Seachange Bulletin #111

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Seachange Bulletin # 111: Tribute to Canadian Nurses: SARS

Editor¹s Note: Seachange Bulletin returns after a three-month gap in which nurses and their allies have been more engaged that ever. These occasional bulletins celebrate the revolution in nursing and bring important news and views to nursing, healthcare and labor activists. Thanks to Bill Bumpus of Union Web Services and the Somerville (Massachusetts) Labor Party, these bulletins are posted at <http://www.seachangebulletin.org>. Because of technical difficulties and a change in ISP, the email data base for these bulletins has been manually transcribed. I apologize in advance to those who are mistakenly on this list, and to any who may have been accidentally dropped. Let me know if you would rather not receive them, or if you know of those who wouldn¹t want to miss any news. Seachange Bulletin can be readily viewed on the Internet once posted. - Sandy Eaton, RN, Quincy, Massachusetts, USA

When We Can't Care, Everyone Hurts

Let's Work Together to Promote Safety, Dignity and Respect in the Workplace
Occupational Health and Safety, Impact of SARS the Focus for Nursing Week
ONA Leaders Meet with Nurses in Ottawa and Waterloo

Ottawa - The impact of SARS on front-line nurses will be the main topic as Ontario Nurses' Association (ONA) provincial leaders continue to meet with members in Ottawa and Waterloo today during Nursing Week, May 12-18. ...

Slow response may have spread SARS, say nurses
Canadian Press, May 27, 2003
<http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&call_pageid=971358637177&c=Article&cid=1052251669054>

The union representing nurses in Ontario added its voice today to the criticism of how the latest SARS outbreak was allowed to develop. It said nurses in two Toronto hospitals reported concerns about possible SARS cases days before public health officials closed units, isolated cases and put people into quarantine. Meanwhile, fallout from the new outbreak may have led Ontario's governing Conservatives to abandon plans for a spring election. ...

Why we need more full-time nurses
Adeline Falk-Rafael, Toronto Star, May 29, 2003
<http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&call_pageid=971358637177&c=Article&cid=1052251679356>

As another SARS outbreak hits Toronto, nurses are again restricted from working in multiple locations to contain the spread of the disease. With 15 per cent of registered nurses in Ontario working for more than one employer, organizations and patients will starve for nursing care. And, 12,000 RNs will starve for a decent income. Compounded by an already exhausted workforce, the system can be thrown into total chaos. But this chaos isn't the fault of the SARS virus; it is ill-conceived policies and poor human resources management. What will it take for the government to act? A month ago Health Minister Tony Clement said he was "surprised" about the level of casual nurses in the workforce. However, it appears the minister's surprise faded quickly because nothing has changed in Ontario. ...

Untie nurses' hands: SARS is a full-time fight
Doris Grinspun, Toronto Globe & Mail, May 30, 2003
<http://www.globeandmail.com/servlet/ArticleNews/TPStory/LAC/20030530/CONURSE//?query=nurses>

Registered nurses in Ontario want to regain control of their practice. Who can blame them? They're trying to make the most of an impossible situation created by years of misguided policy decisions by the Ontario government and health-care employers. These tactics encouraged - sometimes forced - RNs into private staffing agencies in an effort to find job opportunities, better working conditions and higher pay. The health-care budget cuts in the mid-1990s led to massive layoffs of full-time nurses. Employers created a more flexible, "accordion-like casual work force" that was supposed to expand and contract on demand. As cost-cutting policies collided with reality, we got a nursing shortage of epic proportions. Agency RNs who expected to be brought in only occasionally to resolve last-minute crises are now filling gaps on a regular basis. Many employers, having squeezed out any flexibility in their own permanent nursing staff, rely heavily on agency nurses. Agencies are becoming an employer of choice for a growing number of RNs. This is the "new normal." ...

Deal will lighten load for nurses

Same pay for shorter shifts at affected units
Higher pay for agency nurses still a sore point

Nurses working under stressful conditions in SARS-designated hospitals will be working shorter hours for the same pay under a deal worked out among the profession's union, hospitals and the province. The deal covers only those nurses working in the SARS-designated (also called "alliance") hospitals' emergency departments, intensive care units and SARS units. The Ontario Nurses' Association, the union representing the province's nurses, the Ontario Hospital Association, other unions, and the health ministry have "worked out a way to remunerate nurses who are going to be working in the SARS alliance hospitals," Health Minister Tony Clement told reporters yesterday. "The issue has been resolved." However, only the SARS-designated nurses working in the emergency departments, the intensive care units and in the SARS units are covered under the deal.   ...

