CAW Statement on the SARS Outbreak

The Severe Acute Respiratory Syndrome (SARS) public health emergency in Ontario continues to be the subject of heightened concern and vigilance for all Canadians even though the WHO has lifted the travel restriction and no new community cases have been reported. It must remain a high alert situation as healthcare workers continue to be infected in spite of stringent precautions. The need for a high quality, universal public health care system uncompromised by the profit motive could not be more emphasized than by the crisis we have just experienced. We recognize the right of Canadians to know about the hazard and risk associated with SARS. Canadians need to determine the appropriate balance between preventative measures to limit our risk of exposure and continuing our daily routines.

We know that hospitals and long term care facilities throughout Ontario have restricted visits by family and friends and established rigorous infection control procedures. Hundreds of persons, including many staff at facilities potentially exposed to SARS have accepted voluntary quarantine in order to limit the future spread of this infectious disease. Health care workers heeded the call by public health officials to avoid socializing in large groups, particularly where there was a mixing of people from various facilities to prevent cross-contamination.

Our Union represents 25,000 health care workers in Canada in both hospitals and long term care facilities that are subject to these necessary measures. The crisis also highlighted short-comings and indeed a taskforce chaired the University of Toronto Dean of Medicine has been charged with the responsibility of reviewing the overall handling of the crisis. The rationing of essential personal protective equipment for health care such as the N95 mask is but one example of the shortcoming of our crisis response system. This is an apparent acknowledgement of the absence of a provincially coordinated and centralized public health response to acquiring additional supplies of essential personal protective equipment.

Under the Occupational Health and Safety Act, health care workers do not have the fundamental right enjoyed by others to refuse to work when their health or safety is in danger when such a refusal would in turn endanger the life, health or safety of another person - namely a patient or resident.

Health care workers must continue to put themselves in harm's way to ensure the public's access to quality patient care and typically do so without hesitation. The additional risk of exposure to infectious disease for these workers during a public health emergency is underscored by SARS - a disease that has been especially virulent and contagious at the point those infected seek medical attention. As recent case confirm, health care providers are amongst those at greatest risk and bear the heaviest burdens of the most intrusive containment measures - including quarantine and other precautions that limit their ability to engage in public life.

The SARS outbreak and resulting quarantine reminds Canadians of the fragile state of our health human resources and the absolute lack of additional capacity when scores of physicians, paramedics, nurses or other health providers are required to cease providing direct patient care. Our national health care system has precious little surplus capacity to accommodate the additional demands and burden of confronting an epidemic like SARS.

Our Union believes that Canadians have a right to expect that government at all levels is dedicated to the challenge of eradicating communicable disease and ensuring a safe and healthy context for pursuing our life ambitions. Those Canadians providing health care - physicians, paramedics, nurses and other workers - have a right to a safe and healthy workplace. Yet the emergence of new or resurgent infectious communicable diseases, and especially the current SARS epidemic confound health care workers' expectations of a safe and healthy workplace.

We are reassured by the recovery and release of many of the initial SARS cases and reminded that the survival rate after infection represents a 95 to 97 [Cathy has used 96% which is perhaps too precise an estimate to provide] per cent chance that an infected person will survive the illness. It would appear that SARS still represents a potentially lethal disease especially for the vulnerable and elderly.

Clearly, SARS is distinct in both its mode of transmission and its potential fatal outcome for even healthy individuals who contract the disease. SARS has included amongst its early victims Dr. Carlo Urbani, the 46-year old World Health Organization (WHO) physician and infectious disease specialist whose work defined SARS. In Ontario, experts , including Dr. Donald Low, chief microbiologist at Toronto's Mount Sinai Hospital were quarantined.

The SARS outbreak reinforces the vital importance of effective public health regimes within Canada. This is but the most recent of numerous emergent threats to public health that includes anthrax, Norwalk, drug-resistant strains of tuberculosis, and the West Nile virus. That Canada is not well prepared to face new and emerging public health challenges was also noted by the Romanow Commission and our Union calls on all responsible levels of government to commit resources and leadership to the task of rebuilding an effective public health regime within our country.

Prevention and containment of infectious and communicable diseases has long been a key basis for the development of publicly funded and publicly delivered health care in Canada. At a time of heightened concern that increases the physical and financial burden on public facilities in their response to and treatment of infectious disease, Canadians demand a clear commitment from federal and provincial governments that sufficient additional resources will be assured to these same public facilities to fund their precautions and additional measures in response to the SARS epidemic.

We need to also remain vigilant that the anxiety and concern caused by this disease does not give rise to racist attitudes or indiscriminate practices against persons of Chinese or Asian origin. A zero tolerance policy against such unwarranted discrimination must be maintained bearing in mind that SARS is now being reported on four continents.

On behalf of the 250,000 members of the CAW-TCA Canada, and in particular our 25,000 health care members, I urge all levels of government to take all necessary steps to ensure front line workers; now beginning to suffer from 'burn-out' from the astronomical hours of work, have full support, I urge speedy action to implement the promises of full income replacement for those compelled to be absent from work to contain this disease.

This crisis serves to remind us all of the significant contribution and risks faced by front line workers in the health sector. They deserve to be recognized for their selfless contribution and that of the hidden faces of their families and relatives.

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