A possible global influenza pandemic could sicken more than 900,000 people in Toronto, send as many as 12,000 to hospital and kill up to 5,000, Toronto public health officials warned yesterday.
Spurred by the 2003 outbreak of severe acute respiratory syndrome, officials have been working on a pandemic influenza plan, a draft of which is due next month, in the hopes of preparing for a global flu outbreak like those in 1918, 1957 and 1968, which killed millions worldwide.
"I think we are much more ready than we were, pre-SARS. . . . Are we ever really going to be ready for a disaster of this magnitude? You know, it's a difficult question. I think the more prepared we are, the more connections and planning and policies and procedures and agreements in place beforehand, the better," Dr. Barbara Yaffe, city director of communicable disease control, told the board of health yesterday.
The board voted to urge the provincial and federal governments to accelerate their influenza pandemic plans. And it urged the city to make plans to ensure that essential services would be available in the event of an outbreak.
According to a report presented to the board, the influenza virus mutates a little bit each year, with minor changes causing small outbreaks each winter. A pandemic, in which thousands become seriously ill, occurs when the virus undergoes a major mutation, leaving much of the population with little or no immunity.
Public health officials, watching the Asian experience with avian flu, warn that the world is due for a full-blown pandemic, because the last one was almost 40 years ago.
Dr. Yaffe said that in the event of an outbreak, not only could hundreds of thousands of Torontonians potentially fall ill, but also hundreds of thousands more would have to skip work to care for them. This would leave as much as 35 per cent of the city's work force off -- either sick or caring for a sick relative.
"There will be issues around continuing the functioning of society, the delivering of essential services," she said.
At the moment, plans do not call for mass quarantines, only "isolating people who are ill" and urging people to wash their hands and stay home from work if they fall sick.
A vaccine would not be developed for four to six months, Dr. Yaffe said. According to the federal government's pandemic plan, vaccines or anti-viral drugs would go first to health-care workers, police and other essential personnel, and to high-risk groups such as the elderly and the very young.
Unlike SARS, the report says, when transmission was largely limited to hospitals, an influenza pandemic would spread in workplaces, schools and homes.
The report's projected numbers, which predict 910 to 5,000 deaths in Toronto, are based on numbers from the U.S. Centers for Disease Control, based on past epidemics.