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The Toronto SARS Experience: An Analysis of Phase I & II Case Distribution and Fatality Rates

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This report examines the SARS outbreak in Toronto during its initial phases. It details the tragic case of an index patient, a mother, returning to Toronto, developing pneumonia, and later dying at home. It tracks the transmission to her son and subsequent emergency cases, highlighting the timeline of infections and hospital admissions. The impact on the healthcare system is discussed, including the establishment of SARS units, restrictions on hospital access, and screening protocols implemented to combat the outbreak. This analysis serves as a crucial resource for understanding epidemic management in urban centers.

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The Toronto SARS Experience: An Analysis of Phase I & II Case Distribution and Fatality Rates

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  1. SARS: The Toronto Experience

  2. SARS Toronto: Phase I & II

  3. Case Distribution by Age Group

  4. Case Fatality by Age Group

  5. SARS Toronto: Phase I & II

  6. The Problem: • The unrecognized patient

  7. Sunday, February 23 Index Case (Mother) Returns to Toronto and develops pneumonia that week

  8. Wednesday, March 5th Index Case (Mother) Dies at home

  9. Index Case Mr. T (Mother) (Son) Cared for mother at home and develops pneumonia

  10. Friday, March 7th SGH Index Case Mr. T (Mother) (Son) Admitted to SGH

  11. Grace Division Emergency Department March 7

  12. Morning of Thursday, March 13th Intensive Care Unit SGH Mr. T

  13. Grace Division Emergency Department March 16 Mr. P arrives in the emergency department with a LRTI On respiratory precautions from time of admission

  14. Grace Division Emergency Department March 7

  15. Grace Division Emergency Department March 16 Mr. P arrives in the emergency department with a LRTI On respiratory precautions from time of admission

  16. Grace Division Emergency Department March 16; 22:45-23:30

  17. Mr. P’s wife Mr. P Index Case Case A (Son) (Mother)

  18. Mr. P’s wife Mr. P 16 persons 9 persons Index Case Case A (Son) (Mother)

  19. Mr. P’s wife Mr. P 16 persons 9 persons Mr. D Index Case Case A (Son) (Mother)

  20. Grace Division Emergency Department March 7

  21. Mr. P’s wife Mr. P 16 persons 9 persons Mr. D 21 persons Index Case Case A (Son) (Mother)

  22. Mr. P’s wife Mr. P 24 persons 9 persons Mr. D 21 persons Index Case Case A (Son) (Mother)

  23. Mr. P’s wife Mr. P 24 persons 9 persons Mr. D 21 persons Index Case Case A (Son) (Mother) 15 persons

  24. Mr. P’s wife Mr. P 24 persons 9 persons Mr. D 21 persons Index Case Case A (Son) (Mother) 15 persons Mr. R ?

  25. Mr. P’s wife Mr. P 16 persons 9 persons Mr. D 21 persons Index Case Case A (Son) (Mother) 15 persons Mr. R ?

  26. Mr. P’s wife Mr. P 16 persons 9 persons Mr. D 21 persons Index Case Case A (Son) (Mother) 15 persons Mr. R ? 7 persons

  27. Mr. P’s wife Mr. P 16 persons 9 persons Mr. D 21 persons Index Case Case A (Son) (Mother) 15 persons Mr. R ? 7 persons

  28. Wednesday March 26th • Provincial emergency declared • Directives for all hospitals formulated over weekend • Stopped transfer of patients and staff between health care centers • Created SARS units in all hospitals • Restricted access to hospitals including visitors • Screening of all persons accessing hospitals • Institution of precautions

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