Scared to death

The Guardian Toronto dispatch Monday April 7, 2003

So far, more than six Canadians have died from Sars. And with so little known about the virus, it is hard to reassure the public, writes Anne McIlroy

The mystery virus known as Sars flew to Toronto late in February inside the lungs of a 78-year-old woman who had stayed at the same Hong Kong hotel as a sick doctor from Guangdong, China.

She died of severe acute respiratory syndrome on March 5, but not before infecting four other members of her family. The five of them unknowingly spread the disease to more than 120 Canadians, many of them health care workers.

Toronto is now the North American epicentre of the outbreak that began last autumn in Guangdong and which Chinese authorities kept secret. Canada's largest city now has more cases of Sars than any place outside of Asia, and the number of suspected cases rises every day.

There have also been confirmed cases in British Columbia, Alberta, Saskatchewan, Prince Edward Island and New Brunswick.

So far, the disease has infected more than 2,200 people in 16 countries, killing more than 70, including more than half a dozen Canadians.

In Toronto, some hospitals and schools have been closed and thousands of people have been quarantined, including one of the key physicians heading the battle to contain the virus.

The public health system is feeling the pressure, especially with so many nurses in quarantine. Most surgeries have been put on hold. Stores have sold out of protective masks. Parents are yanking their kids out of school if they know another child in the playground has been to China.

One of the reasons Sars has frightened so many Canadians is because its early symptoms are common, especially during cold and flu season.

Symptoms include a dry cough, a feeling of malaise and a temperature over 38C (100.4F). It becomes deadly when it leads to pneumonia, which isn't contagious, but happens when the lungs are so damaged by the virus they fill with fluid.

The fatality rate is about 4%, almost twice that of the deadly flu pandemic that swept the world in 1918-1919, killing as many as 100 million people. There is no cure for Sars, although patients are being treated with anti-viral drugs.

The outbreak has also made Canada seem like a dangerous place to visit. A major international conference on cancer was cancelled last week at the last minute. Australia, Ireland and Spain have advised their citizens not to visit Canada because of the outbreak. One disturbing new development is that the disease seems to be infecting more and more children.

In Canada, public health officials are now urging people not to panic. They say there is no need for people to wear a face masks unless they have been in contact with someone who has been infected the disease. Healthy people are being urged to live their lives normally.

Politicians are going out of their way to show they aren't frightened. The federal health minister, Anne McLellan, who insists there is no reason for people to avoid travel to Canada, says she goes to Toronto every week. Paul Martin, the former finance minister widely expected to become prime minister next year when Jean Chretien steps down, made a much publicised trip late last week to visit the Chinese community in Toronto.

Many people have been avoiding Chinese restaurants for fear of picking up Sars, although there is no evidence it is more widespread in the Chinese community than in the general population.

But public concern about Sars will likely continue to rise until the virus has been contained, or until doctors can answer key questions about it. It is still not known for sure what causes the disease, although the leading suspect is a coronavirus that jumped from cows or birds into humans.

Coronaviruses belong to the family of pathogens that cause the common cold and intestinal disorders in humans. A particularly nasty version of a feline coronavirus kills every cat it infects.

Doctors aren't sure how Sars is spread. They suspect it is carried in small droplets, which means people need direct contact with a carrier to get infected. But it may be spread through the air. No one knows if people can be infectious before they are exhibiting any symptoms. With so little known about the virus, it is hard for public health officials to be reassuring.

Email amcilroy@globeandmail.ca Special report Sars Other articles More articles by Anne McIlroy Useful links Canadian government Canada.com CBC Newsworld Canadian Alliance The Globe and Mail Liberal party of Canada