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Winnipeg — The massive quarantines that confined thousands of Canadians to their homes during last spring's SARS outbreak will not be repeated if the deadly respiratory virus re-emerges, federal health officials say.
About 25,000 Canadians were quarantined while severe acute respiratory syndrome swept around the world this spring, killing 774 people.
While avoiding any suggestion that they overreacted, federal officials who met with SARS experts from around the world in Winnipeg yesterday said that they've overhauled their approach.
Fewer people would be quarantined in future SARS outbreaks, said Arlene King, director of Health Canada's immunization and respiratory infections division. Federal officials also gave new instructions to the provinces yesterday about which masks and protective gear should be worn by health workers, and outlined new surveillance methods to watch for a return of the virus.
Discussion about whether Canada overreacted to SARS was stoked at the Winnipeg conference by the release of a draft study that suggests the "Draconian" quarantine measures were unnecessary.
Robert Parker, deputy medical health officer with the Fraser Health Authority in British Columbia, and a team of other B.C.-based researchers concluded that only people who show symptoms of SARS need to be isolated in their homes, because others who may have been exposed to the virus cannot spread the disease.
Not only was the quarantine unnecessarily large, Dr. Parker reported, but it was also damaging.
"The negative impacts of quarantine included feelings of guilt, anger, fear for the welfare of friends and family, stigmatization and loss of income," Dr. Parker wrote.
Those concerns have prompted the federal government to rethink how it would confront SARS outbreaks, Dr. King said.
"Certainly there is, I think, a broadly held view that the breadth of quarantine that was instituted in many countries, including Canada, is something that we should be looking at in a very hard light," Dr. King said. "I would suspect that we will be, in fact, limiting our quarantine activity [in future outbreaks]."
Frank Plummer, scientific director of the National Microbiology Laboratory in Winnipeg, pointed out that the virus was poorly understood when people began falling ill.
"There really is not the need for widespread quarantine," Dr. Plummer said. "But in the middle of the SARS epidemic that was not known; it is known now."
A key discovery that has tempered the preparations for future outbreaks is the finding that SARS is not especially contagious.
"It appears to be a lot less contagious than other respiratory infections," said Tim Booth, director of viral diagnostics at the National Microbiology Laboratory.
On a scale of one to 10, Dr. Booth said, the flu's contagiousness would rate a 10 while SARS would rate only "about three."
The virus probably can't spread through the air, Dr. Booth said, except in droplets from a sneeze or a cough.
Using the new knowledge about SARS, new federal guidelines were issued yesterday to instruct health workers about what they should wear to protect themselves.
In most situations, an ordinary surgical mask and eye protection will be enough to guard against the virus, Dr. King said. The famous N95 masks and face protection will be used only in situations in which an infected patient's body fluids could be spraying into the air, such as during intubation or suction.
The hunt for a vaccine has progressed rapidly, but some researchers say they're worried that Canada may lack the manufacturing capability. Certain vaccines are made by neutralizing dangerous live samples of the virus, which would require a so-called Level 3 facility that meets a pharmaceutical standard known as Good Manufacturing Practice. No such manufacturing sites exist in Canada.
Another problem confronting public health authorities is the fact that diagnostic tests are unreliable.
