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Lecture

POL101 Lecture 22

9 Pages
128 Views

Department
Political Science
Course Code
POL101Y1
Professor
Dr.David Naylor

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SARS
David Naylor Guest Lecture {22}
Severe Acute Respiratory Syndrome
` retreat of diseases, rise of crime (recent century)
Audio recording started: 12:19 PM March-28-11
SARS.wma
1.Germ theory, what causes infectious diseases, etc.
2.Emergence of antibiotics - suddenly could be treated specifically; germs retreated
3.Period where infectious diseases were retreating, & yet drug-resistant strains, HIV,
malaria, tuberculosis, etc. -> SARS
4.Infectious killing by such germs/diseases, etc.
Early 2003... In the Guangzhou outbreak, one third of infected patients were health
care workers, including a Dr. L.J.K.
` Dr. L traveled to Hong Kong for a wedding on February 21st, 2003
` this hotel basically became the SARS hotel - scores of people affected - the Hotel
Metro Park (name changed in order to attempt to escape its bad notriety)
5.Among the guests he infected, an old woman who returned home to Toronto, became
ill & visited her FP; her son fell ill and went to a local hospital
` outbreak of a respiratory disorder
Diagnosis?
6.History of exposure (?) ... And
7.Fever above 38'C
8.Cough, dyspnea
9.Malaise, Myalgias
10.Diarrhea
And others - but NO DEFINITIVE MARKERS and NO CONSENSUS
How to diagnose when operating in the dark / unaware of what this is / symptoms of
` most people got better quickly, but a subgroup had a disastrous course & died
Treatment
11. Isolation
12.Ventilatory support
13.?Antivirals?
14.?Corticosteroids?
` guessing at treatments
` lungs were heavy/soggy/fluid-filled/losing capacity, etc.
SARS is caused by a coronavirus - can also cause a variety a milder respiratory
syndromes
www.notesolution.com
` this strain had yet to be seen in humans
SARS is a ZOONOSIS - a cross over from animals to humans
` civic cats - eat coffee beans, digest outer fiber, processes beans, comes out the other
end, produces most flavoured coffee (delicacy)
` these cats are also eaten in China - likely that's how the first passage to human
beings occurred
15.People are getting ill, no-one knows what this illness is, or how to treat
16.Some places (e.g. Toronto) decided to shut down the healthcare system - only
emergency still open (most non-urgent surgeries were delayed, etc.)
17.Careful screening was done to make sure ppl didn't enter hospital unless due
attention was paid, etc.
18.Didn't want hospitals (warehousing frail & vulnerable people) to be a
congregation of rapid spread of SARS
19.Try to isolate, etc. - screened people entering, including employees
20.Medical school was largely shut down - city-wide, the climate in the health
profession was one of severe unease - obviously had to make a decision as to where to
put these people - Sunnybrook - a ward to put these people who are potentially deadly -
where they could be looked after - critical care
` bioethics - who to take care of these?
Toronto was an area of concern, people stopped visiting, should Torontonians stop
visiting if they're vectors of SARS, conventions were cancelled, tourism collapsed, etc.
` mayor made the blooper "Who? Who are they?"
` not a pretty time
21.Global phenomenon - not a massive outbreak in Toronto
22. In Hong Kong, however, and Beijing - much more serious; Singapore also
hard-hit
23.What the press reported was a cumulative total - steadily rising total even
though the number of cases was tapering off; a second peak, then things settled down
Severe Acute Respiratory Syndrome: In perspective...
24.November 2002 to July 2003
25.8,098 people worldwide probably had SARS in 29 countries, and 774 died
26.Canada: 438 probable cases, 44 deaths (all in Toronto)
27.Flu kills 750 - 2500 Canadians/year - triple that number die from flu-related
diseases
- "life is a sexually transmitted disease with a 100% fatality rate"
Learning from SARS: Renewal of Public Health in Canada
Emergency/Outbreak Response
28.Also a clinical event - hospitals were where patients were concentrated;
health care workers also affected
www.notesolution.com
29. Isolating public health
` all those elements of background protection/prevention seemed to be thought of as
separate from medical care
30.We, from outset, since thinking about emergency outset response, how to
separate these issues
Public Health Systems Failures
Walkerton, ON 2000
31.Contamination of a community well with E. Coli
North Battleford, SK 2001
32.Estimated 5,800 to 7,100 of city's population affected
Broad Population Health Challenges
` First Nations and Labrador Inuit - 62% overall: Canadian counterparts - 31%
` First Nations & Inuit 20-24 category - 72%
` chronic, non-communicable diseases (dementia, heart disease, cancer, etc. is probably
how most people will leave this world)
Global Public Health
33.Only as strong as its weakest link
34.Travel ubiquitous - airplanes will take you halfway around the world in like 7
hours, etc
Public Health: Under-supported for 20+ Years - multiple reports ignored
ELEMENTS: Health Protection, Prevention and Control of Disease and Injury,
Population Health Assessment and Surveillance, Health Promotion...
Clarity, Collaboration, Coordination and Communication
35.All players worked tirelessly, but poor collaboration, jurisdictional tensions,
inadequate data collection & sharing
36.Lack of clear roles & responsibilities for all levels of gov't led to a
fragmentation of effort
37.A patchwork of systems of disease control currently exists - harmonized
outbreak management protocols required in a public health emergency
38.Effective public communications must be coordinated between all players
Closing the Gap - Three Lines of Response
39.All levels of the public health system require strengthening
oFront-line: local
oSecond Line:
oThird Line:
40.Meaningful repetition
www.notesolution.com

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Description
SARS David Naylor Guest Lecture {22} Severe Acute Respiratory Syndrome retreat of diseases, rise of crime (recent century) Audio recording started: 12:19 PM March-28-11 SARS.wma 1.Germ theory, what causes infectious diseases, etc. 2.Emergence of antibiotics - suddenly could be treated specifically; germs retreated 3.Period where infectious diseases were retreating, & yet drug-resistant strains, HIV, malaria, tuberculosis, etc. -> SARS 4.Infectious killing by such germsdiseases, etc. Early 2003... In the Guangzhou outbreak, one third of infected patients were health care workers, including a Dr. L.J.K. Dr. L traveled to Hong Kong for a wedding on February 21st, 2003 this hotel basically became the SARS hotel - scores of people affected - the Hotel Metro Park (name changed in order to attempt to escape its bad notriety) 5.Among the guests he infected, an old woman who returned home to Toronto, became ill & visited her FP; her son fell ill and went to a local hospital outbreak of a respiratory disorder Diagnosis? 6.History of exposure (?) ... And 7. Fever above 38C 8.Cough, dyspnea 9.Malaise, Myalgias 10. Diarrhea And others - but NO DEFINITIVE MARKERS and NO CONSENSUS How to diagnose when operating in the dark unaware of what this is symptoms of most people got better quickly, but a subgroup had a disastrous course & died Treatment 11. Isolation 12. Ventilatory support 13. ?Antivirals? 14. ?Corticosteroids? guessing at treatments lungs were heavysoggyfluid-filledlosing capacity, etc. SARS is caused by a coronavirus - can also cause a variety a milder respiratory syndromes www.notesolution.com
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