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Canadian Health Officials Hold Press Conference

Aired May 24, 2003 - 17:22   ET


FREDRICKA WHITFIELD, CNN ANCHOR: Hello. I'm Fredricka Whitfield in Atlanta. On now to Toronto, where health officials there are addressing the growing SARS problem, specifically the reported new cases of SARS. Let's listen in.
ERNIE EVES, ONTARIO PREMIER: ... being handled, and all safeguards, procedures and protocols are in place. In this new normal, we will always be vigilant. The situation is related to contained -- and contained to health care facilities, not in the community at large. We are assured by our health care professionals that there is no danger to the general population.

Thank you.

UNIDENTIFIED FEMALE: The premier will take a few questions. Questions for the premier?

QUESTION: Premier, this morning you said that you were very concerned about this emergency (UNINTELLIGIBLE), and that it may affect some of the political things that are going on. Has the situation changed? Have you heard anything that reassured you that you could have an election this summer, or?

EVES: No. I believe in taking care of priorities first, Robert, and priorities are definitely this situation. And, besides the situation, getting 69,000 young people back in the classroom where they belong.

QUESTION: Why would it change it, premier?

EVES: Pardon?

QUESTION: why would this change the election plans (UNINTELLIGIBLE).

EVES: Who said there were election plans? I mean, you know, I have interesting -- interested individuals from a certain party in the Ontario legislature who seem to think there is a plan, but there is -- there isn't a plan to call an election, so it's tough to change what you never had in the first place.


EVES: Well, I don't, unfortunately, control the timing of such situations. You have to deal with them as they present themselves. And we're here dealing with a very serious health care situation today.


EVES: I'm here to get a full brief, as indeed I did yesterday by phone a couple of times, and I got a full briefing this afternoon. I was -- I wanted to be apprised of the situation, and because there is a press conference here today, I'm attending it.


EVES: Well, I think that the health care professionals are being prudent and they are being vigilant, as, indeed, they should be.

QUESTION: (UNINTELLIGIBLE) of another outbreak in SARS can do a lot to hurt tourism in the province, in the city. Are you going to offer any kind of compensation, again, to keep vigilant in trying to overturn the perception of Ontario and Toronto in particular being a SARS zone, a risk for people to come here?

EVES: Well, first of all, I would describe it as a potential outbreak, not as an outbreak myself. I have to be guided by what our health care professionals have to say to us. But obviously, it's the right thing to do is to be prudent about it and to be cautious about it. They are in touch with both Health Canada, pardon me, with Health Canada, with WHO, and with CDC on a daily basis, and keeping them apprised of what the situation is. So -- and I think everybody today has been very prudent in their reaction to this thing.


QUESTION: Premier, are you in talks with WHO and the CDC and are you making the (UNINTELLIGIBLE) alert that the CDC (UNINTELLIGIBLE)?

EVES: Well, we're letting our health care professionals do that in concert with Health Canada on a daily basis.


EVES: Well, the CDC alert is just that. It's an alert, and they have to answer for themselves as to why they did it, but I want to point out the difference between an alert and a travel advisory.


EVES: Well, again, there are certain things in life that you have no control over. We have our input through our health care professionals on a daily basis.

UNIDENTIFIED FEMALE: Premier can take two more. One and two.

QUESTION: Premier, how important is it that Toronto stays (ph) off those advisory lists, and especially looking at the travel advisory and how devastating that was to the economy. How important is it that we not have that situation again?

EVES: Well, obviously, from a business point of view, it's not a positive thing. But what we can do is have the best health care professionals in the world contain the situation as well as possible. That is the first order of business. The other is secondary, quite frankly.

UNIDENTIFIED FEMALE: Final question for the premier.

QUESTION: (OFF-MIKE) and the federal government doesn't give a damn about Toronto. Premier, your opinion about the remarks (UNINTELLIGIBLE) remarks?

EVES: Well, I take it that the mayor had a bad day yesterday, and I'll let him explain his own remarks. I am not going to comment any further on them. I don't think they deserve any further comment. Nothing could be further from the truth.

QUESTION: You said at the beginning, whatever you need just ask.

EVES: Well, the entire resources of the province are behind our health care community, and whatever they need, they will have. Cost is not an issue. We have, I believe, the best health care professionals in the world. I believe they demonstrated that through the previous situation in Toronto. And we are there for them, whatever they need, and I wanted to reinforce that again today that it's not nothing is a question of money here. We are going to provide them with whatever resources they need.


