|Wikileaks:||View 03OTTAWA899 at Wikileaks.org|
|Tags:||AMED SOCI TBIO CASC CA|
|Redacted:||This cable was not redacted by Wikileaks.|
This record is a partial extract of the original cable. The full text of the original cable is not available.
UNCLAS SECTION 01 OF 03 OTTAWA 000899 SIPDIS STATE PLEASE PASS TO CDC STATE FOR WHA/CAN, CA/OSC and M/MED E.O. 12958: N/A TAGS: AMED, SOCI, TBIO, CASC, CA SUBJECT: Ontario Declares SARS Health Emergency Ref: State 072824 1. Summary: Late on March 26, the province of Ontario, faced with growing numbers of cases of Severe Acute Respiratory Syndrome (SARS), officially declared a "provincial emergency." This represents a dramatic upgrade of measures to contain the potential spread of SARS in the greater Toronto area, the epicenter of Canada's SARS cases. In the last several days, "probable" case numbers have jumped to 62, according to March 27 "Globe and Mail" reports, making Ontario the largest disease site outside Asia. Provincial emergency responses and powers include (so far voluntary) quarantine orders, potentially for thousands of residents and scores of emergency medical workers - which could slow responses to `911' calls; the closing of critical care units in two major hospitals; round-the- clock monitoring by a new Provincial Operations Center; and an intense effort to track workers and visitors to Scarborough Grace, the hospital where Toronto's three SARS fatalities were treated. Post will send proposed Public Announcement text via Septel. End summary. Multi-ethnic Metropolis Potentially Vulnerable --------------------------------------------- - 2. Toronto, Canada's most populous urban center with the nation's largest and most diverse ethnic and immigrant populations - including one of the largest Chinese populations outside Asia - has been hit with the majority of the country's Severe Acute Respiratory Syndrome (SARS) cases, including its three fatalities to date. With high travel rates to and from Asia's vulnerable areas - the March 26 "Toronto Star" reports outbound travel from Toronto's Pearson International Airport to southeast Asia at more than 1,000 passengers daily - the SARS risk potential is clear. The Toronto district of Scarborough, with notable concentrations of Asian populations, is the focal point of concern and attention. Scarborough Grace Hospital, where the three SARS fatalities were treated, was completely closed on March 26, while a near-by elementary school has also closed as a precautionary measure. Current Profile - A Four-fold Jump in "Probable or Suspect" Cases --------------------------------------------- -- 3. According to the City of Toronto's March 25 SARS Backgrounder, prominently posted on Toronto's government website, health officials report that, of the three fatalities, two were related and had traveled to Hong Kong, while the third, according to the "Star," had shared the same hospital observation room with the one of the two family victims. As of March 25, the city backgrounder referred to 15 "probable" and five "suspect" cases. Two days later, the March 27 "Globe and Mail" and the CBC report an increase of "probable cases" to at least 62 persons, including a number of health care workers from Scarborough Hospital. Multi-front Response: Institutional Closings and Quarantine Orders; Could Slow `911' Response --------------------------------------------- --- 4. Under Ontario's emergency powers stemming from its "Health Protection and Promotion Act" invoked on March 26, an extensive quarantine search and order is underway, targeting the potentially "thousands of people" who visited, worked, or were treated at Scarborough Grace Hospital from March 16 onward. In addition, the province's "Emergency Plan Act," also invoked, authorizes the use of emergency funds for disaster response, if needed. With SARS now designated a "reportable, virulent, communicable disease," this designation empowers public health officials to prohibit those suspected of SARS from "engaging in activities that may transmit" the disease. According to media, individuals must voluntarily place themselves under a 10-day home quarantine and wear a protective mask when interacting with family members. 5. The quarantine includes, according to CBC reports, an estimated 50 ambulance staff and paramedics who either had contact with victims, or have exhibited possible symptoms of SARS. Provincial emergency officials advised residents to continue to use the "911" number but indicated that response times may be slow. 6. Two major hospitals have been closed or restricted in the past 24-48 hours. Scarborough Grace Hospital staff told us that the facility is completely closed, with access barred by masked security personnel. In downtown Toronto, Mount Sinai, the city's premier medical facility, closed its intensive care unit and emergency room services, according to a hospital public affairs officer. The precautionary closure stems from the fact as reported in the March 27 "Globe and Mail" that a possible SARS patient was transferred to Mount Sinai's acute care unit from Scarborough over the weekend. 7. Working with Canadian federal and Toronto municipal health personnel, Ontario's Ministry of Health and Long-Term Care announced March 26 additional tracking and containment measures including: -- Planning to increase Ontario's isolation bed capacity, potentially using new, unopened facilities as a way to isolate patients with symptoms; and -- Partnering with the City of Toronto in efforts to identify a "broad sweep of people" who may have come into contact with SARS sufferers. Canada Issues Health Travel Advisory while Ontario Implements Health Protection and Promotion Act Powers ----------------------------------------- 8. Health Canada, the nation's federal health ministry, issued a March 25 travel advisory which recommends that persons "defer all travel until further notice to Hanoi, Hong Kong, Guangdong, and Singapore." In addition, federal health officers are distributing SARS information cards to passengers arriving at Toronto's Pearson International Airport from Asian ports of embarkation. According to a pre-clearance contact at Pearson International Airport, airport personnel, including U.S. and Canadian inspection officers, are not yet receiving protective gear or working under special handling rules, although individual services have counseled staff on SARS characteristics. Multiple Info Sites and Free Clinics ------------------------------------ 9. Area residents or travelers concerned about SARS can contact a variety of information resources sponsored by all three levels of government. The public can call the province's Telehealth Ontario hotline, 1-866-979-0000 and Toronto Public health Hotline, 416-338-7600 for clinical information and advice. In addition, a downtown Toronto clinic affiliated with the respected Sunnybrook and Women's College Health Sciences Center opened today offering assessments on a walk-in basis to any individuals worried about the disease. Comment: Province, City Taking SARS Very Seriously ----------------------------------------- 10. Far from minimizing SARS concerns that could potentially affect business or tourist travel to Canada's leading city, health authorities are using whatever legal, research, and public outreach tools they have to educate the public, isolate symptomatics, and respond to this unfolding disease profile. But given a metropolitan population close to five million and strong Asian ties and travel patterns, the difficulty of enforcing extensive quarantine orders, as well as medical uncertainty over the disease's etiology and clinical transmission specifics, it is too soon to know whether Toronto is over the worst. 11. MINIMIZE considered. CELLUCCI
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