Public Health Measures to Control the Spread of the Severe Acute Respiratory Syndrome during the Outbreak in Toronto

Svoboda, Tomislav; Henry, Bonnie; Shulman, L.P.; Kennedy, Erin; Rea, Elizabeth; Ng, Wee Khoon; Wallington, Tamara; Yaffe, Barbara; Gournis, Effie; Vicencio, Elisa; Basrur, Sheela V.; Glazier, Richard H.

doi:10.1056/nejmoa032111

Cited by 250 publications

(162 citation statements)

References 9 publications

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“…A Risk Analysis Framework is presented to facilitate the rapid integration of HCWs' experiences into practice guidelines. [1][2][3][4] These protocols were based on the consensus opinion of infectious disease experts but were initially guided by minimal clinical data. Procedural lists and protocols were frequently revised during the epidemic, sometimes changing several times over the course of a day.…”

Section: Purposementioning

confidence: 99%

Intubation of SARS patients: infection and perspectives of healthcare workers

Caputo

Byrick

Chapman

et al. 2006

Can J Anesth/J Can Anesth

104

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Purpose:The outbreak of severe acute respiratory syndrome (SARS) in 2003 presented major challenges to the safety of anesthesiologists and other healthcare workers (HCWs). This study determined the incidence of SARS transmission to HCWs who intubated patients and analyzed the concerns of HCWs regarding personal and patient safety. Methods: Healthcare workers who performed tracheal intubation in 10 Toronto hospitals were identified using the Ontario Public Health database. A questionnaire was used to collect information from the HCWs. To determine if the patterns of personal protection or concerns changed over time, data were analyzed according to whether the intubation occurred during SARS 1 (February 23 to April 21) or SARS 2 (April 22 to July 1). Results: Thirty-three HCWs who performed 39 intubations on 35 SARS patients were interviewed. Three of 23 HCWs (13%) acquired SARS during SARS 1 whereas none (0/10) acquired SARS during SARS 2. Personal protection increased from SARS 1 to SARS 2 and HCWs' concerns changed over time. During SARS 1, concerns focused on the need for personal protective equipment whereas during SARS 2, concerns focused on the need for strict training and patient care protocols. HCWs perceived that their experiences were ineffectively integrated into risk management protocols. Conclusions: Protection guidelines failed to completely prevent the transmission of SARS to HCWs. Nine percent of the interviewed HCWs who intubated patients contracted SARS. A Risk Analysis Framework is presented to facilitate the rapid integration of HCWs' experiences into practice guidelines. Objectif : L'éclosion du syndrome respiratoire aigu sévère (SRAS) en 2003 a présenté des défis importants à la sécurité des anesthésiologistes et des autres travailleurs de la santé (TS). L'étude a déterminé l'incidence de transmission du SRAS aux TS qui ont intubé des patients et a analysé les préoccupations des TS concernant la sécurité du personnel et des patients. Méthode : Nous avons repéré les TS qui ont réalisé des intubations dans 10 hôpitaux de Toronto grâce à la base de données sur la santé publique de l'Ontario. Un questionnaire a été utilisé pour recueillir les informations des TS. Pour vérifier si les modèles de protection individuelle et les préoccupations avaient changé avec le temps, l'analyse a tenu compte des intubations réalisées pendant les phases I ou II du SRAS

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Section: Purposementioning

confidence: 99%

Intubation of SARS patients: infection and perspectives of healthcare workers

Caputo

Byrick

Chapman

et al. 2006

Can J Anesth/J Can Anesth

104

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“…For example, it was estimated that a one-week delay in the implementation of control measures for SARS in Canada resulted in a 2.6-fold increase in the mean epidemic size and a four-week extension of the mean epidemic duration 2 . In addition, the rapid identification of outbreaks and the implementation of control measures have been crucial in limiting the impact of epidemics, both in preventing more casualties and in shortening the period during which the stringent control measures were needed 3,4 . Not surprisingly, researchers' attention has been directed to the development and evaluation of early warning systems.…”

Section: Why Early Warning System Are Neededmentioning

confidence: 99%

Early warning systems augmented by bacterial genomics

Sintchenko

Holmes

2014

Microbiol. Aust.

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The number of microbial threats -in the form of newly identified pathogens, infections crossing the species barrier to people, diseases adapting to new environments, transmissible drug-resistance genes and microbial agents appearing in more virulent forms -has multiplied to an unprecedented degree. The epidemiology of well-known infectious diseases has also been changing due to the globalisation of trade and in response to immunisation campaigns. This evolving epidemiology presents new challenges to countries' healthcare systems, in terms of both understanding and monitoring of determinants of infections, as well as in terms of service provision and the implementation of appropriate prevention measures. In this article we discuss the concepts of early warning systems and genome sequencing for public health laboratory surveillance and outbreak detection and response. The added value of these new means of surveillance can be seen when clinical and public health laboratory data is harmonised, aggregated and shared. Why early warning system are neededEvidence suggests that traditional surveillance systems are vulnerable to the incomplete and delayed reporting of public health threats, highlighted by recent outbreaks. Many outbreaks have been characterised by delayed recognition and/or public health response.

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“…One reason for this may be the Ontario government's response to an outbreak of severe acute respiratory distress syndrome (SARS) at the time of our study. A government protocol barring students from entering the University's affiliated teaching hospitals (Svoboda et al, 2004) limited our ability to advertise the survey process. It may have also prevented students from accessing the survey via on site Learn Link internet terminals.…”

Section: Limitationsmentioning

confidence: 99%