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Response failed health workers SARS report says Labour Ministry effectively sidelined

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  • Response failed health workers SARS report says Labour Ministry effectively sidelined

    Response failed health workersSARS report says Labour Ministry effectively sidelined during crisis
    By Helen Branswell




    A nurse wears protective clothing outside the door of a quarantined SARS patient at Sunnybrook and Women's Hospital, March 17, 2003. (CP File Photo/Kevin Frayer)
    TORONTO (CP) — The final report of a commission into Toronto’s SARS crisis says those involved in the response failed to ensure the safety of health-care workers, who continued to become infected throughout the four months the virus plagued Ontario hospitals.

    The report by Justice Archie Campbell suggests the Ontario Ministry of Labour play a lead role in the response to future infectious disease outbreaks in hospitals to ensure that workplace safety is given the highest priority.

    The 1,204-page report said the Labour Ministry was effectively sidelined during SARS, which claimed 44 lives during the outbreak in the spring of 2003. And it suggested health-care workers would have been better protected if occupational health experts were involved.

    Campbell was ill and unable to attend a news conference Tuesday as the report was released, but the chief counsel for the commission, Doug Hunt, made a statement and took questions.

    Campbell’s report said changes made throughout the health-care and the public-health sectors in the wake of SARS mean that the people of Ontario are safer than they were before the disease hit.



    “He’s found that although the Ontario government and individual hospitals have taken significant steps to improve our level of protection from infectious outbreaks, serious problems still persist and much remains to be done,” Hunt said.

    The report recommended dozens of changes to hospital practices, disease surveillance and provincial public health and emergency legislation.

    Forty-five per cent of Ontario’s 375 SARS cases were health-care workers, and two nurses and a doctor died from SARS.

    The report said hospitals are as dangerous a place to work as mines and factories. But Ontario hospital workers don’t enjoy the same level of workplace protection as workers in those other sectors.

    Campbell said SARS was a disaster waiting to happen, because Ontario’s public health system had been badly neglected by successive governments of various political stripes.

    “He observed that Vancouver certainly did a better job than Toronto in dealing with SARS,” Hunt said.

    “He found that this was a result of a combination of Vancouver’s better state of preparedness and systemic strengths, along with a certain measure of good fortune in how the case came to the attention of Vancouver authorities.”

    Campbell refused to scapegoat individuals, saying that, in the end, all Ontarians are to blame for not demanding the province put better protections in place.

    Hunt said that Campbell is adamant that the report can’t just occupy space on shelves and become covered in dust.

    The government needs to address the issues that was raised in order to prepare for when a pandemic or another new strange disease comes along, Hunt said.

  • #2
    Re: Response failed health workersSARS report says Labour Ministry effectively sidelined

    Can we have a link to this story, please?

    Comment


    • #3
      Re: Response failed health workersSARS report says Labour Ministry effectively sidelined

      The SARS Commission report is here:



      Note that there are preliminary reports, in which there are brief comparisons of SARS to bird flu, and further details of Vancouver's pandemic plans.

      J.

      Comment


      • #4
        Re: Response failed health workersSARS report says Labour Ministry effectively sidelined

        Originally posted by cartski
        The SARS Commission report is here:



        Note that there are preliminary reports, in which there are brief comparisons of SARS to bird flu, and further details of Vancouver's pandemic plans.

        J.
        Thanks so much to all of you!

        Comment


        • #5
          Re: Response failed health workersSARS report says Labour Ministry effectively sidelined

          Even the introduction is dramatic and scathing, IMO.



          The HB article doesn't convey this, nor does Hunt's reply to questions at the press conference.

          The report seems to underline some of the points made by Osterholm in the other thread today.

          J.

          Comment


          • #6
            Re: Response failed health workersSARS report says Labour Ministry effectively sidelined

            Excellent Report

            The main theme of the report 'The Precautionary Principle' is badly needed outside the health-care system as well. The fear of sticking your neck out will delay critical decisions at all levels, a better safe than sorry mentality will serve us all better in the longterm.

