WHO adds Toronto to SARS no-go list

04-24-2003

The World Health Organization yesterday added Toronto to its list of places that travelers should avoid due to an outbreak of the contagious respiratory disease called SARS.

	INTERACTIVE PACKAGE Click to an interactive package about SARS from the Associated Press with background on the symptoms, cause, spread and treatment of the disease.

Yesterday's advisory brought outcry from Toronto's mayor and some in the city's tourism industry, who said it was an overreaction that would worsen the economic impact already caused by the spread of SARS, or severe acute respiratory syndrome.

WHO also added Beijing and Shanxi Province in China to its list, joining Hong Kong and Guandgong Province as the hot spots for SARS.

Even before the advisory, Canadian tour operators, hotels, theaters and restaurants were taking a huge financial hit as conventions, school groups and tourists canceled planned trips because of fears over the SARS outbreak.

Canada has been the most affected area outside Asia, with 15 SARS deaths as of yesterday, all in the Toronto area.

Toronto, 325 miles and a six-hour drive from Pittsburgh, is a popular travel destination for Western Pennsylvanians because of its theaters, museums and the fact that American dollars are worth $1.50 in Canada.

Because of the outbreak, Lenzner Coach Lines of Ohio Township said yesterday, it has postponed bus trips scheduled for June 7 and Aug. 15.

And Anderson Coach and Travel, based in Mercer County, has canceled trips to Toronto scheduled for April 27, May 11, May 17, June 15 and June 28.

Before the latest advisory, three school districts -- Shaler Area, Bethel Park and Upper St. Clair -- had canceled student trips to Toronto out of concern about SARS.

Also yesterday, Major League Baseball said it would recommend that teams take precautions against SARS when they play in Toronto.

SARS has sickened more than 4,000 people worldwide and killed at least 251.

Toronto Mayor Mel Lastman was furious at the health agency.

"I've never been so angry in all my life," he said, adding that he was "shocked that the medical evidence we have before us does not support this."Dr. Paul Gully, director general of Health Canada, said he would challenge WHO's assertion in a letter.

"Toronto continues to be a safe place," he said.

Dr. Clifford McDonald, an official with the U.S. Centers for Disease Control, noted that the CDC had not issued the same strong advice. The CDC has warned travelers to take precautions when visiting Toronto.

And Toronto medical officer Dr. Sheela Basrur said the outbreak, while serious, "is contained -- largely in hospitals which is, frankly, where it belongs. So we don't have widespread community spread."

But Dr. David Heymann, the World Health Organization's communicable disease chief, said Toronto had not contained the disease. A major reason for WHO's action, he said, is that a cluster of SARS cases among health workers in another country was traced to the Canadian city in the last week.

He would not say where the new cluster emerged, but there have been reports of at least three incidents of SARS being exported from Toronto. One involved a Toronto medical assistant who apparently spread SARS to her family in Manila before she died of it.

That case is the only reported one where an infected person from Canada is known to have triggered SARS in another jurisdiction.

Dr. Colin D'Cuhna, Toronto's commisioner of public health, said that means Toronto is "an exporter of sorts," but not enough for a travel advisory.

"There are worst-case scenarios of losing control completely," said Michael Bliss, an historian of medicine at the University of Toronto. "It could already have happened and we just don't know it. It's like a war, and we still don't know the enemy very well."

The potential economic impact could be devastating. Economic activity in the greater Toronto area accounts for about 20 percent of the national gross domestic product, according to David Dodge, governor of the bank of Canada.

"The ripple effect is huge because the hotel industry, the restaurant industry, sporting events, everything filters out of that," said Rick Naylor, head of Accucom, a company that organizes trade shows to Toronto. "It's not just the conventions."

Ted Carmichael, chief Canadian economist for J.P. Morgan in Toronto, said, "What is uncertain is the duration of the economic impact of SARS. If the outbreak is not contained soon, the negative effect on consumer confidence and business spending are likely to increase."

Melanie Coates, a spokeswoman for the Hotel Royal York in Toronto, said the hotel, which has 1,365 rooms, has a full-time registered nurse on duty.

Coates acknowledged that hotel reservations began dropping off after the American Association for Cancer Research's cancellation, which she said touched off a "media feeding frenzy."

The health advisory, she said, is at odds with normal life in Toronto.

"I ride the subway. We have a fashion show taking place in a half-hour with 450 people," she said, insisting that SARS is mostly a disease of health care workers and has not spread to the broader community.

At The Westin Harbour Castle, a woman who answered the telephone in the management office said: "We're all fine. We're here at work and doing our business. It's the rest of the world that has the problem."

Karen Poppell, a spokeswoman for the Windsor Arms, a boutique hotel with 28 suites, said concerns about SARS are "a little out of control. It's unfortunate. I think Ontario remains a healthy and safe travel destination."

John Karastamatis, a spokesman for Mirvish Productions, a theater company in Toronto, acknowledged that many high school groups from the United States have canceled trips but said, "it seems to be contained to that."

"We do have a lot of calls from Americans who are booked to see 'The Lion King' with concerns not founded in fact. Questions like, if we come to Toronto, we're told we won't be allowed back into the United States, is that true?" Karastamatis said.

In the spring, about 15 percent to 20 percent of Toronto's tourism comes from high school groups from the United States. In the summer, the number of tourists from outside of Canada rises to 50 percent.

"Our fear is that this will stigmatize Toronto and stop people from coming. We think it's unfair. There really is nothing to worry about in Toronto," Karastamatis said.

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