VANCOUVER—To Randy Wax, a critical care specialist physician, there are two generations of health care workers in Canada: “There’s those of us who were there during SARS and remember it vividly, and those who were in school at the time.”

Those like Wax who were there, remember the determination to help people get better, the frustrations over mixed messages on how to deal with SARS and, above all, the worry that they would become sick and infect their families.

“People are scared when they don’t understand a threat — when you get conflicting information,” he said.

Wax recalled his own concern in 2003 about the risk of contracting the virus and passing it on to his wife and young kids while he was working in critical care at Mount Sinai hospital. He became one of the 10,000 people placed under quarantine after coming into contact with someone who had SARS-like symptoms in a meeting. During the quarantine, he had no contact with his family and spent time developing educational materials for other people combating SARS.

With 17 people dead, flights stopped at a major airport in China, and the World Health Organization (WHO) mulling whether to declare a public health emergency, the spread of a coronavirus first detected in China is evoking déjà vu for Canadian health care workers who lived and worked on the front lines of the 2003 SARS crisis.

They hope Canada has learned some “harsh lessons” from the SARS outbreak that killed 44 people in this country. Many are worried that the Wuhan coronavirus could become SARS round two.

“Those who did go through the SARS crisis back in 2003, there are certainly some that are getting very nervous,” Wax said.

Canada’s chief public health officer said earlier this week that the risk of Canadians contracting the virus remains low, but airports in Vancouver, Toronto and Montreal — all of which have direct flights from China — would begin screening passengers as one measure of defence.

As of Wednesday evening, the urgency of the outbreak seemed to be on an upward trend, and one expert said it’s only a matter of time before the first case of the virus, which is from the same family of viruses as SARS, is identified in Canada.

In Wuhan, where the first case of the virus appeared, train stations and the airport were shut down Wednesday amid the rising death toll. Buses, subways, ferries and long-distance shuttle buses would also be temporarily closed, and state-owned media reported that restrictions would be placed on anyone wanting to leave the city of about 11 million people.

Officials from the WHO were considering the question of whether the virus’s ability to cause severe pneumonia had reached the scale of an emergency. Meanwhile, Canadian public health agencies were on standby for direction from the global health group.

“They decided to delay making a decision on whether this is an emergency until tomorrow — it’s interesting that they didn’t say it’s not an emergency right away,” said Steven Hoffman, director of York University’s Global Strategy Lab and public health expert.

“It either is (an emergency), or it almost is, which means that public health authorities should be on guard,” he said.

The fact that the number of people known to be infected has mounted quickly (between Tuesday and Wednesday the count of people who had died went from three to 17), and the large amount of international travel to Canadian cities such as Toronto, Vancouver and Montreal, has Hoffman sure it’s only a matter of time before a case of the coronavirus is identified in this country.

Hoffman said the measures Canada has implemented so far — sharing information between health authorities, placing notices at airports, and checking travel histories at hospitals — are part of a national response informed by “very harsh lessons we learned during the SARS outbreak.”

Wax said one of the major issues for health care workers during the SARS outbreak, was that crucial information about the virus didn’t spread quickly and clearly enough.

SARS’ 10-day incubation period, which meant infected people may not show symptoms for that long, rendered investments in airport screening less effective, while use of burdensome protective equipment made human error more likely. In other words, knowing the specifics of how the virus worked was key to choosing the best strategy to fight it.

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“I think there are lots of lessons learned from SARS but the most important was, when we don’t understand a new infection and new outbreak, it’s much better to start with the highest level of precautions and work our way down,” Wax said. “People forget that people who work in hospitals put themselves at risk. I can say that people were scared.”

But he’s hopeful things have changed for the better. Since the SARS outbreak, improvements have been made not only to the protocols hospitals and health agencies use in case of outbreaks, but also to standard procedures that turn out to be best practice in an outbreak, too.

Wax said taking cautious travel histories, and regularly checking the fit of protective equipment like masks, are best practices that staff at Canadian hospitals are already using in the post-SARS world.

Hoffman said members of the public should take the same precautions they should always take during flu season: Wash your hands, cough into your elbows, let a public health official know if you’re returning from an affected area feeling unwell and if you’re sick, stay home.

With files from the Canadian Press and the Associated Press

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