Nurses point finger at govt
The Straits Times, May 31, 2003
<http://straitstimes.asia1.com.sg/sars/story/0,4395,192061,00.html?>

Toronto - Nurse Carol Tough is angry. The very people who sang her praises as one of the front- line health-care workers have let her down, she says, because restrictions designed to stop the spread of Sars were eased and the virus has come back with a vengeance. For the second time, the 40-year-old emergency room nurse at The Scarborough Hospital is isolated at home in a 10-day quarantine, reported the Toronto Star. The nurse of 16 years blames the government for the new outbreak in Toronto, which flared up in late April and early this month but was first detected only last week. ...

SARS alert ignored: Nurses

Doctors deny they failed to heed warnings about family
`There was no link to any SARS patients:' North York MD

A family cluster of five people with SARS-like symptoms went undetected at North York General Hospital in the weeks leading up to the announcement that a new wave of the deadly respiratory infection was sweeping through the hospital. Nurses say they raised serious concerns which were dismissed by doctors. Even a member of the exposed family pleaded with hospital staff: "Does anybody realize we all have this thing?" Still, not enough was done, charge two emergency room nurses who spoke to the Star yesterday on condition of anonymity, for fear of being fired. "There was a hurriedness to be done with SARS," said one. ...

Toronto SARS cases rise
Lesley Wroughton, Reuters, June 1, 2003

Toronto - Toronto has reported more cases of SARS and says it may have caused the deaths of four people at a hospital on the edge of the city, which could have wider ramifications for its battle against the virus. Public health officials said on Saturday it was still doing autopsies on the four who died earlier this week at the Rouge Valley Centenary hospital east of Toronto and it was not yet clear whether the deaths were from SARS. The Rouge Valley hospital was not on the list of SARS-affected areas but officials have now closed its emergency units and walk-in clinics to the public as a precaution. ...

Nurses demand SARS probe

Officials investigating four deaths feared linked to disease
Mourners at R.S. Kane Funeral Home urged into isolation

Ontario's nurses are calling for an independent review to determine why warnings of Toronto's latest SARS outbreak went unheeded by senior North York hospital staff. The demand for an inquiry by Doris Grinspun, executive director of the Registered Nurses Association of Ontario, came as public health officials confirmed that four recent deaths are being investigated in connection with SARS. The officials have also urged more people into isolation. Grinspun, whose organization represents 16,000 Ontario nurses, has called for a team of outside experts to launch a public inquiry, examining what she says were repeated warnings from nurses that the virus had entered North York General Hospital. ...

Toronto nurses say SARS warnings ignored
Helen Luk, Associated Press, June 2, 2003

Hong Kong - A seventh front-line Hong Kong health care worker died of SARS, it was announced yesterday, and Canadian nurses accused hospital officials of ignoring warnings of Toronto's latest outbreak, which claimed another victim. In Taiwan, officials handed out free thermometers in an island-wide ''take your temperature'' campaign amid signs that containment efforts were paying off. The number of daily infections remained in single digits for the third day in a row. China reported no new SARS deaths yesterday and two new cases on its mainland, the lowest figures for a single day since authorities began reporting them on a daily basis in April. The death toll remained at 332 out of 5,330 cases. Meanwhile, the global death toll approached 770 with more than 8,300 people sickened since the severe acute respiratory syndrome first appeared in southern China in November. Most of the victims have been in China and Hong Kong. In Hong Kong, there were three more deaths, including a 53-year-old ward attendant at Prince of Wales Hospital who was infected with SARS while caring for patients in March. The territory has announced 281 SARS deaths. The deadliest outbreak outside Asia has been in Canada's largest city, Toronto, where authorities thought they had beaten the disease until a cluster of infections was found last month in two city hospitals. Health officials reported yesterday that an unidentified 60-year-old woman had died the day before. The woman was exposed to SARS while in the hospital, but was not a health care worker, said Dr. Colin D'Cunha, Ontario's commissioner of public health. ...

Walkerton-style probe urged in SARS outbreak

Nurses may make request today
Officials probe suspicious deaths

Ontario's plan to review how officials handled Toronto's SARS outbreak is too narrow and must be broadened to a Walkerton-style probe that includes all health-care workers and the public, nurses say. "We are calling for a full, independent, broad-based investigation," said Doris Grinspun, executive director of the Registered Nurses Association of Ontario. "We need to hear and we need to learn from our mistakes because mistakes were certainly made," she said yesterday, adding the nurses expect to make a formal request to the government either today or tomorrow. The demand for an inquiry is in response to a story in the Saturday Star that detailed how, weeks before it was made public, senior staff at North York General Hospital ignored nurses' warnings that a new wave of the respiratory infection was sweeping through the facility. Meanwhile, public health officials are now investigating a fifth death at Rouge Valley Centenary hospital in Scarborough over the past week and the illness of another person in the intensive-care unit as possibly being SARS-related. ...