EVES: That will be up to health care professionals to decide what resources they need, and the appropriate health care facilities will be appropriately compensated.

UNIDENTIFIED FEMALE: Thank you, premier.

EVES: Thank you. Thank you very much. Thank you.

Thanks, Tony (ph).

UNIDENTIFIED MALE: Thank you. Appreciate it.

UNIDENTIFIED FEMALE: So now we will continue. Dr. D'Cunha has some statements and then we'll take media questions.

DR. COLIN D'CUNHA, ONTARIO COMMISSIONER OF PUBLIC HEALTH: Thank you. Good afternoon, ladies and gentlemen. As you know, we still don't have an absolute clinical test for SARS. We identified this disease by its symptoms. The case definition as set out by the World Health Organization and Centers for Disease Control includes a link between the patient under investigation and another person who is previously been diagnosed with SARS. In the present reappearance of these individuals under investigation, call them if you want, suspected cases of SARS, we do not yet have that link.

However, that having been said, our investigation of that link continues. And if there is a link and these cases really are SARS, we intend to find that link. But for practical purposes, from the daily operations, we're treating them as though they are, which means they're in respiratory isolation in hospitals, when they are active cases.

When they're well enough to go home, they go home to 10 days of isolation at home (UNINTELLIGIBLE) before they can resume their normal activities. Similarly, their contacts for now will be placed, and you've heard the appeals over the last two days in isolation, unless they come through with 10 days clear, in which case they go back to their normal activities. And if they, unfortunately, develop one of the signs and symptoms, we'll provide them appropriate health care in that setting.

Now, to refresh everybody's memory, there are three institutions in which measures have been taken, and they vary to different degrees. For those of you who were not here last night, and I see some new faces here, the two ones that have attracted greater attention, or greater action, if you will, the Saint John's Rehabilitation Hospital, on Kamer (ph) Avenue, in the old city (UNINTELLIGIBLE) in the vicinity of Young and Finch (ph). And, of course, North York (ph) General Hospital.

To refresh everybody's memory over there, if somebody was there in the last 10 days, they should, A, be in home isolation. And if they haven't already called Toronto public health, to please do so so that they go on the list, we monitor their conditions from a public health and clinical standpoint and deal with whatever, you know, we have got to deal with.

If someone was in Saint John's Rehab Hospital, either as a patient or as a visitor for the time period May 1 now to May 8, if you are experiencing symptoms, please isolate yourself and still call Toronto public health. If you're not experiencing the symptoms, that's good news, but please call Toronto public health, because we're trying to tie down every loose end.

As far as North York (ph) General Hospital goes, to repeat the time period, April 22 to inclusive of May 12. If you're experiencing one of the symptoms of SARS -- and I'll refresh everybody's memory in a minute as to what they are -- isolate yourself and call Toronto public health, and you know, between Toronto public health and the health care system, we'll sort that out and give you best advice in that set of circumstances.

If you don't have any one of those signs and symptoms, that's great. Go about your normal activity, but please still call Toronto public health because we have got to tie loose ends.

The one I didn't talk about yesterday, because this is an evolving situation was the neurosurgery unit at Saint Michael's Hospital. And a very simple reason for that is a patient from Saint John's Rehab Hospital was transferred there on the 15th of May, so in fact, there are procedures in effect over there, and if you flip over to the rear of the press release, you will notice that the neurosurgery unit for now is closed to new admissions, and staff who have had contact with this particular patient are in isolation as appropriate. To refresh everybody's memories, the sign and symptoms of SARS are dry cough, fever, shortness of breath and, of course, chest X-ray infiltrate signs and symptoms typical of pneumonia.

There is a quite possibility that individuals who visited Saint John's, the emergency room of North York (ph) General may have been exposed to the virus, and so, very clearly, I gave you the dates a few moments ago for your viewers, readers and listeners to take into account and follow the public health directions that we have given.

Reminding everybody about the phone numbers -- if you have SARS questions, please call the SARS info line at 1-888-668-4636. If you have questions about the symptoms of SARS, call tele help at 1-866- 797-0000. And the phone number for Toronto public health again is 416-338-3700.

Closing then my remarks is changes in hospitals and health care facilities, and in addition to the new normal as to how we plan to deal not only with SARS but other infectious diseases including emerging infectious diseases, health care practitioners have been requested to screen for patients who may have attended the facilities that are identified during the dates with a view of separating them out from other people who are seeking care, so that if in fact anyone of them is incubating SARS, we don't see accidental transmission and unintended.