            Comment


            • #7
              Re: Response failed health workersSARS report says Labour Ministry effectively sideli

              Further reaction to the SARS Commission report has just been published in CMAJ:

              Four years after the trauma of the SARS outbreak that claimed 44 lives, Ontario health care workers don't feel a whole lot safer. “On the front lines, there is still not trust in the system…. No one will let their guard down,” says Ontario Nurses Association President Linda Haslam-Stroud.


              with major themes of:

              - occupational safety and health protection for HCWs
              - local re-investment in health care after years of decline
              - communication, jurisdiction, surveillance and planning all lacking in the outbreak
              - the development of "CDC North"

              J.

              Comment


              • #8
                Re: Response failed health workersSARS report says Labour Ministry effectively sideli

                Originally posted by cartski View Post
                Further reaction to the SARS Commission report has just been published in CMAJ:

                Four years after the trauma of the SARS outbreak that claimed 44 lives, Ontario health care workers don't feel a whole lot safer. “On the front lines, there is still not trust in the system…. No one will let their guard down,” says Ontario Nurses Association President Linda Haslam-Stroud.


                with major themes of:

                - occupational safety and health protection for HCWs
                - local re-investment in health care after years of decline
                - communication, jurisdiction, surveillance and planning all lacking in the outbreak
                - the development of "CDC North"

                J.
                I wonder if the Canadian nurses feel safer now. I know I do not. No N95 masks in sight. Thanks for the link.

                Comment


                • #9
                  Re: Response failed health workersSARS report says Labour Ministry effectively sideli

                  I highly doubt it.

                  In the same issue of CMAJ is this interesting (to say the least!) association of errors with stressed nursing conditions, in "The Hazards of Nursing":

                  "A staggering 18% of 18 348 Canadian nurses responding to a recent survey say their patients were "occasionally" or "frequently" administered the wrong medication or dose while in their care, according the first National Survey of the Work and Health of Nurses.

                  On the other side of the coin, nurses themselves are more likely to suffer injury, stress-related health problems, or experience emotional abuse from patients, according to the findings of the survey, the largest and most comprehensive ever undertaken on nurses' working conditions, and physical and mental health. "

                  A staggering 18% of 18 348 Canadian nurses responding to a recent survey say their patients were “occasionally” or “frequently” administered the wrong medication or dose while in their care, according the first National Survey of the Work and Health of Nurses . On the other side of the coin


                  ...with the CIHI (Canadian Institute for Health Information) study, 2005 National Survey of the Work and Health of Nurses here:



                  J.

                  Comment


                  • #10
                    Re: Response failed health workersSARS report says Labour Ministry effectively sideli

                    Further implications from the SARS Commission Report in Ontario are being discussed in the leading medical journal (open access):

                    If Ontario had regionalized its health care delivery system like many other provinces, would Toronto's 2003 severe acute respiratory syndrome (SARS) outbreak have been handled better? Would a decentralized and regionalized system mean better integration and communication among the players? It's a


                    Some quotes:

                    "Would a decentralized and regionalized system mean better integration and communication among the players?"

                    "Two major reports have now indicated that communication and connection among hospitals and other health care institutions was clearly a problem in Toronto during the SARS outbreaks. "

                    "It is set up to be discordant," like having a basketball team playing against a hockey team"

                    J.

                    Comment


                    • #11
                      Re: Response failed health workersSARS report says Labour Ministry effectively sideli

                      CMAJ has just published a book review of SARS in Context, Edited by Drs. Jacalyn Duffin and Arthur Sweetman.

                      SARS in context: memory, history, policy Edited by Jacalyn Duffin and Arthur Sweetman; McGill-Queen's University Press; 2006 210 pp Can$29.95 ISBN 978–0–77353–194–9 Lessons continue to be recounted and learned in the long wake after severe acute respiratory syndrome (SARS) entered Canada 4


                      The book is a much shorter account of the Toronto outbreak than the SARS Commission report. The book recounts the "ground zero" outbreak, the context in terms of medical history, and the involvment of the federal government in the situationl.


                      [ Moderators - should not this whole thread be cross-referenced or duplicated in the SARS thread? ]

                      J.

                      Comment


                      • #12
                        Re: Response failed health workersSARS report says Labour Ministry effectively sideli

                        In the same issue of CMAJ, a research paper has been published about the effect SARS had on hospital admisssions for other medical matters. Note the "interpretations" (conclusion) ....