Eves offers to meet nurses over SARS
Toronto Globe & Mail, June 2, 2003
<http://www.globeandmail.com/servlet/story/RTGAM.20030602.usars0602_3/BNStory/National/?query=nurses>

Ontario Premier Ernie Eves said Monday that he is willing to talk with nurses about how the province handled the SARS crisis, but he distanced himself from the call for a public inquiry. "I'm prepared to sit down, as I'm going to do this afternoon, and talk to leaders in the health-care community to look at how we can publicly review what has gone on with respect to SARS," Mr. Eves said Monday. "That doesn't necessarily mean a public inquiry. But we want to be open and upfront, as we should be, and Ontarians should know about their health-care system." On the weekend, the Registered Nurses Association of Ontario renewed their call for a public inquiry into the handling of the SARS outbreak. Two reviews are already under way, one federal and one provincial, but no plans for a full-fledged inquiry. Nurses are angry that their warnings that SARS was spreading at North York General Hospital - the source of the second wave of the outbreak - were not heeded. Nurses also believe that understaffing and excessive use of casual workers has exacerbated problems the health system has had dealing with SARS. ...

ONA President Barb Wahl to Join Registered Nurses at Scarborough Hospital Rally
Ontario Nurses' Association, June 3, 2003
<http://www.newswire.ca/releases/June2003/03/c8898.html>

Toronto - Barb Wahl, RN, President of the Ontario Nurses' Association (ONA), will be joining an information rally of registered nurses and allied health professionals who are protesting the provincial government's handling of the SARS crisis on Wednesday June 4th. Wahl, who will be speaking at the rally, will be coming from a national conference of nurses being held at the Royal York Hotel in downtown Toronto. She will be bringing with her representatives from nursing unions from across Canada. ...

Ontario nurses want public inquiry into handling of SARS
Canadian Broadcasting Corporation, June 3, 2003
<http://www.cbc.ca/stories/2003/06/02/sars_inquiry030502>

Toronto - Ontario nurses and their union asked the Ontario government Monday to call a public inquiry into how the health-care system handled the SARS outbreak in the province. The nurses want to see an elaborate investigation much like the one that looked into the causes of the tainted water scandal in Walkerton, Ont., but Premier Ernie Eves doesn't believe a public inquiry is the only means to get answers. "The public has a right to know what has gone on and goes on with respect to combating SARS," the premier said. "That doesn't necessarily mean a public inquiry." ... Additional criticism came Monday, from an infection containment expert who believes the spike in SARS cases wouldn't have occurred if health-care workers had used more expensive N95 masks. ...

Nurses offered double pay for SARS work
Canadian Broadcasting Corporation, June 4, 2003

Toronto - Nurses are being offered double their usual wages to treat patients infected with severe acute respiratory syndrome at four Toronto hospitals. The offer comes as health-care workers continue to become infected with the disease, despite precautions taken to protect them in isolation wards. Scarborough General Hospital, North York General Hospital, St. Michael's Hospital and the William Olser Health Centre have extended the double-pay offer, which would increase the top wage for nurses to $66 an hour. The double pay will also go to X-ray technicians and other staff who work with SARS patients or in SARS screening. But some nurses don't want to work in SARS wards until more is known about how the disease is spread, and say they are worried that they'll be ordered to accept the shifts. "Double pay's not worth it," said Chris Franklin. "It's not worth it if you're dead or your family member's dead because of it." Dr. Donald Low, chief microbiologist at Mount Sinai Hospital, said the nurses have good reason to be afraid. ...

Nurses, custodians, dietary, technicians and lab health
workers deliver collective SARS message to Eves' government:
"Call a public enquiry into SARS crisis now"
Canadian Union of Public Employees, June 4, 2003
<http://www.newswire.ca/releases/June2003/04/c9220.html>

Toronto - Faced with the re-emergence of SARS in area hospitals, front line health care, including RPNs and custodial, dietary, and maintenance staff working at the Scarborough Hospital (Scarborough Grace and Scarborough General sites) today called on the Ontario government to revert to a policy of eradication of SARS, and to implement new standardized screening criteria at hospitals province-wide. Several hundred health care workers were joined at a noon rally outside Scarborough General by the provincial leadership of their respective unions and Ontario NDP Leader Howard Hampton. The event is the first time since the SARS outbreak in March that health care workers have joined together to deliver a collective message to the Ernie Eves' government. ...

