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Fri Jan 12, 2007 at 18:34:49 PM EST
SARS was a tragedy. In the space of a few months, the deadly virus emerged from the jungles of central China, killed 44 in Ontario and struck down more than 3301 others with serious lung disease. It caused untold suffering to its victims and their families, forced thousands into quarantine, brought the health system in the Greater Toronto Area and other parts of the province to its knees and seriously impacted health systems in other parts of the country.
Nurses lived daily with the fear that they would die or infect their families with a fatal disease. The nine-year-old daughter of one nurse asked:
Mommy, are you going to die?
Respiratory technicians, doctors, hospital workers, paramedics and home care workers lived with the same fear.
The Ontario Nurses' Association surveyed its members after the outbreak and found that almost two-thirds felt their health and safety had been compromised during the SARS outbreak. More than half felt their SARS work was not adequately respected or they were unsure if it was respected.
So begins the executive summary of the recently release report of the SARS Commission entitiled: Spring of Fear. (Hat tip to CIDRAP.)This is the third and final report of this Commission, which released preliminary reports in April of 2004 and April of 2005.
The report is is based on public hearings, government and health care provider documents, and confidential interviews of more than 600 people connected with SARS, including the health care workers involved. This report tells the story of SARS and addresses these questions:
| Into The Woods :: Spring of Fear - SARS Commission Report Released January 9, 2006
In the wake of SARS many questions arise, including:
Why does SARS matter today?
How bad was SARS?
What went right?
What went wrong?
Were precautions relaxed too soon?
Who is there to blame?
Was information withheld?
Did politics intrude?
Was SARS I preventable?
Was SARS II preventable?
Were health workers adequately protected?
Are we safer now?
What must be done?
In reading through the Introduction (14pgs) to the Executive Summary (70pgs) of this imposing 1200+ page report, there are some lessons that seem to rise up off the page like the ghosts of those that died and Jacob Marley-like urge us to mend our ways before it is too late.
The point is not who is right and who is wrong about airborne transmission. The point is not science, but safety. Scientific knowledge changes constantly. Yesterday's scientific dogma is today's discarded fable. When it comes to worker safety in hospitals, we should not be driven by the scientific dogma of yesterday or even the scientific dogma of today.We should be driven by the precautionary principle that reasonable steps to reduce risk should not await scientific certainty.
Of the almost 375 people who contracted SARS in Ontario, 72 per cent were infected in a heath care setting. Of this group, 45 per cent were health workers. Most of these workers were nurses whose jobs brought them into the closest contact with sick patients. And this does not show the full burden of SARS on nurses and paramedics and other health workers. In many cases nurses sick with undetected SARS brought illness, and in some cases death, home to their families.
It is easy to forget that everyone makes mistakes and that hospitals acted and continue to act in good faith. Ontario was not alone in its failure to protect health workers during SARS. The challenge of this new disease overcame the extent of their current scientific understanding. That is why it is better to forget dogmatic arguments based on current scientific understanding. That is why it is better to follow the precautionary principle that reasonable action to reduce risk should not await scientific certainty.(Emphasis added)
And that is why it is important to recognize that Vancouver, which was spared the devastation that SARS inflicted on Ontario, had a far greater systemic commitment to the precautionary principle.
SARS taught us that we must be ready for the unseen. That is one of the most important lessons of SARS. Although no one did foresee and perhaps no one could foresee the unique convergence of factors that made SARS a perfect storm, we know now that new microbial threats like SARS have happened and can happen again. However, there is no longer any excuse for governments and hospitals to be caught off guard and no longer any excuse for health workers not to have available the maximum level of protection through appropriate equipment and training.
I would encourage those that can to take time to read through at least the Executive Summary and those portions of the report that might shed the most light on the what may be taking its next emergent step around the world.
Given the length of the report, anyone who finds particularly important segments, it would be much appreciated if you could provide the link to that particular section and let us know what you think of it.
Sping of Fear - The SARS Commission
Spring of Fear
Spring of Fear
Final Report Pages 1-873
Spring of Fear
Final Report Pages 874-1204
SARS and Public Health in Ontario
First Interim Report
SARS and Public Health Legislation
Second Interim Report