When the World Health Organisation added my hometown of Toronto to the list of Sars hotspots for tourists to avoid, I was just settling in for a three-week holiday. You’d never guess that the city with a population of three million was being held hostage by a disease, apart that is, from a few scared tourists donning masks at the airport and an eerily quiet Chinatown. Torontonians were too cool for masks – and besides, at 16 Canadian bucks (£7) a pop (instead of the usual $1 [45p]), who could afford them?
Canada’s largest city was finally able to breathe a sigh of relief when the ban was lifted just a week later – the outbreak appeared to be on the wane. But not before the damage was done. To fight the faltering tourist economy – the city’s hotels sat two-thirds empty, causing losses of CAN$125m and thousands of layoffs – Sars-Town became a bargain-shopper’s paradise.
But despite all the discounts – including cheap petrol (only in Toronto was gas 50 cents a litre just weeks after the Iraq war), tax-free weekends, and $1 baseball games (we still lost), despite Ontario premier Ernie Eves and Toronto mayor Mel Lastman beaming at you from every television with the news that Toronto was a safe place to visit, Sars has come back with a vengeance. At the time of writing, five people have died in the new outbreak and more than 7,000 people are in quarantine.
Sars is not as scary as you might believe. Granted, it’s unsettling to know that there’s no test, no cure, and it can kill you. But more people die from the flu, or from falling down the stairs than from the mystery virus. Globally, cases can still be counted in four figures.
In Toronto, the number of deaths hovers around 30 and the average age of death is a ripe old 71. Most people who died also had an underlying illness, like the 99-year old woman whose age may have played a role. You only needed to listen to my nurse mom wearing her Sars gear – the beekeeper visor, mask, disposable gown, and gloves – and droning on about how more than 3,000 children die each day from malaria – to know there are more devastating diseases out there, and to feel assured that we’ll beat this one.
But hey, this is the West, and boy, do we ever hate to be reminded of our vulnerability, or even worse, to be put in the same category as those poor Chinese.
What’s more frightening is why the rest of the industrialised world could prevent Sars from spiralling out of control and Ontario couldn’t. We prided ourselves on not being China – but now officials say that the numbers were deliberately lowballed and we let our guard down too soon, perhaps in an effort to restore Toronto’s tarnished image. We knew that all it took was some simple quarantine and health measures to kiss the virus goodbye.
But when Sars seeped into our system in March, our political leaders at all three levels of government laid low at the golf course or outside the province, ignoring all criticism. We were left in the dark to harvest our paranoia. Asian businesses and restaurants were reduced to ghost towns. The disease became linked to Asians rather than Ontario’s very own hospitals, but there weren’t any leaders around to correct the false association until it started to hurt the economy at large.
When the governments finally acted, they seemed to be solely motivated out of the desire to be seen doing something. The Tory government may promise pots of money, but it’s slow in coming unless you count the flashy ad campaign and photo ops. Toronto has a bill of $10m in public health and ambulance costs that has yet to be paid. Health workers have yet to see compensation promised to them by the province for lost wages because of time off in quarantine. Meanwhile, our prime minister remains to be convinced that Sars merits the $717m he freed up to deal with the 1998 ice storm.
The real reason Sars appears so damaging is that it has illuminated the steady erosion of Ontario’s health care system and our blasé approach to public health.
After all, it was Ontario’s conservative government (that incidentally, is on the verge of calling an election) that caused this crisis with their cuts to the public health system in the past few years. The Tories downloaded public health to our cash-strapped cities – it is now the joint responsibility of the municipal, provincial and federal governments but there’s little communication between the three. Just look at the way different parts of Canada dealt with the fatal disease. British Columbia quickly controlled the spread; the province warned doctors about a worrisome flu outbreak in Hong Kong as early as January. Ontario’s doctors received no such warnings.
Infection controls in hospitals are underfunded and remain in a shoddy state. As Sars has shown, our hospitals are what’s killing us – most of them don’t even have epidemic response plans. Many operations, some of which could have saved lives, have been cancelled as hospitals struggled to cope with the Sars outbreak – again.
Then there’s the nursing shortage, thanks to a Tory decision in the mid-1990s to close hospitals and lay off thousands of full-time nurses because they were ‘redundant’. Health minister Tony Clement admitted that it took the Sars outbreak for him to realise that 15 per cent of our nurses were employed on a casual basis, which means that many of them work in multiple hospitals to make ends meet. But when Sars hit, nurses were restricted from moving around in an attempt to contain the virus. Burnout was the next big headache, and hospitals have been forced to rely on private agency nurses who get paid up to five times as much as staff nurses.
It’s time for the governments to forget the PR fuss. They need to pull the plug on their self-congratulatory advertising. What we really need are substantive policy changes to our health system. As for Sars, disbelieve all the hype, hop on that plane while it’s still cheap and take in some real Toronto culture. There’s no better time to explore the city sans Americans and on a shoestring. It’s yours to discover – just stay away from the killer hospitals and pray that you don’t fall ill.