Toronto nurses fed up
Allison Lawlor, Toronto Globe & Mail, June 4, 2003
<http://www.globeandmail.com/servlet/story/RTGAM.20030604.wsarz604a/BNStory/Front>

Health-care workers rallied outside Scarborough General Hospital in Toronto on Wednesday to protest against the government's handling of SARS and to call for better screening criteria at hospitals provincewide. The rally came just hours before Ontario health officials reported what they called "a number of positive developments" in the containment of the latest SARS outbreak. "We have a strong feeling that we are headed in the right direction in bringing an end to this latest cluster of SARS cases," Health Minister Tony Clement said in a news release. "But, of course, only continued vigilance among health-care workers and people in isolation will ensure a positive result." Several hundred gathered at the noon rally outside the hospital, calling for standardized screening processes at hospitals as well as properly-fitting masks and full-body suits that they can wear while working with SARS patients. ...

Nurses call for full-body 'moon suits'

Protected staff infected

Nurses demanded yesterday that all health care workers dealing with SARS patients be equipped with full-body "moon suits" throughout their shifts after word surfaced that well-protected hospital staff are still being infected with the disease. Two of the three latest cases reported yesterday were nurses who caught SARS during a frantic operation last month to insert a breathing tube into an "almost dead" patient. Experts warned that more infections could still occur as a result of the so-called intubation at North York General Hospital, where an outbreak of the disease was discovered two weeks ago. The contamination is disturbing because officials implemented special precautions for such work weeks ago after protected workers were infected during the first SARS outbreak, prompting a lengthy investigation. New provincial guidelines call for use of a Papr, a head-and-shoulders hood with a battery-operated air filter attached, or a full-body Stryker suit during high-risk procedures. But experts admitted yesterday that emergency intubations, performed when a patient's condition suddenly crashes, often do not leave time for workers to don the most impermeable protective garb. ...

Nurses want input on fighting SARS
Canadian Broadcasting Corporation, June 5, 2003
<http://www.cbc.ca/stories/2003/06/04/nurse_protest030604>

Toronto - Health-care workers rallied in Toronto on Wednesday to protest against the government's handling of SARS and to call for increased input into future decisions. They are calling for standardized screening processes across all hospitals in the city as well as properly fitting masks while working with SARS patients. Nurses also called for a strategy to eradicate SARS, instead of adapting to the so-called "new normal." Ontario Premier Ernie Eves and the government must "put worker and public safety first by focusing on eradicating SARS, not telling us to live and work in the 'new normal,'" said a statement from the Canadian Union of Public Employees (CUPE). CUPE set up picket lines in front of Scarborough General, one of the four city hospitals setting up SARS clinics. Nurses say an offer of double pay to work in the SARS clinics won't change the fact that they've been shut out of the decision-making process. Nurse Susan Brickell says health officials are "absolutely not" consulting nurses for their opinion. "We are the ones who live it and breathe it 24-7," said Brickell. ...

SARS nurses to get extra pay

Those on frontlines in four hospitals will receive double the normal rate, Clements says

Toronto - Nurses dealing firsthand with the SARS crisis have been offered what amounts to danger pay by the Ontario government. Ontario Health Minister Tony Clement announced yesterday that nurses who work with SARS patients in the four Toronto hospitals designated as specialized sites for the disease will be paid double their normal rate. But nurses say the virus has turned every emergency room into a danger zone and any health-care worker, not just those in SARS wards, could become infected. The Ontario Nurses' Association wants all its members to receive increased compensation for putting their lives on the line. And it is demanding additional equipment to ensure that nurses who do come face to face with severe acute respiratory syndrome do not become patients themselves. ...

Canada fears third wave of SARS

Nurses seek inquiry into handling of crisis

Montréal - Weary Canadian public health doctors sought yesterday to determine whether a new outbreak of SARS has erupted in greater Toronto, where 33 people have died of the flulike virus and the medical system in the country's biggest metropolis is straining under the burden of the disease. Reports of the suspected new cluster occurred as an organization representing nurses demanded a formal inquiry into how the country's health care system has handled the SARS crisis. A dozen members of the Registered Nurses Association of Ontario, which says the lives of nurses and other medical professionals have been needlessly placed at risk, staged an angry demonstration at the provincial Legislature wearing surgical masks and other protective garb. ...

Nurses demand SARS inquiry
Andrea Baillie, Canadian Press, June 9, 2003
<http://cnews.canoe.ca/CNEWS/Canada/2003/06/09/107405-cp.html>

Toronto - About a dozen Ontario nurses arrived at the provincial legislature wearing masks emblazoned with the words "muzzled, silenced and ignored" Monday to protest how they've been treated during the SARS outbreak. "Too often this has been the experience of the nursing profession," said Adeline Falk-Rafael of the Registered Nurses Association of Ontario. "We are here to say: no more." The nurses delivered a formal request asking Premier Ernie Eves to hold a public inquiry into the way the province has handled the disease, which has so far killed 33 people in the Toronto area. Doris Grinspun, executive director of the association, has repeatedly called for such a probe and said she's made the premier aware of several issues that need to be examined. For example, she said, some nurses were pressured not to take precautions during the outbreak of severe acute respiratory syndrome. Other nurses have been told to tell callers that health-care facilities had no SARS cases, even if they believed otherwise, she said. Grinspun also said nurses have been ignored when they told officials that members of the same family had SARS-like symptoms. ...

