Life in Toronto shackled by SARS

Boston.com By Colin Nickerson, Globe Staff, 4/27/2003

TORONTO - Canceled theater tickets and poker nights have given way to canceled weddings, as crestfallen brides discover they can bring the groom to the altar but can't coax out-of-town friends and relatives to risk the trip to Toronto for fear of SARS.

''We'd planned for June, but keep getting frantic e-mails and calls - `Is it safe?' Everyone's frightened by the idea of Toronto, especially our loved ones in the States,''' said Kathleen McKay, 27, a commercial artist originally from Quebec.

''So now we're wondering whether to make it next year. In Montreal. I mean, who wants to get married in an empty church?''

At Union Station, Canada's biggest rail hub, some arriving passengers slip on surgical masks, or simply clamp a handkerchief over nose and mouth before braving the streets.

''When someone sneezes on the commuter car, people react like it's a gunshot,'' said James Stevens, 39, an executive with one of the city's financial firms. ''Everyone flinches, and eyes go wide.''

Chinese restaurants, which have been all but deserted for weeks, have taken to airing desperate radio ads boasting of disinfected tables and sterilized napkins rather than promoting flavorful salt-and-pepper shrimp or General Tao's Chicken. ''At Mandarin, we have a longstanding tradition of being masters of good health,'' goes one blurb, run by a well-known buffet chain.

Health officials insisted last week that severe acute respiratory syndrome has been all but conquered in Toronto, the country's largest city and its financial center - with 4.6 million people in the metropolitan area, and about half of Canada's corporate headquarters. Yet the city continues to be pilloried and shunned.

There have been 20 SARS deaths in and around Toronto, and at least 268 people have been infected with the disease, by far the worst outbreak of the virulent virus outside Asia.

Residents of the proud Queen City are reeling.

''It's like living in a leper colony,'' said Darsit Singh, a 32-year-old construction engineer. ''I have to keep calling home to India - India! - reassuring my family, `Hey, it's OK, no one's dying in the streets.'''

The World Health Organization stunned Canada last week by issuing a strong warning against ''unnecessary'' travel to Toronto because of the risk of contracting the virus that causes SARS.

Government leaders and public health officials voiced outrage at the advisory, which effectively placed Toronto at the same level of international alarm as such SARS hot zones as Beijing and southern China, where the disease has spread much farther and has exacted a far deadlier toll.

Last week, Mayor Mel Lastman, a blustery former TV pitchman, lashed out at the United Nations health body in an interview with CNN: ''They've never even been to Toronto; they're located somewhere in Geneva,'' he said. ''They're hurting Toronto badly.''

In headlines abroad and at home, Toronto has been dubbed the ''Pariah City'' in this frightening SARS spring. To wit:

British Airways crews have been instructed to stay out of Toronto hotels and to travel to Montreal instead.

Some cruise ship lines in the Caribbean have announced that they will not accept Torontonians as passengers.

Several conference organizers in the United States are starting to demand that anyone from southern Ontario wanting to attend must bring a medical certificate proving he or she isn't infected by SARS.

Australia, Britain, France, Ireland, and Venezuela are among countries that have advised citizens against venturing into southern Ontario. (The United States has advised travelers crossing the northern border to avoid hospitals, to pack a first aid kit, and to wash their hands frequently.)

In Massachusetts, the Marian Fathers religious order has asked 450 pilgrims from Toronto to stay away from an annual outdoor Mass officials scheduled for today at the Shrine of Divine Mercy in the Berkshires.

''Even US baseball teams visiting the Blue Jays have been warned not to mingle with fans,'' the National Post said in a gloomy editorial. ''The WHO advisory can only compound the economic fallout the SARS scare has already wrought in Ontario.''

Toronto hotels are facing the worst slump in occupancy rates experienced anywhere in North America since the 9/11 terror attacks, with more than 70 percent of rooms empty in some cases.

''The SARS outbreak is creating not just a public health crisis; it has become a jobs crisis in Toronto's hospitality industry,'' said Paul Clifford of Toronto's hotel and restaurant union.

Economic analysts fear the damage done by SARS will reverbrate through the entire Canadian economy. David Dodge, governor of the Bank of Canada, warned that national economic growth will be slowed significantly this year because of SARS.

Ted Carmichael, chief Canadian economist with J. P. Morgan Securities Canada Inc., estimated that the outbreak would siphon billions of dollars from the economy and would cut economic growth across the country by half this year.

Public health officials said that Toronto has turned the corner in its fight against SARS, thanks to fast action by physicians and dramatic quarantine measures. At one point, more than 10,000 Canadians were under emergency orders to remain at home, often only because of suspicion that they might have been exposed.

''We're seeing an incredible decrease in the curve, I don't think there is a crisis anymore,'' said Dr. Donald Low, chief microbiologist at Toronto's Mount Sinai Hospital and one of the physicians at the forefront of the battle to contain SARS.

As eight new cases were reported in Toronto late last week, however, Ontario Public Health Commissioner James Young acknowledged, ''We're not out of the woods yet.''

Under intense pressure from the Canadian government, the World Health Organization indicated that on Tuesday it will review its warning against travel to Toronto, according to Canadian officials.

But a top official yesterday said yesterday that the outbreak in southern Ontario is still regarded as one of the most serious in the world. And the organization is especially concerned that the disease might continue to spill from Canada into the United States and other countries. A nursing assistant from Ontario died last week in the Philippines after contracting the disease in Toronto. Her father also died.

There is growing concern among epidemiologists that the Canada strain of SARS may be more virulent than those in Asia.

Canada remained adamant that the economically-devastating travel warning is unwarranted. ''We all believe that the World Health Organization came to the wrong conclusion,'' Prime Minister Jean Chretien told reporters. ''We believe that Toronto is a good place to visit and it is a safe place.''

SARS, which has a mortality rate of about 6 percent, has killed 293 people and has infected about 5,000 in more than 20 countries since first appearing in China's Guangdong Province in November, according to official figures.

SARS arrived in Toronto on Feb. 23, borne by a 78-year-old grandmother who was returning to suburban Scarborough after a trip to Hong Kong, where she contracted the virus from another guest at the Metropole Hotel. The grandmother, Kwan Sui-Chu, died at home on March 5, with the coroner listing ''heart failure'' as the cause, paying no attention to the flu-like symptoms she had suffered.

But Kwan's 43-year-old son, Tse Chi Kwai, contracted the mystery ailment and was taken to Scarborough Grace Hospital, where he came in contact with an estimated 200 doctors, nurses, health technicians, and fellow patients before his ailment was recognized for what it was - a new killer virus hitherto confined to China.

Since then, however, Canadian public health officials insist that the disease has been confined to an ''index'' of persons known to have been exposed directly or indirectly to the original Toronto victims. At least 66 of those infected with SARS in the Toronto area are health professionals.

''There is no evidence of casual transmission of SARS in Toronto and every case can be linked back to the index case,'' said Dr. Paul Gully of Health Canada, the federal Health Ministry.

This story ran on page A1 of the Boston Globe on 4/27/2003.