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SARS Was Deadly in Canada. Is the Country Ready for Coronavirus? SARS Was Deadly in Canada. Is the Country Ready for Coronavirus?
(about 8 hours later)
Canada Letter is a weekly newsletter from our Canada bureau, written by Canadian correspondent Ian Austen. Sign up to get it by email.Canada Letter is a weekly newsletter from our Canada bureau, written by Canadian correspondent Ian Austen. Sign up to get it by email.
The SARS virus outbreak in 2003 that infected 375 people in Toronto, killing 44, left behind a widespread physical reminder of that dark time. While they have become often out of order and otherwise neglected in recent years, dispensers for hand sanitizer are still found in most public buildings at their entrances and dotted along their hallways.The SARS virus outbreak in 2003 that infected 375 people in Toronto, killing 44, left behind a widespread physical reminder of that dark time. While they have become often out of order and otherwise neglected in recent years, dispensers for hand sanitizer are still found in most public buildings at their entrances and dotted along their hallways.
The fear that pervaded the Toronto area during SARS resurfaced this week, if to a lesser extent, as the Wuhan coronavirus continued its rapid spread in China and around the world.The fear that pervaded the Toronto area during SARS resurfaced this week, if to a lesser extent, as the Wuhan coronavirus continued its rapid spread in China and around the world.
Traveling alongside that fear is xenophobia and discrimination against people of Chinese origin or people who simply appear to be from China. The public school board in York Region, north of Toronto, issued a statement effectively rebuking more than 9,000 people who signed a petition demanding that the children in a family recently returned from China be kept from their classes.Traveling alongside that fear is xenophobia and discrimination against people of Chinese origin or people who simply appear to be from China. The public school board in York Region, north of Toronto, issued a statement effectively rebuking more than 9,000 people who signed a petition demanding that the children in a family recently returned from China be kept from their classes.
[Read: As Coronavirus Spreads, So Does Anti-Chinese Sentiment][Read: As Coronavirus Spreads, So Does Anti-Chinese Sentiment]
As I write this, four cases of coronavirus have been reported in Canada and the anti-Chinese sentiment appears limited. The health care system is working smoothly, and officials have been open about what they’re doing and what’s going on. That’s a marked contrast to SARS, where chaos and mistakes, all cloaked in secrecy, dominated.As I write this, four cases of coronavirus have been reported in Canada and the anti-Chinese sentiment appears limited. The health care system is working smoothly, and officials have been open about what they’re doing and what’s going on. That’s a marked contrast to SARS, where chaos and mistakes, all cloaked in secrecy, dominated.
The extent of the turmoil in 2003 had dimmed in my memory until I recently read the report from an inquiry Ontario did after the outbreak.The extent of the turmoil in 2003 had dimmed in my memory until I recently read the report from an inquiry Ontario did after the outbreak.
“Our public health and emergency infrastructures were in a sorry state of decay, starved for resources by governments of all three political parties,” Justice Archie Campbell wrote in his final report released in 2006. “The only thing that saved us from a worse disaster was the courage and sacrifice and personal initiative of those who stepped up — the nurses, the doctors, the paramedics and all the others — sometimes at great personal risk, to get us through a crisis that never should have happened.”“Our public health and emergency infrastructures were in a sorry state of decay, starved for resources by governments of all three political parties,” Justice Archie Campbell wrote in his final report released in 2006. “The only thing that saved us from a worse disaster was the courage and sacrifice and personal initiative of those who stepped up — the nurses, the doctors, the paramedics and all the others — sometimes at great personal risk, to get us through a crisis that never should have happened.”
Looking back, two things stand out about Toronto’s SARS outbreak. First, hospitals became the place where most people contracted SARS, 72 percent of them. And of the those patients, 45 percent were health care workers who became infected on the job.Looking back, two things stand out about Toronto’s SARS outbreak. First, hospitals became the place where most people contracted SARS, 72 percent of them. And of the those patients, 45 percent were health care workers who became infected on the job.
Then, after officials believed the crisis had turned the corner — to the point where Health Canada ran advertisements to that effect — they were forced to acknowledge under questioning at a news conference that a second lethal round of infections was underway.Then, after officials believed the crisis had turned the corner — to the point where Health Canada ran advertisements to that effect — they were forced to acknowledge under questioning at a news conference that a second lethal round of infections was underway.