Seven cleared of SARS, but new quarantines in place
Canadian Broadcasting Corporation, June 11, 2003
<http://toronto.cbc.ca/regional/servlet/View?filename=to_sarswhitby20030611>

Toronto - Almost half of the patients at a Toronto-area dialysis clinic who were suspected of having SARS have been cleared of the disease, public health officials said Wednesday. But doctors are watching people in two long-term care facilities after some residents showed signs of respiratory illness. Doctors said tests show that seven of the 15 patients at the Lakeridge Health Corp. dialysis clinic in Whitby are free from SARS. Seven others are still being tested and doctors are conducting an autopsy on one patient who died before a diagnosis could be made. ...

SARS quarantined nurses laid off
Canadian Broadcasting Corporation, June 12, 2003

Toronto - More than a dozen registered nurses under home quarantine because of a potential outbreak of SARS in Whitby have received layoff notices. The 15 nurses worked at the Lakeridge Health Corporation dialysis clinic, which is currently under investigation by public health officials. Another four nurses are also being laid off from the organization's Oshawa site, but they are not in quarantine. The hospital's chief of human resources says the layoffs were in the works before the SARS outbreak. But Sid Ryan, the president of CUPE Ontario and a provincial NDP candidate, said it was "sheer lunacy" to proceed with staff cuts at a time when the health-care system is struggling with SARS. ...

SARS masks not tested as promised, say nurses
Canadian Press, June 13, 2003
<http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&c=Article&cid=1052251833891&call_pageid=968332188492&col=968705899037>

The province's Labour Ministry has reneged on a promise to the union representing Ontario nurses to fit-test SARS masks systematically at all hospitals, a union spokesman said today. The Ontario Nurses Association "is very upset that (concerns over) this core piece" of health protection for nurses haven't been addressed, Peter Birt said in an interview. As a result, the union, which has been fighting for weeks for mandatory testing of masks to ensure they screen out SARS germs, will be meeting this weekend to consider action that may include the laying of health and safety complaints by individual nurses against hospitals, said Birt. "If the ministry has called off systematic testing of masks, they're (union executive) going to have to do something." The union's outrage over the SARS masks came as public health officials announced Friday that a nurse at North York General Hospital may be behind the second outbreak of the respiratory illness. ...

Unions question lending nurses to Toronto
Canadian Broadcasting Corporation, June 17, 2003
<http://www.cbc.ca/stories/2003/06/17/nurse030617>

Winnipeg - Nursing union leaders in Ontario and Manitoba say they're opposed to a plan to send nurses from Winnipeg to help Toronto cope with its SARS outbreak. Winnipeg's Regional Health Authority has given permission for 10 to 15 emergency and critical-care nurses to go to Toronto's Sunnybrook and Women's College Health Centre. The hospital is not dealing with severe acute respiratory syndrome, but will help with the extra workload caused by the SARS outbreak. Still, the head of the Ontario Nurses' Association says the Winnipeg nurses haven't been told the whole story. "They are being told they are coming to a non-SARS hospital," said Barb Wahl. "In our view, in Toronto there is no such thing. There are some hospitals that don't have SARS patients, but who's to know where the next one could be?" Wahl also questioned whether the extra help is needed. She said about half her members are casual employees who would be willing to work extra shifts. ...

Nurses to Eves: "Huge Concerns" about SARS mask testing and public safety
Ontario Nurses' Association, June 18, 2003
<http://www.newswire.ca/releases/June2003/18/c4770.html>

Toronto - In a strongly worded letter to Premier Ernie Eves, the Ontario Nurses' Association (ONA) has raised "huge" concerns about the effectiveness of masks against SARS and the Minister of Labour's decision to ease off on fit-testing requirements. "There is ample evidence that many of the Toronto area hospitals have not met the basic health and safety requirement for mask fit-testing as set out in the Occupational Health and Safety Act," said ONA President Barb Wahl, RN, told Premier Eves in the letter. "ONA is taking this strong position because of our serious concerns for the health of the public and our members. If these two basic measures are addressed, Toronto, Ontario will be a safer place for all, visitors and residents." ONA has also sent a copy of the letter to the World Health Organization, the Centers for Disease Control (CDC), Toronto Mayor Mel Lastman and others to explain why Ontario nurses are still concerned about SARS and the possibility of further infections. CDC investigations have linked the spread of SARS to improperly fitted personal protective equipment. ONA is the union representing 46,000 registered nurses and allied health professionals working in hospitals, long term care facilities, community agencies, industry and other settings across Ontario. ...