                        Background: Restrictions on the nonurgent use of hospital services were imposed in March 2003 to control an outbreak of severe acute respiratory syndrome (SARS) in Toronto, Ont. We describe the impact of these restrictions on health care utilization and suggest lessons for future epidemics. Methods: We performed a retrospective population-based study of the Greater Toronto Area (hereafter referred to as Toronto) and unaffected comparison regions (Ottawa and London, Ont.) before, during and after the SARS outbreak (April 2001–March 2004). We determined the adjusted rates of hospital admissions, emergency department and outpatient visits, diagnostic testing and drug prescribing. Results: During the early and late SARS restriction periods, the rate of overall and medical admissions decreased by 10%–12% in Toronto; there was no change in the comparison regions. The rate of elective surgery in Toronto fell by 22% and 15% during the early and late restriction periods respectively and by 8% in the comparison regions. The admission rates for urgent surgery remained unchanged in all regions; those for some acute serious medical conditions decreased by 15%–21%. The rates of elective cardiac procedures declined by up to 66% in Toronto and by 71% in the comparison regions; the rates of urgent and semi-urgent procedures declined little or increased. High-acuity visits to emergency departments fell by 37% in Toronto, and inter-hospital patient transfers fell by 44% in the circum-Toronto area. Drug prescribing and primary care visits were unchanged in all regions. Interpretation: The restrictions achieved modest reductions in overall hospital admissions and substantial reductions in the use of elective services. Brief reductions occurred in admissions for some acute serious conditions, high-acuity visits to emergency departments and inter-hospital patient transfers suggesting that access to care for some potentially seriously ill patients was affected.


                        Effect of widespread restrictions on the use of hospital services during an outbreak of severe acute respiratory syndrome
                        Michael J. Schull, Th?r?se A. Stukel, Marian J. Vermeulen, Merrick Zwarenstein, David A. Alter, Douglas G. Manuel, Astrid Guttmann, Andreas Laupacis and Brian Schwartz
                        From the Institute for Clinical Evaluative Sciences....



                        Abstract


                        Background: Restrictions on the nonurgent use of hospital services were imposed in March 2003 to control an outbreak of severe acute respiratory syndrome (SARS) in Toronto, Ont. We describe the impact of these restrictions on health care utilization and suggest lessons for future epidemics.

                        Methods: We performed a retrospective population-based study of the Greater Toronto Area (hereafter referred to as Toronto) and unaffected comparison regions (Ottawa and London, Ont.) before, during and after the SARS outbreak (April 2001?March 2004). We determined the adjusted rates of hospital admissions, emergency department and outpatient visits, diagnostic testing and drug prescribing.

                        Results: During the early and late SARS restriction periods, the rate of overall and medical admissions decreased by 10%?12% in Toronto; there was no change in the comparison regions. The rate of elective surgery in Toronto fell by 22% and 15% during the early and late restriction periods respectively and by 8% in the comparison regions. The admission rates for urgent surgery remained unchanged in all regions; those for some acute serious medical conditions decreased by 15%?21%. The rates of elective cardiac procedures declined by up to 66% in Toronto and by 71% in the comparison regions; the rates of urgent and semi-urgent procedures declined little or increased. High-acuity visits to emergency departments fell by 37% in Toronto, and inter-hospital patient transfers fell by 44% in the circum-Toronto area. Drug prescribing and primary care visits were unchanged in all regions.

                        Interpretation: The restrictions achieved modest reductions in overall hospital admissions and substantial reductions in the use of elective services. Brief reductions occurred in admissions for some acute serious conditions, high-acuity visits to emergency departments and inter-hospital patient transfers suggesting that access to care for some potentially seriously ill patients was affected.

                        Comment


                        • #13
                          Re: Response failed health workersSARS report says Labour Ministry effectively sideli

                          Originally posted by Blue View Post
                          I wonder if the Canadian nurses feel safer now. I know I do not. No N95 masks in sight. Thanks for the link.
                          have alot of n95 masks stocked up and think it only right to donate these to a local hospital with some food when the time comes,cannot blame anyone who decides to take care of their own loved ones at home when they will not be protected at work.

                          Comment

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