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Canada disputes sars alert { April 25 2003 } Original Source Link: (May no longer be active)
http://www.washingtonpost.com/wp-dyn/articles/A34725-2003Apr24.htmlhttp://www.washingtonpost.com/wp-dyn/articles/A34725-2003Apr24.html
Canada Disputes SARS Travel Alert
Officials Say Rate of New Cases Is Down, but WHO Will Not Rescind Warning
By DeNeen L. Brown
Washington Post Foreign Service
Friday, April 25, 2003; Page A16
TORONTO, April 24 -- The World Health Organization refused today to rescind its travel warning for Toronto, saying that the advisory may even extend beyond three weeks and will not be lifted until there are no more new SARS cases reported in Toronto or "exported" from Canada.
WHO officials said they decided to issue the warning after receiving evidence that SARS cases were "exported" from Canada to the Philippines, the United States, Australia and possibly Bulgaria. The case in the Philippines, officials said, was particularly disturbing because a nurse assistant who traveled from Toronto to Manila may have spread the virus to 60 other people, who are now being quarantined.
WHO officials said they also were concerned about the virus spreading to undeveloped countries where health care facilities are ill-equipped to handle SARS, severe acute respiratory syndrome, which has proved to be a highly infectious and sometimes fatal disease.
The Toronto decision will be reviewed in three weeks, which is considered to be twice the time period of incubation of the disease, WHO officials said. Canadian public health officials furiously defended the city and demanded that WHO drop the advisory it issued Wednesday. They said it could potentially devastate Canada's economy.
Officials said they believe the SARS crisis in Canada has peaked and that the rate of new cases has declined. As of Wednesday, Canadian federal officials reported 330 probable and suspect cases in Canada. Officials of Health Canada, the department of health, said there was no increase in the number of probable cases after Tuesday. In Ontario, officials reported 136 probable and 121 suspect cases. There have been 16 deaths reported, including the 46-year-old woman who died in the Philippines who may have contracted SARS in Toronto. The latest fatality was a 78-year-old woman, who died Wednesday.
"The actions of the WHO are wrong and irresponsible and I demand the WHO rescind this advisory," said Ontario Premier Ernie Eves. "There is no scientific basis for it to be issued." Eves said that officials at the U.S. Centers for Disease Control and Prevention have complimented the city on its handling of the illness. "The CDC has confirmed that the risk of transmission is low in Toronto."
Officials also stepped up enforcement of quarantines. Eves announced that any of the thousands of people still in quarantine would be incarcerated in hospitals if they break quarantine and "put others at risk."
Colin D'Cunha, Ontario's commissioner of public health, said the situation in Toronto appears to be improving. He said there are 89 SARS patients in hospitals, which he said was a decline from 125 two weeks ago. "The numbers show Toronto is safe," D'Cunha said. "We've taken extraordinary precaution. We are extremely disappointed with the World Health Organization. We didn't find their scientific evidence to be convincing."
WHO officials said they made their determination about Toronto based on what they said was evidence that SARS was spreading in the community and that some people who may have contracted SARS in Toronto were traveling to other countries.
"The outbreak in this area has continued to grow in magnitude and has affected groups outside the initial risk groups of hospital workers, their families and other close person-to-person contacts, although all the cases reported have identified links to known SARS cases," WHO said in a statement. "In addition, a small number of persons with SARS, now in other countries in the world, appear to have acquired the infection while in Toronto."
Officials and medical specialists angrily discounted the WHO arguments. Don Low, chief microbiologist at Mount Sinai Hospital, said he believed the decision was based on politics. "I think they were looking for a scapegoat and we are the scapegoat," Low said. "Their decisions don't hold water. Why doesn't Singapore have an advisory?"
"To call it disappointing and troubling would be an understatement," said James Young, Ontario's commissioner of public security. "The WHO acknowledge there is a big difference between the outbreak here and Beijing. They are using a one-size-fits-all definition."
Ontario public health officials said they participated today in a conference call with WHO officials, who they said have declined invitations to visit Toronto. "We pointed out our numbers are going down," Young said. "We are on a descending part of the epi-curve. We remain puzzled they decide to put us on the list now when the problem is improving instead of two weeks ago when cases were rising."
Officials said the cluster of cases in a religious group that WHO was concerned about has not spread beyond 29 members of that group and the two doctors who treated them. "They have gone beyond the 10-day quarantine in the community cluster and there are no new cases on day 12," D'Cunha said.
Young said there is no clear evidence that cases from Toronto spread to Australia, the Philippines or Bulgaria. "They raised the cases in Australia," Young said. "We researched that and do not believe those are SARS cases. They said someone traveled from Toronto to Bulgaria, but they have no idea whether the person was in the East or in the West or whether the person was in Toronto. We are extremely disappointed in the science."
© 2003 The Washington Post Company
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