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Biotech / Medical : SARS and Avian Flu -- Ignore unavailable to you. Want to Upgrade?

To: RealMuLan who wrote (732)	5/6/2003 8:09:17 PM
From: RealMuLan	Read Replies (1) \| Respond to of 4232

The really bad news about SARS By MARGARET WENTE Tuesday, May 6, 2003 - Page A17 globeandmail.com When Toronto health officials need to test someone for SARS, they can't get the results locally. They have to send the patient's samples to Canada's most advanced microbiology lab, the one that deals with the world's newest and most dangerous infectious diseases. This lab is in Winnipeg. Why Winnipeg? After all, that city is not among our top medical centres. In fact, it's not easy to get top scientists to go work there. This essential lab is in Winnipeg because that was the hometown of a previous federal health minister, who cut a deal to throw some patronage its way after the city lost a big aerospace contract, also for political reasons. This is how we run public health in Canada. In a devastating story on Saturday, Globe reporters Carolyn Abraham and Lisa Priest revealed other shortcomings in the system that's supposed to protect us from the next pandemic. It's a mess. There's no co-ordination. There's no way to gather, share and communicate fast-changing information quickly. Worse still, nobody's in charge. Thanks to near-heroic efforts by public health officials, we managed to fight off a SARS fire spreading at lightning speed with an organization about as sophisticated as an improvised bucket brigade. Under the circumstances, it's a miracle we got it under control. "SARS was an accident waiting to happen," said William Bowie, an infectious disease specialist at the University of British Columbia, who was astonished at how badly equipped the province was to fight the outbreak. "Ontario does not seem able to pull together an integrated effort, either for pandemic planning or to deal with bioterrorism." Ontario's fragmented public health system has been hit by years of funding cutbacks. The province no longer has a decent public microbiology lab. But the organizational and information problems may be even worse. The province has 37 different public health units, each with different reporting systems and no common database. So doctors can't connect patient information with lab results. Comprehensive data are hard to gather, and there's no system in place to analyze them anyway. Public health officials aren't even able to broadcast urgent bulletins to hospitals and doctors by computer. Any ordinary business has better information systems than our public health system does. Meantime, government bureaucrats are so obsessed with confidentiality that they can't decide whether officials in Toronto should be allowed to peek at data from York Region. And they are obsessively concerned with privacy, at the expense of public safety. When public health officials were desperate to contact the seatmates of an infected GO Train rider, the only information they initially dared to release was her gender. Later, they boldly told us she was a nurse. They stalled on disclosing the name of the religious group where 500 people were exposed, in case someone might discriminate against them. For a time, many officials and politicians appeared more horrified by the theoretical spread of discrimination than by the actual spread of SARS. It reminded me of the days after 9/11, when it was considered rude to mention that the terrorists were from the Middle East. But fighting viruses is like fighting terrorism. You can't do it with a few small-town cops on the beat. You need something a little more sophisticated. The Americans have the powerful Centers for Disease Control and Prevention, an arms-length agency with enormous clout and a budget of $7.2-billion. Needless to say, its infectious-diseases lab is not a thousand miles away from a major medical centre. But it's unlikely that we'll ever have our own CDC, because public health is a provincial responsibility, and that means nobody would stand for it. In Canada, we never let a sensible idea get in the way of politics. I was on vacation in Europe last week (they let me in after I declared that I was SARS-free), and saw how Toronto's reputation has been trashed around the world. "Could the spread of SARS have been prevented?" asked Time, insinuating that we botched it. The New York Times has been particularly brutal. One front-page piece purported to document a disastrous "chain of missteps," and another one last Friday suggested that health officials had withheld information about two fresh SARS cases until we had finished lobbying the World Health Organization in Geneva to change its mind. Many of these allegations were plain wrong. And our mayor made it worse when he went on CNN and bragged that he'd never heard of the WHO: "I don't know who this group is." He left the unfortunate impression that we don't have a clue what we're doing up here. I hate like hell to admit it. But in too many dangerous ways, we don't.