Nurses warn of more SARS infections
Marlene Habib, Canadian Press, June 18, 2003
<http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&call_pageid=971358637177&c=Article&cid=1052251872245>

The Ontario nurses' union accused the provincial government today of negligence for failing to protect health-care workers from SARS and raised "huge concerns" to international health groups about further threats to public safety because of inadequate protective measures. The Ontario Labour Ministry eased off fit-testing of masks to protect against SARS, while hospitals have relaxed protective standards at the risk of endangering health-care workers, the Ontario Nurses Association says in a tersely worded letter. Copies were sent to Premier Ernie Eves, the Ontario Labour and Health ministries, Toronto Mayor Mel Lastman, Health Canada, the World Health Organization and the US Centers for Disease Control. ... CDC investigations have linked the spread of SARS to improperly fitted personal protective equipment, the union says. ...

SARS bureaucracy inundates doctors

Health ministry swamps staff with cumbersome directives
MDs and nurses confused, unsure how to comply

Doctors across the province are drowning in paper as the health ministry scrambles to outline a new reality for hospitals and health-care workers in a post-SARS world. Since SARS first surfaced in the city three months ago, the ministry has issued more than 50 bulletins and directives ordering new procedures for everything from transferring patients to screening staff. In bureaucratese - a complex and often confusing brand of English reserved mostly for government documents and divorce papers - the province has commanded where and when nurses and doctors must wear masks and gowns, who can get in and out of hospitals and what to do when a staff member or visitor has a fever. The latest directives aim to sketch out a "new normal." The only problem is, they're so confusing and cumbersome, many doctors and hospitals have been left scratching their heads over how to comply. ...

Eves turns down probe plea
Theresa Boyle, Toronto Star, June 24, 2003
<http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&call_pageid=971358637177&c=Article&cid=1052251719682>

Premier Ernie Eves has told Ontario nurses there is no need for a public inquiry into the SARS crisis. In a hastily arranged meeting yesterday, Eves discussed plans with several health-care groups for a "review" of how the government has managed the SARS outbreak. Over the last few days, some nurses have told the Star that their warnings about a re-emergence of severe acute respiratory syndrome at North York General Hospital had been ignored by senior hospital officials. But while the nurses have demanded a full-fledged, public inquiry, Eves rejected those calls yesterday: "We're committed to an open and public process. We think that the Ontario public has a right to know what goes on in their health-care system." Instead, he and Health Minister Tony Clement announced a review would be headed by "an individual who will be seen as respected and independent of the government," Clement said. "We are grappling with a way to have a public and open and honest discussion without getting into the blame game," the health minister added. Nurses at North York General say that if their warnings been heeded, fewer people would have become sick and fewer would have died. ...

Fear and loathing on hospital floor

Endlessly masked, gowned, shielded
Nurse hasn't told mother, children

In the course of a single shift, Grace goes through at least 25 pairs of latex gloves, 10 gowns, 10 masks and five sets of green scrubs. For the registered nurse in the SARS unit of a GTA hospital, frequent wardrobe changes have become de rigueur in this "new-normal" era of infection control. The bridge of her nose is peeling because of the chafing from two masks she must constantly wear. They have left red indentations on the sides of her mouth, making her look as though she's got cat whiskers. Even though the infection control precautions seem excessive, she sometimes worries they're not enough. "We wonder all the time if we're going to get sick. We just hope that the isolation techniques that we're using are good enough," says Grace, not her real name. She has asked that her identity be kept confidential because of a hospital edict prohibiting staff from talking to the media. Plus, she has a personal stake in keeping her status as a SARS nurse quiet. Her mother and two young children don't even know. "I don't want to alarm them," she says, her voice cracking with emotion. "I don't want them to worry about me." ...

Be prepared for new bugs, Clement says

Infectious disease the `new normal,' conference told Minister praises health workers as `true heroes'

Washington - Ontario Health Minister Tony Clement challenged an international audience yesterday to rethink global public health procedures and their own preparedness in the wake of this spring's SARS crisis. Clement told a biotechnology conference here that every elected and appointed minister of health the world over must face the "new normal" of the threat of infectious disease. Governments should be on the same high level of alert they would be in the face of a threatened bioterrorism attack, Clement told his audience. They must also provide every incentive possible for the biotech industry to search for a vaccine, a cure or even greater understanding of the disease that spread throughout the GTA, costing the city millions in tourism revenue and dealing it an international black eye. ...

