SARS Backgrounder

Prepared by the Canadian Auto Workers Union. Some of the information may not apply in New Zealand. Check with your union.

SARS - Severe Acute Respiratory Syndrome

What is it?

SARS is a severe form of pneumonia, accompanied by a fever. A small number of those affected can become severely ill.

How do I get it?

It is believed the illness is spread through droplets from coughing and sneezing, or from direct face-to-face contact with an ill person. SARS is highly contagious and can spread quickly. Symptoms usually appear two to ten days after direct contact with a SARS patient.

Who is at greatest risk?

Individuals who have had direct contact with a SARS patient.

Can you die from SARS?

Fortunately, since SARS is just a severe form of pneumonia, 96% of SARS patients recover. As with other forms of pneumonia, elderly patients who are already ill are most at risk. The fatality rate for SARS is the same as for pneumonia and influenza.

What are the symptoms?

- Sudden onset of fever (greater than 38o C or 100.4oF) - And one or more of the following: - Respiratory symptoms: cough, shortness of breath, difficulty breathing - Severe headache, severe fatigue, muscle aches and pains

How is it treated?

Patients with SARS are being treated in hospital with antibiotics and antiviral agents and are receiving supportive care. Cases are being kept in isolation rooms and hospital staff are using appropriate precautions.

What should I do if I think I have it?

You should seek medical attention. Cover your nose and mouth with a clean mask or towel immediately and go to your nearest hospital as soon as possible.

Should I wear a mask in public or at work?

The risk of contracting SARS from someone in a public place or a workplace (apart from a hospital) is extremely remote. The CAW does not recommend members wear masks or gloves unless they are health care workers treating SARS patients. We insist, however, if workers in other workplaces want to wear masks or gloves to give them peace of mind, employers allow them to do so.

Are Asians more at risk?

No. In our multicultural society we need to recognize that people have different traditions. In countries like China and Japan it is a common practice during flu season for those with colds or flu to wear a mask to protect others from infection and for those who want to protect themselves from the risk of infection, to wear a mask.

Where is SARS found?

SARS is now found on all continents and in many countries throughout the world. Most cases have been found in Guangdong Province in China (which is where SARS originated in November, 2002), Hong Kong, Singapore and Hanoi in Vietnam.

Many cities in Canada have SARS cases. Toronto is the Canadian city with the most SARS cases. As of April 13, 2003, Canada has had 283 cases and 13 deaths. The U.S. has had 166 cases and worldwide there have been 2,960 cases and 19 deaths.

Is it worse than the flu and other types of pneumonia?

To give a sense of perspective, Statistics Canada reports there were 8,032 deaths among Canadians from pneumonia and influenza during 1997, the most recent year statistics were reported for these diseases. The death rate for pneumonia and influenza, 3.7% is the same as for SARS.

Should I wash my hands often?

One of the best ways of protecting yourself from any respiratory disease is to effectively, thoroughly and carefully wash your hands, including fingers and fingernails. For best results, remove your rings. Soap and warm water are really all that are needed. Frequent use of antiseptic soap is not recommended for proper hygiene.

Remember, many people catch colds by touching surfaces that have been touched by someone with a cold and then infect themselves by inadvertently putting their hands near their mouth or rubbing their eyes.

What should health care workers in contact with SARS patients do?

Health care workers who are in contact with SARS patients or working in isolation units need to take special precautions. Stringent infection control procedures must be followed, including the use of isolation rooms with negative pressure and the use of personal protective equipment.

They must wear properly fitted N95 masks which must be kept clean. Face shields and goggles must be worn in direct patient care, high risk areas. Long sleeved gowns must be worn for direct patient care in high risk areas. Gloves must be worn in high risk areas. Whenever PPE is removed it must not be contaminated and hands must be thoroughly and effectively washed.

Stringent precautions must also be taken for all workers who clean rooms or linens. Rooms and all surfaces should be cleaned with a broad-spectrum disinfectant certified to kill viruses. The product must be properly diluted and used according to recommended precautions.

Employers must provide all health care workers who are or who could be exposed to SARS with effective education and training and personal protective equipment.

All workers have the right to refuse work which is likely to endanger them. Health care workers also have the right to refuse work which is likely to endanger them, with the exception in some provinces such as Ontario, that their refusal does not directly endanger the life, health or safety of another person.

Employers have the responsibility to provide stringent infection control procedures, personal protective equipment and education and training for all people in direct contact with SARS patients. Refuse to work unless these are provided.

The joint occupational health and safety committee should be fully involved with issues of strict infection control procedures, the provision and use of PPE, and education and training.

This disease appears to follow a dose-response relationship. It appears the greater the direct exposure to SARS, the higher the risk of infection.

Why are people quarantined?

Since SARS is highly contagious it is important that people who have been in contact with a SARS patient isolate themselves by staying home for 10 days and not allowing visitors. They should wear a mask when they are in the same room as a family member and change their mask twice a day.

They must not share personal items such as towels, drinking cups or cutlery. They must wash their hands frequently and sleep in separate rooms. If they remain symptom free, they can return to their normal life after 10 days. Family members of quarantined people may go to work or school. They do not have to wear a mask. Everyone in the house should check their temperature twice a day (do not share thermometers). If anyone develops a fever over 38 degrees Celsius or 100.4 Fahrenheit or any other SARS symptom, seek medical help.

Since SARS is now by law a reportable communicable disease, quarantine orders are enforceable.

Will I lose pay if I'm off work due to quarantine or illness?

If you are off work due to SARS you have contracted away from work, you qualify under the provisions of your sick plan at work. If you are off work due to SARS you contracted at work, you qualify for workers' compensation benefits.

The CAW has been able to persuade a number of employers to ensure people sick with SARS or who are in quarantine receive topped up sick pay both by the elimination of any waiting period and by topping up sick benefits to regular pay.

As well, we have been successful in persuading the federal government to eliminate the two week waiting period for sick pay under the Employment Insurance sick benefits both for SARS patients and for those in quarantine.