To remind everybody, this continues to be a disease acquired amidst particularly health care workers, in health care facilities, and in close direct contact of known cases of SARS. This is not a disease out there in the general community.

So, I will stop there with remarks and I guess open it up for questions from the media.


DR. DON LOW, MICROBIOLOGIST, MOUNT SINAI HOSPITAL: Yes. That's the working diagnosis. There's some things we have to answer with regards to the -- the official definition, but clinically we think they have it.


D'CUNHA: Well, that's exactly why we're treating them as though they were SARS and put in place the very procedures that we had running in March and April. I'm not going to let the semantics of the definition stop us from doing the correct public health thing, and that's exactly what we said yesterday.

QUESTION: Why wasn't the (UNINTELLIGIBLE) filled into the extent of potential problems yesterday? And what was results (UNINTELLIGIBLE) today in that teleconference?

D'CUNHA: Well, I think you've got to realize the following. First and foremost, the information that we had coming here delayed in the afternoon was five persons under investigation. If you recollect from yesterday, Dr. Low came straight to you from North York (ph) General. That was information hot off the press. Keep in mind, also, the time zone.

Essentially, I have only one position. We are open and transparent and we transmit the information in as timely a manner as possible. As I'm speaking with you, I'm not going to leave you with an impression, but it wouldn't surprise me that my cell phone would ring or Dr. Low's cell phone would ring, and we may discover either one of the 33 has come off the list, or there may be an addition to the list, and that's the very nature of the persons under investigation category. We've covered this ground for those of you who remember March and April, but that having been said, and without ducking any issues, we're treating them as SARS. We are isolating their contacts, we are isolating them in hospital, because we're very keen to wrestle this one down to the ground.


LOW: I mean, these are -- my clinical opinion is one thing, but it doesn't necessarily mean it meets a definition, and, you know, are we going to start reporting things that I feel are SARS, and, you know, there may be problems with that. So I mean, these are, you know, these are early times and that's part of the investigation, and we sort of run this problem of trying to keep people informed yet not trying to provide them information that's not correct, and it's a difficult line to walk.

QUESTION: (UNINTELLIGIBLE) says that they were told today by Health Canada that the 96-year-old and the 80-year-old were not part of the investigation. I take it that's not true.

LOW: Well -- I -- they're part of the investigation.


LOW: I think it was a 96-year-old -- yes. That's why I still feel that was the index case.


LOW: May have acquired it? No. Don't know yet. Again, it's something obviously in that ward that we're concerned about, what happened there, and we're yet to identify where the breech has been.

QUESTION: (OFF-MIKE) How many in each facilities?

D'CUNHA: I'll start it, and correct me if I'm wrong. (UNINTELLIGIBLE) Saint Michael's Hospital, if you capture the original place, they come in the classification -- that person will come in the classification of Saint John's Regional Hospital, and that's six. The other 24 are -- the other 27 are not -- off those 27, some are in some other facilities that I'm sure Dr. Low will give you details.


D'CUNHA: And just before I leave and turn over to Don to clarify a little more, I think I want to stress to all of you, Dr. Low is assisting us as also whole (ph) team in looking at every chart in North York (ph) General. We simply don't want to miss another cult (ph). This morning, one of my colleague from Health Canada also came in who's assisting.

UNIDENTIFIED MALE: We need to define a cult (ph)...

D'CUNHA: Sure. A cult (ph) is someone who on initial look- through doesn't make the cut, has a potential -- what's looked at not to meet that high index of suspicion, and as Dr. Low made it very clear, what happened is, as I understand it and he'll elaborate a little more is the person was post-surgery. Some patients post- surgery do get a pneumonia, probably related to the anesthesia, plus he was evaluated, did not present with the classical signs and symptoms of SARS, so may have been under the surface, if you will, and you know, hindsight is always great. Vision is always 20/20. I need glasses to come to 20/20. Don, I don't know if you want to add something to what I just said?

LOW: No.

WHITFIELD: We've been listening to Dr. Colin D'Cunha and Dr. Don Low, both members of the probing team, the health care workers in Toronto exploring the origins of what now appears to be the reports of two new SARS cases.

Now, those doctors are also saying that they do believe that those cases are linked. Five of those cases do involve health care workers at at least one hospital, Saint John Hospital. They're still not clear as to the SARS exposure, however. That is something they're still looking into, but they say of those cases, all are in isolation.


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