HP was responsible for controlling infectious diseases inside Toronto’s borders and according to Ontario’s law requirements THP had to assign to each medical facility, personnel with the attribution of participating in the internal infectious control committee, managing – additionally – the tracking of diseases that potentially threaten the public health. Unfortunately, because THP didn’t supervise infection control in the hospitals and other medical facilities, it had a low interaction with medical staff, and that fact contributed significantly to making very difficult THP’s job of identifying SARS cases. (VARLEY, 2005)
With the evolution of the SARS crisis, the competent authorities declared the situation an emergency, activating the Provincial Operations Center (POC), and assigning as its co-managers Colin D’Cunha and Jim Young. (VARLEY, 2005)
The co-managing came to show its self as a trouble in communication and decision making process.
Facing the lack of expertise on Ontario’s Public Health in matters such as infectious and epidemiological analyses, POC created units to take care of those aspects. In resume there wasn’t a plan on how to proceed in infectious disease crisis, and a bureaucratic network was created by POC to orient the medical facilities on how to proceed when facing a suspect or probable SARS case. (VARLEY, 2005)
The inexistence of a plan made all de decisions harder to be taken. There were no pre established protocols, reason why all the strategies were being tried in first hand and every time one of them failed the crisis deepen, for example thought the Healthy Ministry recommended all medical professionals in Grater Toronto to use N95 masks, there weren’t that many masks in the Canada market and the insufficiency of masks made various hospital workers unsatisfied and scared.
Eventually the WHO issued a report dissuading non essential trips to Toronto. Canada representatives protest against WHO’s initiative using as an argument the fact that there hadn’t been any new SARS cases for more than 10 days. Sadly, though WHO came to reconsider its advisory SARS outbroke once again in Toronto. (VARLEY, 2005) That fact left a palpable impression that Canada and Ontario’s health officials concerned with the WHO’s negative advisory, suffered of cognitive bias and ignored disconfirming data that could be pointing to remain cases of SARS in the city.
Taking in to account the experience Toronto authorities gained with the SARS crisis, to improve its readiness and response ability, it should implement the following recommendations.
Create a procedure plan to be experimented before and implemented whenever it is necessary.
Develop an emergency plan for infectious diseases occasions.
Even though in crisis cases pre established plans may postpone effective solutions, in the SARS Toronto case, if a contingency plan had previously been formulated and the medical personnel had been well prepared, there was a great chance consequences would not have been so grate, and the whole situation could have had the characteristics of a routine emergencies. On the other hand, annihilating a routine emergency event, novelty was undoubtedly an element in SARS case.
Have a well prepared department of infectious diseases in charge of implement
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