Nurses Say They've Been Muzzled, Silenced and Ignored
Nurses' Voice, June 27, 2003
<http://www.nursesunions.ca/na/NV-06-27-2003.pdf>

A dozen Ontario nurses recently arrived at the provincial legislature wearing masks emblazoned with the words "muzzled, silenced and ignored" to protest how they've been treated during the SARS outbreak. The nurses delivered a formal request asking Ontario Premier Ernie Eves to hold a public inquiry into the way the province handled the SARS outbreak. Premier Eves, resisting the nurses call for a inquiry, said he didn't believe the SARS situation was ³the same² as the tainted-water disaster in Walkerton - which prompted officials to call a public inquiry. However, the nurses argued that the scope of SARS much bigger than Walkerton - SARS has already killed over 30 people in the Toronto area. Bowing to mounting public pressure, a few days later Eves agreed to a public review of the SARS outbreak, stating there will be a "full, open, public, investigative process."

Editorial: A wake-up call for our hospitals
Toronto Star, June 27, 2003
<http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&call_pageid=971358637177&c=Article&cid=1056665411685>

When a 44-year-old man who had trouble breathing turned up at Scarborough Grace Hospital on March 7, he helped set in motion a chain of events that brought our hospital system to the brink of collapse. The man, whose mother had died of what we now know is SARS, spent the night on a gurney in the emergency room. Only feet away, on another gurney, was a 76-year-old man being treated for an irregular heartbeat. Both men died of SARS. But not before infecting others. With hindsight, it's easy to see where our health-care system made mistakes when first faced with the SARS outbreak. It's also easy to see how this early incident helped spark a full-blown crisis. Why, for example, was anyone left lying in emergency for 12 hours? Or why was a man with respiratory problems doing next to an elderly man? Sadly, overcrowded emergency rooms are a fact of life in Ontario hospitals. So, too, are a lack of beds, with intensive care units routinely running at 100 per cent capacity, and regular medical beds at 95 per cent capacity. So, too, are the many nurses who must travel from hospital to hospital, working a day here, two there, trying to patch together a full-time job. ...

A desperate need for more funding
Toronto Star, June 30, 2003
<http://www.thestar.com/NASApp/cs/ContentServer?pagename=thestar/Layout/Article_Type1&call_pageid=971358637177&c=Article&cid=1056751810106>

In a series of editorials over the past four days, we have drawn a number of connections between strains in our ailing health-care system that contributed to the scale of the SARS outbreak, and inadequate funding of health by both Ottawa and Queen's Park. From public health, the first line of defence, to the hospitals where doctors and nurses fought pitched battles against the disease, the war against SARS was hampered by poor intelligence, too few armaments, and communication systems that were no match for the disease. ...

Health system can't cope
Ethel Meade, Toronto, Toronto Star, June 30, 2003
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Health Minister Tony Clement seems to think that no blame could possibly be attached to his government for the years of underfunding that left neither our hospitals nor our public health system able to respond immediately and adequately to the SARS crisis. Pointing out increases in absolute dollars deliberately hides the plain fact that the increases never kept up with the increasing needs. Our health-care system has been on a downhill slide since the Tory-sponsored restructuring that took money out of acute care hospitals without putting the savings into alternative community-based care. Today's shortage of nurses began with the layoffs of thousands of nurses. In the early days of the SARS crisis, Clement "discovered" for the first time how few full-time nursing jobs existed, with thousands working on a casual basis that often make it necessary to work at several different hospitals to earn a week's pay. ...

SARS Kills Nurse, Death Toll Reaches 39 in Canada
Reuters, June 30, 2003
<http://story.news.yahoo.com/news?tmpl=story&u=/nm/20030630/hl_nm/sars_canada_dc_1>

Toronto - A 51-year-old nurse who worked at North York General Hospital has died from SARS, the Ministry of Health reported on Sunday, bringing the SARS-related death toll to 39 in Canada. This was the first healthcare worker to succumb to the flu-like disease, health officials said on Sunday. "This tragic outbreak has claimed many victims. My thoughts go out to the family and friends of this health care worker who worked so tirelessly for all of us," said Tony Clement, Minister of Health and Long-Term Care, in a press release. There were 23 active probable SARS cases in and around the Toronto area on Friday, down from 24 one week ago and 44 cases on June 16. Some 13 patients are still hospitalized and in critical condition, but health officials said the number of infected people continues to decline. Severe acute respiratory syndrome has been confined to Toronto, the only place outside Asia where people have died of SARS. ...

