*this story was originally published in Canadian Disasters 2006 and Canadian Disasters - 43 True Stories 2013 by Scholastic Canada. Copyright René Schmidt
SARS in TORONTO
The cages in the market reeked of filth and disease. Dozens of wild animals like turtles, snakes, goats, chickens, frogs, giant salamanders and wild civet-cats were kept in dirty cages in the crowded open market in Guangdong Province, China. Many of the cages were stacked on top of each other and these unhappy animals were filthy and sick. Some were dying. Bacteria and viruses from their feces and blood covered the cages. They were to be sold as exotic foods for restaurants in the area. Some people in the region enjoy the unusual flavours. Others believe eating the meat of certain animals gives healing powers. But these animals would cause death instead.
Some of these animals had a strange new virus. It gave them a sickness like a cold. But this virus was different and deadly to humans who might catch it. A few workers who handled cages or slaughtered the animals caught this virus. Perhaps they touched their mouths or rubbed their eyes without washing hands. Perhaps the virus spread from animals sneezing or biting the humans. It really doesn’t matter how. Soon the virus entered their cells as easily as an ordinary cold virus does.
Since viruses cannot reproduce on their own, they invade human or animal cells and use the cell’s ability to make copies of itself. After the virus makes thousands of copies of itself, the cell breaks open and dies, releasing the viruses to invade other cells. The host animal or person becomes sick.
In this case, the virus was a mutation – a type of change in the way the virus works. It was like a common cold, spreading easily in water droplets from person to person, such as with a sneeze or a cough. But it could also survive on surfaces such as door knobs and counter tops for up to 24 hours. This virus attacked the lungs of the victim, causing a serious illness similar to pneumonia. In some cases it caused death. What made it difficult to trace the spread of the illness was that the victim typically would feel fine for days or even a week after being infected.
Workers from the Guangdong market began to arrive at a local hospital complaining of high fever, shortness of breath and muscle aches. They were treated for pneumonia and given antibiotics, but they only got worse. Their family members started getting the same illness, as did doctors and nurses who had treated these patients. Some of the victims began to die as doctors watched their usual treatments fail. Within weeks, in January of 2003, the situation was alarming. Doctors informed the local health department. They had no name for the new illness, did not know how to treat it and could not prevent it. They knew almost nothing about it.
The Chinese Government decided to keep it secret. In China the government can control the newspapers and radio. They didn’t want to admit that they had no cure to this mysterious illness. They also knew foreign travellers would become nervous and not want to visit. Tourism brings much needed money to the region. Unfortunately, sick people travelled to larger hospitals in other parts of China. Doctors and nurses there were not prepared for the new disease and many of them became sick also.
In February 2003 one of the doctors from the Guangdong region went to a wedding in the island of Hong Kong. Dr. Liu Jianlun felt ill and had a bad cough, but he decided it was just a cold and he was well enough to travel. After reaching the Metropole Hotel in Hong Kong he began to get a fever and was taken to hospital. Suspecting he had this strange new illness he warned the doctors and nurses in the Hong Kong hospital to wear masks and gloves when examining him. This warning saved their lives. But others who had stayed at the Metropole Hotel began to be sick. Some had ridden in an elevator with the coughing Dr. Jianlun. Some had served him breakfast and others had attended the wedding with him. In a short time the doctor had passed the deadly virus to more than twenty people.
By now the Chinese government admitted they had an epidemic of a new type of pneumonia. Over 300 people were affected. Hong Kong doctors were quick to realize this was the same illness as in mainland China, but it was too late. Many of the affected hotel guests were already in their own countries. They were back home in Singapore, Vietnam and Toronto, unknowingly bringing a deadly souvenir.
Researchers found the virus was a type of corona virus, a small round virus with points around its edge, looking like a corona, or crown. It looked like a cold virus. And the disease was given a name; S.A.R.S., standing for Sudden Acute (serious) Respiratory Syndrome. Tragically, Dr. Carlo Urbani of Hanoi, Vietnam, the man who first identified and named SARS, was soon dead of it.
Within a week a 78 year old Canadian woman who had visited relatives in Hong Kong became ill. Her doctors in Toronto treated her for pneumonia but she died five days later. She had stayed in the same hotel as the doctor from Guangdong Province. Her son then became ill and died in a Scarborough hospital eight days after that. Family members and health care workers who had helped the mother and son were soon sick and unknowingly spreading the deadly disease to others. Within weeks Toronto was seriously affected by SARS, but very little was known about it.
