Page - 36 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE36 SARS On March 7, 2003, a man was admitted to the Scarborough Grace Hospital in Ontario with symptoms of a respiratory illness. He waited in a crowded emergency department for over 16 hours, setting into motion a chain of infection that would eventually lead to 44 deaths. By March 23, SARS was officially declared a “reportable, communicable, and virulent” disease under provincial public health legislation. The outbreak lasted four months. Health care workers comprised a large proportion of the SARS deaths in Ontario and, while the virus was transmitted within families, there was little community spread.13 When analyzing the outbreak for the province three years later, the Honourable Archie Campbell stated that “[t]he surprise is not that Ontario’s response to SARS worked so badly, but that it worked at all, given the lack of preparation and systems and infrastructure.”14 The Campbell Report, commissioned by the Government of Ontario, also highlighted the “profound lack of awareness” regarding best prac- tices for, and commitment to, worker safety.15 The National Advisory Committee on SARS and Public Health (the Naylor Report), with a national mandate, focused both on limitations in response capacity (training, resources, equipment, institutions) and on the need for greater coordination and communication.16 This report noted that the epidemiological information necessary to respond to the out- break was simply not available in a timely or systematic manner. The disease-tracking platform was a relic from the 1980s; data handling protocols were unclear or non-existent; and there was no central data- base. The Naylor Report looked closely at the need for collaboration between key players. It identified localized problems, such as turf wars between institutions and different practices across public health units (such as the determination of thresholds for quarantine). 13. There was likely little to no asymptomatic spread of SARS, and the incubation time for the virus was much shorter than for COVID-19. 14. The SARS Commission, Spring  of  Fear, vol 1 (Toronto: The SARS Commission, 2006) at 10, online: Archives of Ontario <http://www.archives.gov.on.ca/en/e_ records/sars/report/index.html>. 15. This prompted both constitutional litigation and tort claims by health care prac- titioners: Abarquez v Ontario, 2009 ONCA 374; Lorian Hardcastle, “Governmental Tort Liability for Negligence in the Health Sector” (2004) 30:1 Queen’s LJ 156. 16. National Advisory Committee on SARS and Public Health, Learning  from  SARS:  Renewal of Public Health in Canada (Ottawa: Health Canada, 2003), online (pdf): Government  of  Canada <https://www.canada.ca/content/dam/phac-aspc/migra- tion/phac-aspc/publicat/sars-sras/pdf/sars-e.pdf>.