SARS death of health-care worker 'won't be last'

Nurse was 51, worked at North York General Hospital

SARS has claimed the life of its first health-care worker in Canada - though likely not its last. But the disease's toll on the health-care sector goes beyond the lives it will claim, experts say. The fallout from Toronto's prolonged and difficult struggle against SARS will drive health-care professionals from the field, they fear. "There are nurses who will not come back to work. There are infection control practitioners who will leave ... because it was too much on top of everything else," said Dr. Allison McGeer, head of infection control at Mount Sinai Hospital and a SARS survivor. Part of it is the uncertainty, the fact there is no reliable way to distinguish a patient with a regular cough from a patient carrying a virus that can kill, McGeer said. Part is the fact the health-care system was already stretched to the limit before the SARS disaster made a difficult job exponentially more so. Part is the fear of acquiring a disease that could be transmitted - with fatal results - to colleagues, friends, family. ...

SARS death called preventable

North York General nurse had always followed precautions
Colleagues renew call for provincial action to ensure safety

The first Canadian nurse to die from SARS was a careful professional who kept her mask on and warned family and colleagues that the respiratory disease was more dangerous than most people thought. The death of Nelia Laroza has led the Ontario Nurses Association to renew calls for the province to ensure hospitals are meeting SARS safety directives for medical personnel. "Nurses believe this death could have been prevented," said Carolyn Edgar, president-coordinator of the nurses' union at North York General. Laroza, 51, of Markham, was infected the week before public health officials discovered a second wave of the disease. She was infected at North York General Hospital where, according to interviews with a dozen nurses and one doctor, warning bells related to a second SARS outbreak were repeatedly raised in April and early May. Nurses and doctors, concerned that possible SARS cases were being discounted, were ignored, according to senior nursing officials. ...

Funeral Service for RN on Friday, July 4
Ontario Nurses¹ Association, July 3, 2003
<http://www.ona.org/wac/pr/Advisory re July 4 service for RN.pdf>

Toronto ­ A funeral service will be held for registered nurse Nelia Laroza, veteran of 20 years of nursing and a long-time member of the Ontario Nurses¹ Association (ONA). The funeral will be held on Friday at 10 a.m. at St. Michael¹s Cathedral, 200 Bond Street. Laroza, 51, of Markham, also worked at Riverdale Hospital and in her native Philippines. ONA is deeply saddened by the loss of this dedicated nurse and cherished member of our association. ³Our heartfelt condolences go out to Nelia¹s husband and children, and to her colleagues at North York, who are devastated by her loss,² said ONA First Vice-President Brenda Hallihan, RN. ³Her death is a stark reminder of the potential perils our caring professional nurses heroically face each day on the job. Her loss is a terrible blow to the nurses at North York General and to the nursing profession.² Hallihan will be representing ONA at the funeral service on Friday, and she and other nurses in attendance will be wearing a black ribbon in honour of their fallen colleague. ...

City off SARS list ... again

But WHO advises to remain vigilant
Decision good news for tourism

SARS appears to be under control in Toronto, but health-care providers must remain on high alert for any potential new cases to avoid another outbreak, the World Health Organization warned yesterday after removing the city from its list of SARS-affected areas. While Toronto's removal is "very good news ... it's important to remain vigilant right now because this could be a time when hospitals are letting down their guard," WHO spokesperson Maria Cheng said from Geneva. "Obviously that's very dangerous with a disease like SARS, where you could have one new case slip through the cracks and spark a new outbreak." Provincial officials battling to stop the disease from spreading agreed, saying it could be months before hospitals ease up on restrictions put in place since severe acute respiratory syndrome first appeared in March. ...

Doctors, nurses fight for lives in 'SARS-free' city

21 still in hospital - 11 critical - as WHO clears Toronto

Their city has been declared SARS free, but for several gravely ill patients in Toronto, the disease remains a grim reality that could yet prove fatal. The 11 people listed in critical condition - many of them doctors and nurses - have been connected to ventilators for weeks, have probably all had tracheotomies and risk contracting new infections through the breathing and intravenous tubes that are keeping them alive. At least a few of the patients will probably not get better. "Some of those people, we hope, will make a full and complete recovery," said Dr. Andrew Simor, head microbiologist at Toronto's Sunnybrook and Women's College Health Sciences Centre and a leading SARS expert. "There is also a chance that some of these people may yet die from their disease - and for those who survive, some of them may be left with significant damage to their lungs." The death toll already stands at 39, with a funeral scheduled today for the latest victim, nurse Nelia Laroza, the first health care worker felled by the ailment. ...

ON THE WEB ...

New website dedicated to Ontario¹s brave health care workers who fought to contain the SARS outbreak. You can also send a thank-you note by clicking on the Guest Book! <http://www.geocities.com/thankyouontariohealth>