SARS SHUTS TORONTO SCHOOL, 6,400 IN QUARANTINE (Nurses' Calls Not Heeded!!!!!)

WashingtonPost ^ | May 28, 2003 | Rajiv Sekhri

[travelnurse]

Yep... the Ontario Nurses Assn., when the SARS epidemic first hit Toronto, were up in arms because they did not have the proper respirator masks for the health care workers.

As with any infectious disease, especially in a hospital care setting, proper protective gear has proven to be very effective in the spread of contagious diseases. These doctors/administrators know that. Of course, when you're lax, and let your guard down, the contamination will spread like a fire.

Their socialized health care system just does not want to pay for the proper equipment for their employees, which is expensive.

We don't have the problem in the states because we use the right equipment, and we don't let our guard down with any infectious/contagious disease.

The Canadian health care system just as bad as a thrid world health-care system.

[per loin]

Perhaps soon we will see health care workers leaving, as in Taiwan. BTW, they had another 50 new cases today.

[travelnurse]

Toronto is now so short on health care workers that they have what is called a 'working quarantine'. Health care workers who SHOULD be in quarentine are allowed to come to work as long as they keep a face mask on and don't use public transit. No kidding.

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Many of their nurses are quitting entirely from what I have heard. I feel bad for the innocent sick people, but it serves the Canadian Govt. Health Right.

[myprecious]

"The risk of getting SARS in this kind of setting (a school) is very low,"

This guy has never been into a school. Kids put everything in their mouths that will fit and put their mouth on everything that will not. I even had a high school boy chew on the seat in front of him the other day on my bus - ripped a big chunk out of the vinyl. Kids are major cootie distributors.

[travelnurse]

Yep... See post #23.

[Bluewave]

I'm going to respectfully disagree one more time.

Even a relatively small outbreak of SARS will overwhelm the American medical system in a matter of days. You have two problems. Personnel and equipment. Do the numbers, there are only a few thousand isolation beds in the entire country with approved ventilation. A few hundred cases in any city will shut down the hospitals.

This is not a political issue. It is public health issue and the ongoing efforts to assign philosophical and management blame are wrong.

How is spread?

How do we stop it?

How do we treat it?

[travelnurse]

I respectfully disagree. I really hate to disagree, even respectfully with a nurse, but, until the route of transmission of the disease is well known and understood, infection control techniques are not going to be effective.

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I respect your opinion, even if you are mistaken in this case.
Gowns, gloves and proper respirator mask have been clinically proven to be a protective barrier against cross-contamination, and very effective. These people have just been lax, and too cheap to provide the proper the equipment.

[PLK]

Nurses have a long history of fighting with administration and others who stand to lose money in the fight for good infection control. For example, hospitals insist we play "musical beds" to maximize census in units with multi-bed rooms. This involves constant moving of patients to match gender, solve roommate disputes, and prevent patients from being subjected to demented or acutely confused patients who are disruptive and upsetting to others.

Unfortunately, this is not good practice in an environment where nosocomial infections (exposure occurs while hospitalized) can be very serious, often antibiotic-resistant, and occasionally deadly. In fact, JCAHO, the institution that accredits hospitals, has issued a "sentinel event alert" about nosocomial infections, and it will result in major rules being issued that will force American hospitals to get a grip on lax infection control practices.

There are many other examples: I recall arguing with a physician about the need to place a patient in isolation because TB was suspected by the nurses based on the patient's history; the M.D. refused because he did not want to "subject" his patient to it. Hello???? He won, the nurses lost - later, the patient proved to be positive for respiratory TB and every nurse in the entire unit had to go on prophylactic TB medications.

I'm sure every nurse on FR could cite a testimonial to this issue.

[GirlShortstop]

Canadian Prime Minister Jean Chretien said Toronto's problem was under control.

I have to ask:  wtf does that guy know about *anything*?!?!

[DannyTN]

"SARS, isn't that like a really bad cold? "

Yeah a cold with a 20% chance of killing you.

A cold that makes the flu look like the picture of health, like a glowing pregnant woman.

[Bluewave]

It appears that we are going to have to disagree. I could go on and on, but we would wind up searching for things to argue about rather than solve the problem.

The cross contamination error rates in gown, gloves, and masks are sufficiently high for me to question their efficacy. It really depends on how contagious this disease turns out to be and how insidious the route of infection is. Suppose it can enter through the ears? How is your mask going to help you there?

[IYAAYAS]

I'll bite

How is spread? Airborne, and surface contamination.

How do we stop it? ?

How do we treat it? can't, only genetic immunity.

[travelnurse]

Nurses, by law are required to protect themselves and others from infectious/contagious diseases in the United States... No matter what the MD or administrator says, it is the nurse's responsibility to take control of the situation to protect herself/himself and others. And hospitals/doctors and administrators are required by law to follow the protocol.

[travelnurse]

Suppose it can enter through the ears? How is your mask going to help you there?

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You wear head gear.

From what I have learned about SARS, (and not what the media is telling us) SARS is considered to be air borne, direct contact, and body fluids/wastes. The same as other many contagious diseases.

[Reagan is King]

Canadian Health Minister Anne McLellan said there "is absolutely no reason not to visit Toronto, to eat in the restaurants and go to shows and lead life in a normal way."

Yah right, I'll fly right up there and visit. Just like I would fly to Taiwan or China right now. NOT! They don't need to worry about tourist dollars right now, they need to take the SARS seriously and quit worrying about WHO travel warnings and their tourism.

[philomath]

just to stir a little: if the hypothesis of transmission from fomites 40 days after initial contamination is correct, how are we gonna deal with the rooms' furniture, beds, etc. prevention of patient-patient transmission looks problematic at this early stage....

[travelnurse]

How do we stop it?

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Stay away from areas where you know there is SARS -- Toronto-- no matter what you read about "it's safe in Toronto", these people are lying through their teeth.

[ChemistCat]

40 days before onset of symptoms is bad, but it's worse if it can be transmitted before onset of symptoms, or if very some people can get a very mild case and still spread it to others who won't. If that's the case, I don't think there's much we can do short of closing our borders now and praying really hard.

[Lucy Lake]

Ping.

[sakic]

Basic infection control guidelines will prevent the spread of any infectious/contagious disease which these people are not doing.

I understand how that would make sense if there was not an incubation period but if as some say, it can be 40 days long, I don't see how basic infection control guidelines could help prevent an outbreak.