Tony Clement was Ontario minister of health during the SARS outbreak in 2003.
Imagine your city in the throes of an out-of-control outbreak of a newly emerging disease. This past weekend, with news of the first confirmed coronavirus case in Toronto, it was all too easy to ponder that dreaded scenario.
Like many of you who lived through the experience of SARS in Toronto in 2003, I shuddered as I watched China scramble to grapple with the coronavirus outbreak. And like you, I was concerned when the first case of coronavirus was confirmed here.
I served as Ontario’s minister of health during the SARS outbreak. At that time, we contemplated last-resort contingencies such as school suspensions and the cancellation of public events in Toronto, should the city fail to lock down the spread of the virus.
We avoided the full impact of such scenarios through a combination of factors: the dedication of front-line health-care workers at every level; temporary changes such as limited patient transfers and family hospital visits; the vigilance of the public in taking common sense steps to reduce risk of exposure and transfer; and, frankly, luck. As crippling as SARS was to Toronto, as devastating as it was for many families, it could have been worse.
No jurisdiction can count on luck breaking its way forever. The hard lesson of SARS 17 years ago is this: Complacency about public health by successive governments – including my own – contributed to the challenge of containing SARS. Some of the lessons learned from SARS have better prepared us for another outbreak. For example, when I became federal health minister in 2006, I made it a priority to implement a national pandemic strategy because co-ordinated effort at every level of government – something sorely missing during SARS – would be an asset in the event of future outbreaks.
Some other hard-won lessons from SARS that should be considered now that the coronavirus has arrived here:
Vigilance is the new normal
Anti-infection protocols at hospitals implemented in the wake of SARS must endure. All levels of the health-care system – from family physicians to home-care professionals to hospitals – should be on alert and ever vigilant, especially during respiratory virus season.
Bring the key stakeholders together early
Improvising those relationships in the middle of the emergency is exponentially more difficult. Doctors, nurses, hospitals, ambulance services, testing labs, public-health experts, health ministry officials and anyone else who would be called on to serve the public should be brought together to collaborate on planning and execution before a crisis hits.
During SARS, municipal and provincial officials held daily briefings to align messages to the public and for the sake of transparency. Some questioned the necessity of those briefings. But in a health emergency, accessibility to trusted information is essential to get the public to buy in to mitigation strategies. I can tell you, it was not always pleasant to stand and answer the difficult questions about the crisis, but in the big picture, the public responded to that openness and accountability.
Better co-ordination with global organizations
In the SARS crisis, mismanaged communication with the World Health Organization led to what I and many others believed was an unnecessary travel ban imposed on Toronto. Viruses do not respect international borders, and the WHO has a legitimate and important role in leading the global fight against diseases. We need to ensure the federal government, as the key conduit of information on Canada’s efforts, accurately and efficiently communicates that to the WHO.
Make the outbreak the singular public-health priority
Public-health units provide a variety of vital services to our communities – from infant health to restaurant inspections to disease surveillance and intervention. But in the event of an outbreak, containment must be the priority and all parties should be ready and willing to redeploy resources to bring about a swifter, safer resolution to the crisis at hand.
Finally, in our modern world of integrated economies, concentrated urban living and freedom of movement around the globe, disease outbreaks are a sustained risk. We need to reimagine our concept of what qualifies as a disaster. Any jurisdiction in Canada that becomes a geographical vector for the disease should be eligible for reasonable and validated financial support and compensation, just as surely as we step in to aid areas affected by flood and wildfire.
The lessons of SARS have better prepared us to respond to current and future threats to public health. But that preparation should not lead us to forget the most important lesson of all – complacency is not a luxury any community can afford.