Then and now: The ‘huge differences’ between SARS and Wuhan coronavirus

TORONTO — As the number of coronavirus cases continues to rise, including the first confirmed case in the U.S., so do concerns over the potential for an outbreak similar to the deadly 2003 SARS epidemic.

But experts say the Canadian health care system is well equipped to handle any potential coronavirus cases thanks to the lessons learned during the SARS outbreak, which led to the deaths of 44 Canadians and 774 people worldwide.

There are “huge differences” between medical preparedness then and now, said microbiologist Allison McGeer.

“The science behind diagnosing viral illness has advanced so much in the last 17 years,” McGeer told CTV’s Your Morning on Wednesday. McGeer, who works at Mount Sinai Hospital, was on the ground during the 2003 outbreak in Toronto. She even contracted the virus herself.

“This (new coronavirus) was a disease that was recognized on Dec. 29 and 10 days later we have identified the virus, we have a sequence, we can test for it. That’s incredibly faster than we could manage in 2003,” she said.

Health officials didn’t confirm SARS was a coronavirus until the mid-way point of the outbreak. The new illness, described by the World Health Organization as a novel coronavirus, falls under a larger family of coronaviruses which includes severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).

An expert WHO panel is set to meet Wednesday to decide whether an international emergency should be declared. On Tuesday, the U.S. became the fifth country to report a case of the illness, following China, Thailand, Japan, and South Korea. The man returned to the Seattle area last week after travelling to the Wuhan area, where the outbreak began. Officials say the man, in his 30s, is in hospital in good condition.

No cases have been reported in Canada, and the country’s chief public health officer said there is no reason for panic as the risk to Canadians remains low.

Ontario’s Chief Medical Officer Dr. David Williams said hospitals are already employing protocols established during the 2003 SARS outbreak in anticipation of any Canadian cases.

“We’re getting calls already from hospitals and others that have clients they’ve seen that are concerned because they had some travel history to China,” Williams told CTV News Channel Tuesday. “We still have no cases in Canada, but that doesn’t mean we shouldn’t be aware of that and shouldn’t be alert to setting out systems up and being prepared in case that does occur.”


There are at least two significant differences between the Wuhan coronavirus and SARS that have already been identified, added McGeer.

The first is that the illness doesn’t appear to transmit well in hospitals. During the SARS outbreak, 43 per cent of cases were health care workers.

“SARS was a major problem because people were very infectious when they developed severe illness,” said McGeer. While the new coronavirus has been transmitted to some health care workers in Wuhan, the numbers are much smaller than the SARS outbreak.

The second key difference that is reassuring health care experts is that the coronavirus doesn’t appear to be easily transmitted from person-to-person. But the case is developing day-by-day, said McGeer.

“It is transmitted to some extent from person-to-person but it doesn’t look, at the moment, as if it is transmitted enough from person to person for us to worry about it at the distance we are from Wuhan,” she said.

“So far, all of the cases have come from Wuhan or had very close links to Wuhan.”


But the proficiency of these systems could be challenged by overcrowded emergency rooms.

“SARS came to a hospital in Toronto in 2003. One case made three cases, three cases made 12 cases, and so on, and so on,” David Fisman, infectious disease expert and professor at the University of Toronto’s Dalla Lana School of Public Health, told by phone Tuesday.

“What you see here is a bug that is behaving just like SARS did; just like MERS did… What we know from our experience from SARS is that we do have vulnerability in Toronto from hospital outbreaks.”

Fisman said that it’s likely Canada could see a case of coronavirus considering the number of Chinese nationals and Chinese-Canadians who live here, or have family here.

“In general, that should be no big deal outside of the healthcare context,” he explained.

“The difficulty is just the physical plant. People come to you, they’re sick and you can’t say go away. We don’t have a lot of space especially in our ERs.”

Overcrowding, especially during the height of flu season, is the perfect breeding ground for these types of outbreaks, Fisman said.

“I think people are more knowledgeable, and it’s a totally different world now in terms of how people with respiratory issues are handled,” he added.

“This is our stress test. Did we learn enough from SARS to not drop the ball this time?”

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