Pandemic evokes memories of SARS

When retired nurse Hedda Canlas first heard about the outbreak of COVID-19 in Canada, her response was immediate. “Can I volunteer?” she wondered.

“Being a nurse,” she explained, “you really have an instinct to help.”

But she quickly realized that at the age of 70 she was at elevated risk of getting sick and passing infection to her husband and other family members. Coronavirus disease 2019 (COVID-19) was killing tens of thousands of people worldwide, many of them seniors. Instead, she decided, she would pray for the nurses and doctors who were confronting the virus on the front line ... a role she was in 17 years ago.

In an interview from her home east of Toronto, Canlas recalled that time. It was 2003 and she was being thrust onto the front line of another novel infectious disease, severe acute respiratory syndrome (SARS). The virus struck her workplace, Scarborough General Hospital, where she was working in the dialysis unit that received patients routinely transferred in from the hospital’s Scarborough Grace campus.

Also at Scarborough General was Mirander Chan-Wah, a registered nurse at the coronary care unit, which treated patients with acute heart problems. Chan-Wah had grown up in Hong Kong, where SARS first spread from mainland China.

On March 7, 2003, a patient showed up at Scarborough Grace with high fever and difficulty breathing. The patient’s recently deceased mother had visited Hong Kong and been infected there with SARS, it later emerged. Unknowingly, the man spread the infection to two other patients waiting in the emergency room.

Once the SARS outbreak became known, precautions were instituted throughout the hospital. The situation suddenly became close to Chan-Wah, she recalled in an interview from the hospital, where she still works.

The outbreak revealed a system that was unprepared to deal with a spreading epidemic. “We didn’t have a proper room — a negative pressure room,” she said. The hospital had to install a massive air exhaust system to ensure the virus would not escape into other parts of the building.

In 2003 Canlas was administering dialysis to patients, many of them elderly. Since it wasn’t always known who might be infected, she took standard precautions around every patient. When she was treating someone known to be SARS-positive, even more stringent measures were applied, such as working in the new negative-pressure area.

“We took precautions for everyone,” Chan-Wah said, but with identified SARS patients, they took “extra, extra care. We really all (had) to dress up like a spaceman.”

Chan-Wah recalled having had adequate personal protective equipment during the SARS crisis. “Not like this time — there seems to be a shortage of masks, for example.”

The scale of the SARS outbreak was also smaller, both women noted. In 2003, Canada was one of only five nations with more than 100 cases. This time, more than 130 countries have exceeded 100 COVID-19 cases, and the top five nations have well over 100,000 cases each.

SARS also didn’t have much in the way of community spread. SARS in Ontario was largely confined to the hospital system.Among Ontario’s 375 probable or confirmed SARS cases, health-care workers accounted for 169 cases, a staggering 45 per cent.

“Nobody wanted to work, but we had to,” she said. The prevailing attitude among staff was “it’s our job.” One educator even came in despite being pregnant, so she could demonstrate for staff how to put on protective equipment properly.

“Personally, I take (COVID-19) a bit more (calmly) just because we have experience (from) before. The last time, nobody really knew what to do.”

Chan-Wah even chuckled as she thought about everything she and her colleagues went through 17 years ago. “I can still remember the time. It was so stressful. You had at least one or two persons to help you put all (that) equipment on: double mask, a cover, then a special suit, double gowns. They even had a little fan inside the suit to keep the circulation going so we wouldn’t get suffocated. It was awful.

“Deep down, the fear (of the) unknown — every one of us (had) this same feeling. But we tried to work, to function as normally as we could,” Chan-Wah said, recounting one staff meeting at which she had flown off the handle over a minor matter, though her manager excused the outburst as understandable. “Everybody was so tense that you (could) break so easily.”

Canlas and Chan-Wah both recall their fear of inadvertently infecting family members. Once the nurses got home, their uniforms would go straight into the laundry to be washed alone and they would shower immediately. As staff working directly with SARS patients, both had to stay self-isolated even at home. Chan-Wah wore an N95 mask at home when she couldn’t avoid being around family members. Each woman had her own eating utensils.

As for dealing with the stresses past and present, Canlas said, “The only consolation I have all the time is talking to God, prayer — and He answers ... in His time.”

At Scarborough General during SARS, she said, she tried to comfort distraught patients in the dialysis unit. She offered prayer to patients who were open to it.

Churches also remained open during the SARS outbreak and Canlas was able to attend Mass. This time, she said, it’s “a different scenario.” Toronto Cardinal Thomas Collins’ decision in March 2020 to suspend public Masses throughout the Archdiocese of Toronto is something she is reconciled to. “It’s for the safety of everybody. The cardinal knows what’s going on.”

And although she longs now to go back to church, she said of the current restrictions, “It’s not forever!”

For Chan-Wah, the 21st-century pandemic has been a time to e-mail friends and share what she calls a more positive perspective. With fewer distractions, she said, “we’re actually more connected to our surroundings ... to the trees, the grass, the flowers. It’s almost a time to calm everybody down. And also to realize how vulnerable human beings are. We’ve invented so many things, we think we are so superior to other living things, but we can’t even fight against an invisible virus.”

Canlas, too, emphasized the limitations of human beings. “It’s only God you can really depend on in this crisis,” and “it’s only through prayer because there’s nothing we can do.”

She remembers coming to a similar conclusion during SARS. “It’s only God who has the reason why this is happening.” One of the results was a deepening of her faith.

She and her husband Ricardo are members of Couples for Christ. She recalled how in 2003 their son, Ricardo Jr., belonged to CFC Youth for Christ. It was he who persuaded his parents to join CFC. Currently she and Ricardo Sr. participate in virtual prayer meetings with neighbours who are fellow CFC members. “So, actually, it’s more intimate. God is telling us one thing: just to love one another, to be close together even if this thing is happening.

“This is one way of telling us to be together, united, to love each other, love your neighbour. No more fighting.”

The effects of the current pandemic on those living through it won’t be known for years, but it will certainly leave an indelible mark on front-line health workers, just as SARS affected Canlas and Chan-Wah in ways that continue to resurface today.

Chan-Wah recalled: “It was 17 years ago, but it’s just that this feeling is always there when I think about SARS. Every time when it was mentioned, it all came back to me.”

(Yoshioka is a writer, medical editor and speaker with a PhD in the history of medicine. Originally published by The B.C. Catholic.)