SARS was even less understood than the coronavirus, which is nevertheless surrounded by many unknowns. There was not, among other things, any diagnostic test available for SARS during the outbreak.SARS was even less understood than the coronavirus, which is nevertheless surrounded by many unknowns. There was not, among other things, any diagnostic test available for SARS during the outbreak.
“The commission has not heard of any country or any health system that foresaw SARS,” the 2006 inquiry found. “SARS taught us that we must be ready for the unseen.”“The commission has not heard of any country or any health system that foresaw SARS,” the 2006 inquiry found. “SARS taught us that we must be ready for the unseen.”
As the report repeatedly notes, Canada had an example of the right way to handle outbreaks during SARS. Vancouver’s infection control systems, its well-developed systems for protecting health care workers and its clearly defined hospital protocols for dealing with outbreaks, made it possible for the city to successfully contain its five cases, only one of which involved a health care worker.As the report repeatedly notes, Canada had an example of the right way to handle outbreaks during SARS. Vancouver’s infection control systems, its well-developed systems for protecting health care workers and its clearly defined hospital protocols for dealing with outbreaks, made it possible for the city to successfully contain its five cases, only one of which involved a health care worker.
The coronavirus, so far, isn’t as virulent as SARS, and the number of admissions related to it here remains relatively low.The coronavirus, so far, isn’t as virulent as SARS, and the number of admissions related to it here remains relatively low.
“When I compare this to what I experienced as an emergency physician during SARS, this is a different situation and a better situation,” Dr. Daniel Kollek, a professor of emergency medicine at McMaster University in Hamilton told me. “I think we are more ready.”“When I compare this to what I experienced as an emergency physician during SARS, this is a different situation and a better situation,” Dr. Daniel Kollek, a professor of emergency medicine at McMaster University in Hamilton told me. “I think we are more ready.”
The changes over the last 17 years include better training, better systems for identifying infected patients and more hospital rooms with air filtering equipment. Additionally, clear and consistent updates and instructions from health authorities are now being given promptly to doctors, nurses and hospital administrators.The changes over the last 17 years include better training, better systems for identifying infected patients and more hospital rooms with air filtering equipment. Additionally, clear and consistent updates and instructions from health authorities are now being given promptly to doctors, nurses and hospital administrators.
Canada does still lag, Dr. Kollek said, in planning for handling large-scale emergencies. Among other things, he said, in an era when many hospitals are regularly running at or beyond capacity, there is still no way to discharge patients who are not as seriously ill to free up beds during a crisis. He also said that large-scale health crises could be better handled by initially assessing patients outside of hospitals.Canada does still lag, Dr. Kollek said, in planning for handling large-scale emergencies. Among other things, he said, in an era when many hospitals are regularly running at or beyond capacity, there is still no way to discharge patients who are not as seriously ill to free up beds during a crisis. He also said that large-scale health crises could be better handled by initially assessing patients outside of hospitals.
Times journalists from around the world, including me, are following the coronavirus situation as it develops.Times journalists from around the world, including me, are following the coronavirus situation as it develops.
Among the results of that is a regularly updated map of infections worldwide and a constantly revised briefing. You can find the most recent live briefing via the link at the top of every article we’ve published related to the outbreak, including the map.Among the results of that is a regularly updated map of infections worldwide and a constantly revised briefing. You can find the most recent live briefing via the link at the top of every article we’ve published related to the outbreak, including the map.
[Read: Coronavirus Map: Tracking the Spread of the Outbreak][Read: Coronavirus Map: Tracking the Spread of the Outbreak]
Our correspondents based in China and Hong Kong have, of course, been following developments there closely.Our correspondents based in China and Hong Kong have, of course, been following developments there closely.
Steven Lee Myers visited the shadowy world of Chinese markets that illegally sell live wildlife. As with SARS, coronavirus appears to have jumped from animals to humans through the consumption of wildlife, which, he writes, is “driven as much by the desire to flaunt wealth as by a mix of superstition and belief about the health benefits of wildlife.”Steven Lee Myers visited the shadowy world of Chinese markets that illegally sell live wildlife. As with SARS, coronavirus appears to have jumped from animals to humans through the consumption of wildlife, which, he writes, is “driven as much by the desire to flaunt wealth as by a mix of superstition and belief about the health benefits of wildlife.”