Ontario health authorities admitted the situation right away and newspapers reported the sickness. The World Health Organization was notified and asked for help in dealing with the crisis. Toronto had by far the largest number of suspected cases. The corona virus was the same as those in Hong Kong. Suddenly people became suspicious of each other and avoided anyone who may have travelled to Hong Kong or China. Chinese restaurants, normally very busy, were suddenly almost deserted. Nobody wanted to take any chances.
Persons who had travelled to China recently were told to call their doctors and stay in their homes and not go to out for at least ten days. Medical workers who may have been exposed to the corona virus were also told to avoid public areas and crowds and wear masks when in public.
Toronto is the most cosmopolitan city in the world. Africans, Asians, East and West Indians, South Americans and people from the Pacific Rim live peacefully side by side. Most Torontonians or their parents are from another country. This makes Toronto a great tourist spot because it is also one of the safest cities in North America. But as the SARS crisis hit, the World Health Organization declared Toronto a high-risk destination and advised people not to travel to Toronto. Tourism almost stopped completely. Those leaving from Pearson International Airport were screened for possible traces of illness. Hotels lost millions of dollars in business.
Health care workers had the hardest time of all. Not only were they in the greatest danger of accidentally getting the disease, no matter how careful they were, they had to carry on and work extra shifts to help fight this terrible disease. They had to wear masks, face shields and gowns to protect themselves and their patients. Medical workers were not allowed to sit close together in lounges or while eating and could not share food during lunch breaks. They kept away from each other, adding to the fearful atmosphere.
All visitors and workers at hospitals were required to submit to a screening before they entered the building. Their temperature was taken and many questions were asked. In some Toronto hospitals no visitors were allowed unless that person was likely to die within a day. Then only one relative could stay with the dying person. Heart-broken families had to decide who would spend the final hours with a beloved grandparent or uncle. All over Canada hospitals were put on alert and restrictions were made. Of Ontario’s 211 hospitals, many ran out of the surgical masks needed to protect everyone.
Early in May of 2003, it was believed there were no new cases of SARS. The World Health Organization lifted the travel ban to Toronto. Hospitals relaxed some of the rules. They believed all SARS cases were known about and isolated. It was not true. In two hospitals, SARS was continuing to spread because the patients were thought to have some other disease. It was a deadly mistake. These few SARS patients quickly spread the disease to 78 others. SARS was not over yet. The travel ban to Toronto was again put into place and restrictions in Toronto hospitals became more serious than ever. Finally, in July, health authorities could say SARS was under control.
The heroes of the SARS epidemic were the medical people. Forty percent of those who caught SARS were nurses, doctors, technicians and cleaning staff. The virus was most easily caught in hospitals. In one hospital fifteen health care workers were infected with SARS while desperately trying to save a life. They had to put a breathing tube down a struggling SARS patient’s throat. Not fully conscious, the patient had torn the masks off several nurses and doctors and his coughing spread SARS viruses to those trying to help him.
Eventually over 23 000 people in the Toronto area were under orders to be quarantined (made to stay at home) at one time or another. But with all the precautions, death still came. Many hundreds of people became exposed to SARS by being in the wrong place at the wrong time.
Forty Canadians died of SARS, including two nurses who contracted the disease caring for others. All were from the Toronto area. 51-year-old Nelia Laroza and 58-year-old Tecla Lin died on July 19th 2003, at the end of the SARS crisis.
The world-wide death toll was much worse. By the end of 2003, the death toll was 774 dead out of 8098 cases in 29 countries. Many experts today believe there were many unreported cases, especially in the U.S.A.
Although the SARS crisis is over, a cure was never found. SARS was contained and the virus died with the victims. But SARS or a disease like it could happen again and cause the deaths of hundreds more.
Why is SARS such a disaster? Every year the Flu kills many more people than SARS ever did. SARS was so serious because it showed how easily a virus like the common cold virus can change into something deadly and very hard to defend against. With world-wide travel so common, new viruses quickly spread and affect thousands before anything can be done. Medical authorities now have returned to strict rules dealing with hospitals and patient care. They are better prepared for a SARS-like crisis in the future. Health care workers wash their hands more often and are much more cautious. Visiting hours are more strictly enforced than in the past. SARS or an illness like it, can easily come again. Wash your hands!