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Toronto: New SARS outbreak provokes nurses protest
By Lee Parsons
10 June 2003
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Several hundred nurses demonstrated June 4 outside Scarborough
General Hospital in Torontos east end to demand better protection
for health care workers treating suspected SARS (severe acute
respiratory syndrome) patients. They also demanded that Ontarios
Tory government order a public inquiry into the handling of the
Toronto SARS outbreak.
Outside of the Asian-Pacific region, no city has been more
adversely affected by SARS than Toronto. At least 32 persons have
died of the disease in the Toronto area since last March and there
continue to be more than 60 active SARS cases.
Last month, government officials and medical experts announced
that all transmission of SARS in Toronto had ceased. But on May
22 and 23, they were forced to concede that a new cluster of SARS
carriers had been discovered and that this fresh outbreak was
due to undetected cases of SARS infection within Torontos
hospitals.
Amongst the complaints raised by the Ontario Nurses Association
is that hospital administrators brushed aside the suspicions of
several nurses that some of their patients had contracted SARS.
Several of the persons in question later proved to be SARS carriers.
The medical rationale for dismissing the nurses suspicions
was that no link could be established between the patients they
suspected of having SARS and any person known to have contracted
the disease. But given the fever-pitch campaign that Canadian,
Ontario and Toronto politicians and business leaders mounted to
overturn a World Health Organisation (WHO) advisory against travel
to Toronto and then declare the city open for business,
there is little doubt that there was an official mindset againstif
not outright resistance toentertaining the notion the SARS
crisis might not be over.
Nurses from North York General where the disease re-emerged
three weeks ago, told the Toronto Star they were admonished
by the hospitals SARS management team co-chair for overreacting.
Dr. Barbara Mederski is alleged to have said, There was
no reason to keep alerting public health of individuals
the nurses thought could be SARS carriers because we [dont]
have a problem.
Wednesdays protest also demanded that those nurses coming
in contact with SARS patients be given better equipment, including
protective suits.
The heightened concern over contracting the disease is well
founded according to health care experts. Ugis Bickis, a consultant
on environmental hygiene at Queens University in Kingston,
Ont., says health care officials ignored warnings from him and
others that the surgical masks being dispensed to Toronto nurses
and other health care workers would not protect them from a highly
contagious disease like SARS.
Surgical masks are estimated to remove up to 50 percent of
airborne contaminants, while the more expensive N95 can block
up to 95 per cent. Although Health Canada has now stipulated that
N95 masks should be used when there is a danger of SARS infection,
union officials report that some health workers are still being
given the lower-quality masks.
It also has come to light that at least one quarter of the
Toronto hospitals designated to treat SARS patients do not have
negative-pressure rooms. Such rooms contain air in a given area
and are considered the only safe method for limiting the spread
of infection in a hospital facility. Dr. Colin DCunha, chief
medical officer of health for Ontario, had previously said, No
patient will be moved to a hospital that doesnt have one.
Yet this week, many hospitals were still in the process of converting
rooms to negative-pressure. According to Dr. Ted Boadway, the
Ontario Medical Associations health policy director, What
you cant say is that anybody was ready for this because
nobody was.
Last Wednesdays demonstration also demanded that nurses
be given double pay in light of the danger that they run of contracting
SARS. Nurses were outraged when they learned that nurses hired
through temporary agencies to deal with the staffing shortage
produced by the SARS crisis have been given such premiums, while
those with full- or part-time jobs, and who have borne the brunt
of the fight against SARS, have continued to be paid at the regular
rate.
Ontario Tory Health Minister Tony Clement has since agreed
to pay the higher rate to front-line workers at four
affected hospitals in the Toronto area: Scarborough General, North
York General, St. Michaels and William Olser Health Centre.
He drew the line, however, at raising pay rates for health care
workers not specifically designated to deal with SARS patients.
An underlying issue for nurses is the drastic staffing cuts
that Ontario hospitals have made over the past five years. In
the late 1990s, more than 10,000 nursing positions were eliminated;
and today, half of all nurses have only casual or part-time jobs.
The casualisation of nursing was a major factor in
the initial spread of SARS, as nurses who are forced to work at
two or more hospitals to make ends meet unwittingly carried the
infection from one hospital to another.
The SARS outbreak has exposed the damage wrought to Ontarios
public heath and hospital systems by the massive cuts imposed
by the federal Liberal and provincial Tory governments. That the
Tories themselves recognise this is underscored by their categorical
rejection of the nurses call for a public inquiry. According
to Premier Ernie Eves and Health Minster Tony Clement, an inquiry
would be too adversarial and would result in finger-pointing.
Instead, the government is proposing to have medical experts conduct
a review of how the crisis was handled.
No doubt, the government fears a repeat of the public inquiry
into the Walkerton water contamination tragedy. It found that
Tory cuts to the Environment Ministry and privatisation and deregulation
of water-testing had contributed to the deaths of seven people.
See Also:
Canada: Budget cuts played
pivotal role in SARS crisis
[24 May 2003]
The science and sociology
of SARSPart 1: Viruses and the nature of present outbreak
[12 May 2003]
The science and sociology
of SARSPart 2: Science, internationalism and the profit
motive
[13 May 2003]
SARS outbreak exposes public
health decay in Toronto
[25 April 2003]
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