[Read: China’s Omnivorous Markets Are in the Eye of a Lethal Outbreak Once Again][Read: China’s Omnivorous Markets Are in the Eye of a Lethal Outbreak Once Again]
The wildlife delicacy that appears to have distributed the coronavirus to people is bats. James Gorman, a Times Science writer, explains that bats have a unique ability among mammals to carry many viruses with no ill effects to themselves.The wildlife delicacy that appears to have distributed the coronavirus to people is bats. James Gorman, a Times Science writer, explains that bats have a unique ability among mammals to carry many viruses with no ill effects to themselves.
[Read: How Do Bats Live With So Many Viruses?][Read: How Do Bats Live With So Many Viruses?]
Finally, the question on many of our minds: Where is this outbreak headed? Knvul Sheikh, Derek Watkins, Jin Wu and Mika Gröndahl have looked at six factors that will direct the course of the outbreak.Finally, the question on many of our minds: Where is this outbreak headed? Knvul Sheikh, Derek Watkins, Jin Wu and Mika Gröndahl have looked at six factors that will direct the course of the outbreak.
Updated June 16, 2020Updated June 16, 2020
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
[Read: How Bad Will the Coronavirus Outbreak Get? Here Are 6 Key Factors][Read: How Bad Will the Coronavirus Outbreak Get? Here Are 6 Key Factors]
When Rhona Wurtele and her identical twin, Rhoda, were 5 years old, their father strapped skis on them before sending them downhill in Montreal’s Westmount neighborhood. Rhona died last month at age 97. In her obituary, Richard Goldstein write that the “Flying Twins” went on to become the pioneers of women’s skiing in Canada.When Rhona Wurtele and her identical twin, Rhoda, were 5 years old, their father strapped skis on them before sending them downhill in Montreal’s Westmount neighborhood. Rhona died last month at age 97. In her obituary, Richard Goldstein write that the “Flying Twins” went on to become the pioneers of women’s skiing in Canada.
As Parliament began considering the new trade deal that will replace NAFTA this week, President Trump signed it into American law in Washington. Ana Swanson and Jim Tankersley looked into the key changes it will bring.As Parliament began considering the new trade deal that will replace NAFTA this week, President Trump signed it into American law in Washington. Ana Swanson and Jim Tankersley looked into the key changes it will bring.
The fashion sensation, or at least the most exclusive bit of fashion, at the Sundance Film Festival was a special edition jacket from Canada Goose.The fashion sensation, or at least the most exclusive bit of fashion, at the Sundance Film Festival was a special edition jacket from Canada Goose.
Prince Harry and his wife, Meghan, have renounced British taxpayer money as they embark on their new lives as non-royals and part-time residents of Canada. But, as Benjamin Mueller reports, their multimillion-dollar income, while ostensibly private, will come from “a generous mix of public giveaways: medieval landholdings passed from one male heir to the next, sweeping tax relief, indemnity from some laws and exemptions from others, ownership of long stretches of coastline and all the treasure buried in Cornwall.”Prince Harry and his wife, Meghan, have renounced British taxpayer money as they embark on their new lives as non-royals and part-time residents of Canada. But, as Benjamin Mueller reports, their multimillion-dollar income, while ostensibly private, will come from “a generous mix of public giveaways: medieval landholdings passed from one male heir to the next, sweeping tax relief, indemnity from some laws and exemptions from others, ownership of long stretches of coastline and all the treasure buried in Cornwall.”
Travel’s popular 36 Hours series visited Whistler where the high level of the skiing is paired with similarly high prices.Travel’s popular 36 Hours series visited Whistler where the high level of the skiing is paired with similarly high prices.
Shaun the Sheep and the world of Mossy Bottom Farm are among the offerings streaming this month in Canada on Netflix.Shaun the Sheep and the world of Mossy Bottom Farm are among the offerings streaming this month in Canada on Netflix.
A native of Windsor, Ontario, Ian Austen was educated in Toronto, lives in Ottawa and has reported about Canada for The New York Times for the past 16 years. Follow him on Twitter at @ianrausten.A native of Windsor, Ontario, Ian Austen was educated in Toronto, lives in Ottawa and has reported about Canada for The New York Times for the past 16 years. Follow him on Twitter at @ianrausten.
We’re eager to have your thoughts about this newsletter and events in Canada in general. Please send them to nytcanada@nytimes.com.We’re eager to have your thoughts about this newsletter and events in Canada in general. Please send them to nytcanada@nytimes.com.
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