Crazy Eights Lesson 2 Show recorded

Crazy Eights – Lesson 2 Show 2SARS in Ontario : 

Crazy Eights – Lesson 2 Show 2SARS in Ontario

Problems Encountered : 

Problems Encountered Lack of preparedness No plan, leadership issues Communication Issues Transparency, information systems, information demands Lack of a coordinated response Central public health coordination Lack of surge capability Epidemiological units, laboratory, scientific expertise Legal confusion Issues Ineffective linkages Hospitals, clinicians, government organizations

Legal Confusion : 

Legal Confusion Authority for Decision Making Who legally was in charge of the outbreak? Enforcement What were the consequences of not following directives issued to hospitals? Communication and Privacy Issues Who had the ultimate responsibility for the classification of a case: the local jurisdiction or the province? What specific information had to be transmitted, by whom, when and to whom? To what extent could public officials and private experts share data and for what purpose? Who was obliged to notify relatives that a family member was classified as a suspect or probable case? Did privacy rights prevent the sharing of information necessary to fight the outbreak?

Jurisdictional Level : 

Jurisdictional Level Provincial Federal / International Local Volunteers Police

Enforcement : 

Enforcement Confusion in existing laws Isolation/Quarantine Protective Measures Enforced: Airport Screenings Non-urgent hospital use

Public Response : 

Public Response Sources of Information Public Compliance Psychological Impact

Media Coverage : 

Media Coverage Dissemination of information to the public Privacy Dissemination of information to physicians Bureaucratic limitations Coordination of effort

Leadership Issues : 

Leadership Issues What Went Wrong? Staffing issues Management mistakes What Went Right? Skill of staff System development Cooperation Legislation

Areas of Improvement : 

Areas of Improvement Independence of local public health centers Improvements to public health infrastructure Improved communication International cooperation Standardized reporting methods

References : 

References Blendon RJ, Benson JM, DesRoches CM, Raleigh E, Taylor-Clark K. The public's response to Severe Acute Respiratory Syndrome in Toronto and the United States.  CID 2004;38: 925-931.  Campbell, Archie. (2004). The SARS Commission Interim Report: SARS And Public Health In Ontario. Toronto, Ontario, Canada: Author. Federalism and public health law in Canada: opportunities and unanswered questions. Health Law Review Winter, 2005. Available from Goliath business knowledge on demand. www.goliath.ecnext.com Gostin LO, Bayer R, Fairchild AL. Ethical and Legal Challenges posed by Severe Acute Respiratory Syndrome: Implications for the control of severe infectious disease threats. JAMA. 2003;290(24):3229-3237. Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R. SARS Control and Psychological Effects of Quarantine, Toronto, Canada.  Emerging Infectious Diseases. July 2004;10(7): 1206-1212.

References : 

References Reynolds DL, Garay JR, Deamund SL, Moran MK, Gold W, Styra R.  Understanding, compliance and psychological impact of the SARS quarantine experience.  Epidemiol Infect. 2008; 136: 997-100. Rothstein, Mark A., Alcade, M. Gabriela, Elster, Nanette R., Majumder, Mary Anderlik, Palmer, Larry I., Stone, T. Howard, et al. (2003) Quarantine And Isolation: Lessons Learned From SARS. Washington, DC: Author. Schull, Michael J., Stukel, Thérèse A., Vermeulen, Marian J., Zwarenstein, Merrick, Alter, David A., Manuel, Douglas G., et al. (2007). Effect of widespread restrictions on the use of hospital services during an outbreak of severe acute respiratory syndrome. Canadian Medical Association Journal. 176 (13), 1827-1832. St. John RK, King A, de Jong D, Bodie-Collins M, Squires SG, Tam TWS. Border screening for SARS. Emerg Infect Dis 2005 Jan . Available from http://www.cdc.gov/ncidod/EID/vol11no01/04-0835.htm.