Who decides? Toronto has trouble containing the SARS outbreaks

The recent outbreaks of severe acute respiratory syndrome (SARS) in Toronto shone a harsh light on the inadequacies and outright failures of neoliberal public health policies and practices. It also showed clearly the extent to which neoliberal governments prioritize business security above the health and social security of workers. Even more than this, however, the SARS crises have revealed the ways in which the priorities of capitalism make people ill.

Toronto public health officials distributed information about SARS to Toronto hospitals in early February. It is not clear when the Ministry of Health first received alerts about SARS from the World Health Organization. It is also uncertain what their response was, including whether they notified regional public health officials or front-line healthcare workers.

By late-April Ontario's Premier, Ernie Eves had not even recalled the legislature to devise a plan for dealing with the various aspects of the crisis. For weeks the Tory plan appeared to consist of little more than suggestions to "wash your hands." As street nurses Cathy Crowe and Kathy Hardill point out, the thousands of people in Toronto who have to rely on shelters with no soap or towels (and limited air circulation) do not have this as an available option. And how do homeless people follow a quarantine?

Governments only responded, and even then largely in terms of public relations, after the embarrassment of the World Health Organization (WHO) warning and the threat of losses for tourist industry owners. Prior to that they seemed rather unconcerned about the developing crisis.

SARS, like the Walkerton tragedy before it (which saw several people die and hundreds become sick after privatization and cuts to water inspection contributed to e-coli contamination of the town's drinking water), revealed the damage done to the health care system in Ontario by the Tories.

As Tom Baker, a national CUPE representative for nursing and allied health staff noted, the Tories' privatization affront-line health services played a major part in the Province's s inability to keep up with the outbreak and in its detachment from local officials. Likewise, street nurses Crowe and Hardill note that the "polarization of community health activists and public health officials," resulting from cuts to the public health infrastructure, has been "detrimental to creating a cohesive response to the SARS crisis."

Cuts to health care which put systems under greater strain, left fewer people to pick up the extra work, resulting in delays for people requiring other services. Clearly public health requires a large increase in resources.

The problems caused by the lack of public health resources were compounded by the failure of any level of government to compensate workers who had to go under quarantine. Similarly, nothing was forthcoming to assist tenants facing evictions or people unable to make utilities payments due to SARS layoffs or work cutbacks. That this failure played a part in the spread of SARS in Toronto, and in the spread of panic over SARS, was highlighted when an infected nurse from Mount Sinai hospital took public transportation to work on April 14 and 15 because she could not afford to miss.

Instead, provincial government money has come as subsidies to capital, especially those involved in tourist industries, and exclusive hotels and restaurants.

The government was more concerned with helping tourist industry bosses rather than workers. The government largesse shown to entertainment magnates and hotel companies, through subsidies to ticket prices, did not extend to workers in food, entertainment and hotel industries who were affected by layoffs or lost hours. As late as May 27, Hotel Employees, Restaurant Employees (HERE) Local 75 were still requesting meetings with federal Industry Minister Allan Rock and Human Resources Minister Jane Stewart. Local 75 president Paul Clifford noted: "There as been no additional funds from senior levels of government directed towards hospitality workers. No EI (employment insurance) funds, no waiving of the two-week waiting period for EI, no relaxing of EI regulations and many workers and their families are going under."

The federal government offered such "symbolic support" as holding a cabinet meeting at an exclusive Toronto hotel, to and from which they were chauffeured with great haste. Other responses were little more than gimmicks, including the proposal to pay the Rolling Stones $10 million in public money to put on a "free" concert. While Liberal MP Dennis Mills (Toronto-Danforth), whose earlier contribution to fighting SARS was to bring the Prime Minister to town for lunch, pressed for the concert funds, the PM turned down the request.

Overall the economic damage directly related to SARS will likely be small. Tourism in Toronto had been ill for some time before the SARS outbreak.

Two key factors behind recent economic concerns have received almost no mention: the Canadian dollar and rising electricity costs. The dollar's increase in value has played a far greater part in the tourism drop-off than SARS and has also affected Canadian exports. Also, the Tory deregulation of utilities has resulted in a doubling of electricity costs for many companies.

The impact of SARS will more likely be political rather than economic as it has exposed the lack of concern among all levels of government for public health and workers' standards of living.

In fact, much of the fearful image of Toronto under SARS was built up by stationing police in front of closed off hospitals - which, along with statements by the Province may have contributed to getting the WHO advisory against travel to Toronto.

Even worse, the province's rush to proclaim the crisis over (following the WTO advisory) seems to have played a major part in a renewed outbreak at the end of May. During the second outbreak more than 7000 people were quarantined, but compensation packages have still not been made available. Finally, during the second outbreak - after weeks of stress-filled overtime shifts, and suffering some of the city's highest infection rates - nurses, through their union, put forward a demand for "danger pay."

The Tory handling of the outbreak may play a part in the provincial elections. Tellingly, Premier Eves cancelled his election announcement, which had been planned for the week in which the second outbreak occurred. Anger over the Tory bungling of the SARS crisis is running high, extending into their support base among suburban consumers in the regions surrounding Toronto.

Jeff Shantz is a member of CUPE Local 3903 and is active in the Toronto General Defence Committee.

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