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Looking Back To SARS I/II Outbreaks and Reflecting on The Current Public Health Crisis

The capital city of the Canadian province of Ontario is known for the city’s fine art, culture, and cuisine, and is one of the most multicultural communities in the world (Varady pg. 3). On weekdays from 8:00 a.m. to 4:00 p.m., students, parents, and members of the community alike adhered to a strict regimen. Everything in their lives was controlled. By mid-April, 2003, a viral respiratory disease of zoonotic origin caused by severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1) secured human-to-human transmission, forcing “a provincial emergency to be declared on March 26” (May, pg. 5) in Toronto, Canada.


The vicious fight against the destructive virus was a complex and stressful skirmish for the citizens of Toronto. Larissa May, MD, and Richard Schabas, MD FRCPC have been dedicating their lives to exploring and researching the processes and scientific mechanisms underlying medical emergencies. Both May and Schabas documented and analyzed how politicians, medical professionals, and Canadians behaved to the public health crisis of SARS.


The origin of SARS — believed to be in Guangdong Province in China — had a cluster of pneumonia-like cases that began to arise, particularly from frontline health care workers. Similarly, on Dec. 31, 2019, The Wuhan Municipal Health Commission issued a health report regarding several cases of pneumonia among health care workers in the city of Wuhan, China (Wuhan City Health Committee). Public health officials of the Wuhan Health Committee told the public, “[t]he disease is preventable and controllable” however no measures were taken to contain the virus. In comparison, the Chief of Staff at the North Toronto General Hospital (NTGH), Dr. Bill Osler was “sanguine,” about the pneumonia cases, and implemented strict precautionary measures, and “shared his concerns on a biweekly teleconference call with other public health officials” at the onset of the outbreak in 2003 (May, 5) marking a stark difference in leadership.


By April 23, 2003, the World Health Organization (WHO) issued an official travel advisory — a recommendation to not visit Toronto for nonessential travel. By this time, a once flourishing economy now looked grim. For 20 days following the travel advisory, “SARS was gone, almost as suddenly as it had arrived” (May, 5). While the incubation period, set for 2-14 days, was quite short, the virus swiftly made its way back into the maple leaf territory.


Taking lessons learned from our current pandemic, SARS-CoV-2, the virus that causes COVID-19 (coronavirus disease 2019), letting our guard down too soon can be a fatal move. Instead, it is important to learn from our mistakes, remain vigilant, and proceed with caution in the subsequent months to avoid a resurgence of new infections.


In 2003 in Toronto, elected politicians urged the W.H.O. to release travel advisory recommendations for their city. During Dr. Bill Osler’s biweekly meetings, public health officials shared an attitude of “SARS is over…[t]ime to move on” (May, 6). In the early days of our current pandemic, once Governors dropped stay-at-home orders, the mindset was quite similar. In July 2020, over 150 demonstrators gathered at an anti-mask rally in Salt Lake City, Utah with some carrying posters that read “no masks” and “it [masks] doesn’t work anyway. Not for me and not for my kids" (Tanner, The Salt Lake Tribune).


Along similar lines, the COVID-19 pandemic has been politicized — from mask-wearing, vaccine mandates, restrictions, and more. Around the world, many regions have suffered far more gravely from the crisis e.g. U.S., India, and Brazil than others. One factor that has contributed to significant casualties is government policy responses. I have witnessed first-hand government officials politicize health procedures, such as mask mandates or vaccine passports. On a matter such as public health, having a leader who has well-rounded knowledge, or an appointed official to advise the leader regarding health outbreaks can mean the difference between losing a couple of lives or tens of thousands. In May and Schabas’s case study, a politicization of the public health mandates, or ridiculing top infectious disease specialists is a key difference between SARS I/II and our current pandemic.


Lastly, a stark difference in how government officials tracked initial cases of SARS I/II and SARS-CoV-2 could have assisted in lowering the level of community transmission and infection from international personalities and residents of Toronto. In Toronto, during SARS II, hospitals screened visitors and patients upon their entry, “[i]ronically…[p]eople should have been screened on the way out, not the way in,” says May and Schabas. During the initial phases of the pandemic, the U.S. C.D.C and state governments were supplied with contact tracing tools, and kits for tracking cases.


As the U.S. reached record level of daily cases, deaths, and hospitalizations, fueled by the deadly Omicron variant during January it is important to reflect on the Toronto case study and continue practicing safe measures — mask-wearing, getting vaccinated, etc — until the level of community transmission is at low-figures for a duration (beyond the incubation period) of time.



Works Cited


May, Larissa, and Richard Schabas. “The Toronto Severe Acute Respiratory Syndrome II Experience.” Essential Case Studies in Public Health: Putting Public Health into Practice, by Katherine Hunting and Brenda L. Gleason, Jones & Bartlett Learning, 2012, pp. 5–13.


Tanner, Courtney. “In Separate Rallies, Utahns Protest Mask Mandate and Demand In-Person Classes.” The Salt Lake Tribune, 15 July 2020, www.sltrib.com/news/education/2020/07/15/packed-meeting-utah/'/.


Varady, David P. “Desegregating the City.” Desegregating the City Ghettos, Enclaves, and Inequality, State University of New York Press, 2005, pp. 1–3.


Wuhan City Health Committee. “Notification of Wuhan Municipal Health Commission on the Current Situation of Pneumonia in our City.” Wuhan Municipal Health Commision, Wuhan City Health Committee, 31 Dec. 2019, 13:38:05, web.archive.org/web/20200109215413/wjw.wuhan.gov.cn/front/web/showDetail/2019123108989.



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