Steve Quayle News Alerts

April 2, 2003
Christie Blatchford, National Post

TORONTO - A key member of the high-level team of experts tracking the spread of Severe Acute Respiratory Syndrome, or SARS, is himself in voluntary isolation at his Toronto home.

Dr. Don Low, microbiologist-in-chief at Mount Sinai Hospital and one of the main clinicians who has been treating the province's growing number of SARS patients, is among six members of the Ontario team who were quarantined Monday night after another team member was diagnosed with a probable case of the illness.

"True irony," Dr. Low said with a chuckle last night of the fact that his potential exposure came not at his downtown hospital where he was actively treating patients and where extreme precautions against SARS are the new norm -- even before entering Mount Sinai, staff and public have to have their temperature taken at the door -- but rather at a meeting of the expert team last Saturday.

In a telephone interview with the National Post, the 57-year-old said he was "feeling great," showing none of the telltale symptoms of the illness -- chiefly a high fever and malaise -- but admitted he was "a little frustrated" by being relegated to the sidelines of the fight against SARS.

His five fellow team members are also asymptomatic, and healthy.

The team of provincial and municipal experts has been meeting at least once daily at the provincial operations centre, in a government office in central Toronto, since the crisis began to unfold in mid-March.

On Monday night, Ontario Public Security Commissioner Dr. Jim Young said at a press briefing yesterday, while in the middle of another such meeting, the team abruptly learned that one of its own, an unidentified frontline health worker, had begun showing SARS symptoms on Sunday.

That meant, by the conservative approach these experts are taking, the woman may have been infectious in the 24 hours before -- and that in turn meant that anyone who had been at the team's meeting last Saturday potentially was exposed to the virus.

"We closed the building last evening," Dr. Young said, phoned the Toronto health department immediately, and awaited the arrival of deputy Medical Officer of Health Dr. Bonnie Henry. She then interviewed all the team members who were there to determine their potential risk of exposure -- the same process thousands of Ontarians have been going through for days now -- while others were contacted by phone and questioned.

The quizzing, Dr. Young said yesterday, went on until the early hours of yesterday morning.

During it, Dr. Low said last night, other team members remembered that at the Saturday meeting, at some point, he and the unidentified female worker "were discussing a problem in a separate room, and that she had her mask off."

The woman, recruited to the team in the early days of the crisis according to Dr. Young, was then feeling perfectly fine, but was wearing the mask, albeit only on and off, as a precaution.

Since it is face-to-face contact for more than five minutes that is deemed risky, that brief discussion with the woman constituted Dr. Low's potential exposure, he said, while the other five team members had either sat close to or had contact with the woman at the meeting when she had "lowered her mask to get a breath or sip a coffee."

Other team members, such as Dr. Young and Public Health Commissioner Dr. Colin D'Cunha, who sat by the phone Monday night at his home waiting to find out if he would have to go into isolation, were deemed not to have been put at risk, though both men said yesterday they were monitoring their health carefully and looking for signs of the illness.

Dr. Low said the lesson to be taken from his potential exposure is that, "It's not the one you know, but the person you don't know who may be infected. That's the recurring theme of this." He said the best evidence thus far is that people are not likely infectious before they begin showing signs of the illness, but that "we're using a very conservative zone of safety.

"We're experiencing such an unusual phenomena here, we've never seen it like this before," he said. "We don't have a good handle on it yet, we're learning more, so we have to do everything possible to contain it. By identifying high-risk individuals, people who may have the disease or who may be incubating it, we could end this in 10 days. We could do it. But it's logistically so difficult to do."

He said about 7 o'clock Monday night he realized he would have to go into quarantine. "I phoned my son before I left for home," he told the Post, "and said, 'You're outta there!' " His son packed a bag and went to stay with Dr. Low's former wife, with whom he is close and who lives only about a mile away.

Yesterday morning, he said, she "was by to drop off some stuff at the front door," and then phoned him to say there was food on the step, waiting for him. He was slated to appear on CBC's The National Monday night, he said, "and I'm sure they're wondering what happened to me."

Dr. Low is also working the phones and e-mail frantically to stay in touch with the Centers for Disease Control in Atlanta, and was amused to learn that the province has ordered a fax machine for his house to keep him busy.

Because he is at home by himself, he doesn't have to wear a face mask.

His replacement at yesterday's press briefing, Dr. Andrew Simor, head of microbiology at Sunnybrook and Women's College Health Centre, said that the good news is that from his hospital's experience, "It is possible to prevent the infection" from spreading "once the proper infection control measures are in place." There has been no transmission of SARS at Sunnybrook, Dr. Simor said, and some of his patients have already been discharged, fully recovered.

But Dr. Low cautioned that yesterday's rise in the numbers -- two more elderly patients died of SARS, bringing the death total to six in Ontario, and as of noon yesterday, there were a total of 124 probable or suspected cases in the province, 13 more than the day before -- is not likely the end.

That jump was expected, he said, "and I expect them to increase over the next few days."

Though all Ontario cases are traceable to the original SARS outbreak at the Scarborough Grace Hospital, since closed -- with the exception of four that are linked to travel to other "hot spots" in southeast Asia -- Dr. Low predicts that the "great majority" of cases will end up being ruled not the result of face-to-face contact, but of indirect contact -- or as it's sometimes called, "elevator button" contact.

He and other experts are increasingly of the view that the illness is caused by a new coronavirus that may be easily transmitted not only by droplets in a sneeze or direct physical touch, but also by indirect contact via table tops, hospital bed rails and the like.

Other members of the coronavirus family can live for "a couple of hours on surfaces," Dr. Low said.

That underlines the need for the very behaviour Ontario Health Minister Tony Clement was demonstrating for the cameras yesterday -- regular and thorough handwashing.

The vast majority of those, like Dr. Low, who are in isolation will not develop SARS, and the vast majority of those who do will fully recover.

cblatchford@nationalpost.com

http://www.nationalpost.com/national/story.html?id=26A869E2-E8C2-4FB8-853B-EEDC8E3FADA8