City’s Overall Death Rate Didn’t Spike During SARS

While unprecedented infection control measures during the 2003 SARS outbreak in Toronto limited access to medical care in the Greater Toronto Area (GTA), the city’s overall death rate did not spike, according to a study led by University of Toronto professors.

“Despite a prolonged period of intense clinical service restrictions, we found no significant change in mortality rates compared with corresponding periods in previous years,” the study noted. “The widespread limitation of access to medical services did not appear to have any short-term effects on deaths within the population.”The observational study, published in the peer-reviewed journal BMC Public Health, was led by Steven Hwang, a U of T professor of medicine and a physician at St. Michael’s Hospital. It examined population mortality during the SARS outbreak using death registry data, census data, and statistical analysis of mortality rates from 2001-2003. No significant change was seen in the mortality rate in the GTA before, during and after the SARS outbreak compared to 2001 and 2002.During the outbreak, infection control practices led to the closure of four hospitals, the cancellation of all non-emergency surgical services, postponement of most outpatient clinics and limited access to physicians, diagnostic testing and hospital laboratories.”Previous studies looking at events such as physicians’ strikes had suggested that decreased access to health care could have substantial health effects on the population,” explained Hwang. “Our data indicates the opposite – during SARS, patients with severe illnesses retained the ability to access life-saving services.”This finding provides useful insight into the management of future outbreaks of influenza or other infectious diseases, said contributing author Chaim Bell, a U of T medical professor and a St. Michael’s Hospital physician.”The health-care system must have a co-ordinated response to infectious disease outbreaks that balances infection control practices with the need to maintain access to critical services,” Bell said. “Developing a data capture and reporting system ahead of an outbreak would equip decision-makers with timely information that could help determine what services should be prioritized.”(Source: BMC Public Health : Julie Saccone : University of Toronto : August 2007)