario’s Public Health in matters such as infectious and epidemiological analyses, POC created units to take care of those aspects. In resume there wasn’t a plan on how to proceed in infectious disease crisis, and a bureaucratic network was created by POC to orient the medical facilities on how to proceed when facing a suspect or probable SARS case. (VARLEY, 2005)

The inexistence of a plan made all de decisions harder to be taken. There were no pre established protocols, reason why all the strategies were being tried in first hand and every time one of them failed the crisis deepen, for example thought the Healthy Ministry recommended all medical professionals in Grater Toronto to use N95 masks, there weren’t that many masks in the Canada market and the insufficiency of masks made various hospital