Ottawa — The federal government should put up to $100-million into trying to develop a SARS vaccine as quickly as possible because of the increasing difficulty of containing the disease, top medical officials say.
David Patrick, an epidemiologist on the front lines of the crisis in British Columbia, said yesterday that Ottawa must kick-start the development of a vaccine now because there's a good chance that severe acute respiratory syndrome may spread around the world despite efforts to contain it.
He said his call for speedy development of a vaccine is echoed by other medical experts, including Frank Plummer, head of Canada's national microbiology laboratory in Winnipeg.
Dr. Patrick said the government should also streamline the vaccination-development process to about six months from the usual three to five years.
"I would say it would be [Prime Minister Jean] Chrétien's best legacy if he would ante up the development money that may be needed for that," said Dr. Patrick, director of communicable-disease epidemiology at the B.C. Centre for Disease Control.
"To develop that vaccine, $10-million to $100-million may be required."
Until the past few days, public-health officials were cautiously optimistic that the current Canadian SARS outbreak, centred in Toronto, could be contained.
But several developments have raised concerns that the disease may be spreading more widely and may not be traceable to the original cases found at Scarborough Grace Hospital in Toronto.
Public-health officials continue to investigate a Toronto condominium building where SARS was discovered in people who were not linked. And 450 people are still in quarantine in Montreal and New York after a Toronto man with SARS attended a Primerica Financial Services meeting in Montreal last weekend.
He was one of 500 members of a religious group exposed to SARS through the family of a man who died from the disease.
Also yesterday, a suburban Vancouver hospital closed off two wards and sent more than 30 hospital employees home after an acute-care nurse who was treating a SARS patient was diagnosed as a suspect case.
The nurse, who is at home in isolation, worked two shifts at Royal Columbian Hospital in New Westminster earlier this month while possibly contagious, said Don Bower, a spokesman for the Fraser Health Authority.
She had been treating a female SARS patient who fell ill after returning from a trip to Hong Kong. Mr. Bower said the nurse had contact with 35 co-workers and 13 patients, nine of whom are still in hospital.
The acute-care nurse is the second British Columbia health-care worker to be affected by SARS. Earlier this week, another Royal Columbian nurse who was treating the same SARS patient was diagnosed as a probable suspect. She is in serious but stable condition in a Vancouver hospital.
Toronto Public Health officials said SARS was not a factor in the death of an employee of The Globe and Mail this week. A group of Globe employees was allowed out of quarantine.
By yesterday, Health Canada reported a decrease in SARS cases, down to 304 from 306 a day earlier. There have been 13 deaths in Canada. Early today, Singapore reported its 14th SARS death, overtaking Canada as the country with the third highest total of deaths in the world.
Dr. Patrick said officials can contain the disease to a degree, but news of the spread to the church group convinced B.C. officials that work must begin immediately on a vaccine.
"We can do a better job of containment for the time being if we can, and it might be nice for Toronto to get help from other areas of Ontario, but I think what we're seeing in Toronto and Hong Kong is a reminder that, though this epidemic moves more slowly than influenza, it's got the potential to spread globally," he said.
"It's going to be very tough for us to keep holding the line with public- health staff."
There are a number of good signs that researchers may be successful in finding a vaccine, Dr. Patrick said. Animals have already received inoculations to protect them against other strains of the virus. Experts have not come to a final agreement yet on the identity of the virus, but work must begin, he said. "We don't have a lot of time."
To get there quickly, Dr. Patrick said a number of steps could be speeded up or simultaneously parcelled out to several different researchers.
"I hate to use the analogy, but it's almost like a war footing," he said. "We have to be way more co-ordinated than we have been before."
Dr. Patrick said medical officers have started to broach the subject in regular meetings on the virus. Individuals working on an HIV vaccine will be contacted next week about a brainstorming session, he added.
"It will take some top leadership to take a first-rate interest in this if we're going to get there."
Paul Gully, a Health Canada official, said federal and provincial officials are examining the various forms of transmission of the disease to establish how it can best be avoided. He noted that not everybody who comes in contact with the virus contracts it.
Ottawa also plans to examine the feasibility of screening aircraft travellers for fevers, as has happened overseas.
Meanwhile, the man who represents Canada's doctors said the Canadian Medical Association will look at whether health workers should be brought to Toronto to relieve those on the front lines.
CMA President Dana Hanson said he plans to discuss the possibility with Ontario doctors. Staff involved in emergency services and infectious disease may need help. The city may also require aid in dealing with patients whose surgery or other treatment has been postponed.
"There are a lot of people out there now who are being impacted by this well beyond the front-line workers," he said.
Dr. Hanson said his organization plans to approach nurses who may be under stress.
With a report from Jane Armstrong in Vancouver and AFP.
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