1793.1 Emergency Response System Under Duress: The Public Health Fight to Contain SARS in Toronto (Epilogue)
This epilogue accompanies the cases 1792.0 and 1793.0. This two-part case examines the response of the Toronto and Ontario public health and hospital systems to the outbreak of SARS in the spring of 2003. It describes both the public health system in place at the time SARS came to Toronto and the stress and adaptations which resulted from the onset of the disease--introduced to Toronto by a lone airplane passenger from Hong Kong who, by terrible coincidence, had contact with a SARS victim (the so-called "index patient" who'd brought the illness from mainland China) at a Hong Kong hotel. This crisis management case makes clear that Toronto had great difficulty in coping with the respiratory virus. It emerged as the second hardest-hit city in the world and was slapped with a World Health Organization travel ban, a virtually unprecedented turn of events for a major city in a developed country. The case raises the questions of whether Toronto's problems were the result of long-term under-funding of the public health system and highlights systemic communications problems which came to play a dramatic role in the SARS story. It focuses, as well, on the question of whether quarantine is a useful weapon in the modern struggle against disease and, if so, what form such action should take.