THEY'RE JUST OLD

During the course of the last week I'd been watching reports from Canada on the growing number of deaths at a Toronto nursing home. For days, the cause was said to be unknown, but the situation was described as "under control." But the deaths mounted. Then the government said not to worry the whole thing was probably caused by Legionnaires'disease. Anyway, health authorities said, the dead were old. "Some people are fragile enough that they may still succumb to this," David McKeown of Toronto's healt department said at a briefing that included Toronto Mayor David Miller and Dr. Donald Low, medical director of Ontario's Public Health Laboratories. "There is not and never was a threat to the general public," Toronto Mayor David Miller, said. He didn't add but we know he was telling everyone, "just a few old folks in a nursing home." Governmental officials seemed more concerned with tourism then the death of the residents of the nursing home. Toronto Coun. George Mammoliti said he feared the coverage could "scare the living daylights out of people" and cause long-lasting damage to the city's tourism industry. "SARS killed us economically," said Mammoliti. "We really don't need this." One newspaper brought the "thank God they're just old" together with bring on the tourists line as it without shame reported, "Earlier this week, local government officials and business owners took a collective sigh of relief when it was revealed that the mysterious deaths of 17 elderly people in Toronto, Canada was actually due to Legionnaires' disease, a non-contagious form of pneumonia that typically only affects the elderly or immunocompromised."

The following is taken from the Ocotber 8th Toronto Star...

Nothing normal about 17 dead in a week
Politicians focused on Toronto's image

by
THOMAS WALKOM

Now that the "mystery virus" that killed 17 residents of a Scarborough nursing home has been tentatively identified, everything in Toronto is business as usual.

The tourists can keep coming; the hotels can continue to boom. The city's media, which for reasons best known to themselves chose to downplay this rather astonishing public health story, can deliver a smug "I told you so" to the doomsayers.

Did foreigners refer to Toronto as "ground zero" of a mystery disease? Fie upon them. As it turned out, the pathogen that health officials originally called a mystery virus is neither a virus nor a mystery. It's a well-known pneumonia-causing bacterium that goes by the name of legionnaires' disease.

Or, to be more accurate, it is "likely" legionnaires' disease, according to Toronto's chief medical health officer David McKeown

As such, it's both treatable and non-contagious. So relax. Don't sweat it. There's no problem.

Except for the fact that 17 people died in one week.

Now, let us assume, for the sake of argument, that a disease has just killed 17 infants at the Hospital for Sick Children and caused 38 more people, including nursing staff and adult visitors, to be hospitalized.

Assume further that for a week or more public health authorities have no idea what this disease is or how to fight it.

In fact, they initially misidentify it as a virus.

How would you expect the public and government to react?

I would expect outrage. I would expect parents to demand that something be done to prevent similar outbreaks at other hospitals, child-care centres or schools.

I would expect political leaders to be on the hot seat.

I would expect Torontonians to be more concerned by the outbreak's immediate human cost than its effect on the city's tourist trade.

And I would expect this story to dominate the front pages of the newspapers.

But replace 17 infants with 17 nursing home residents and, for some inexplicable reason, everything changes.

The provincial government response, for instance, has been to say that old people die.

Such things, Health Minister George Smitherman said on Wednesday, are "regrettably not a new story."

In fact, Smitherman is wrong.

It is true that old people, like infants, are susceptible to disease. It is true that people get sick. But in the Toronto of recent memory, it is unprecedented for so many to die in such a short period of time from the same disease.

In the winter of 1997-98, a particularly virulent strain of influenza ravaged one Scarborough nursing home.

But the 16 deaths then occurred over a month, not a week. And not all deaths were attributable to the same cause.

Even during the Toronto SARS outbreak of 2003 — one that ultimately claimed the lives of 44 — there were never 17 deaths recorded in one week.

And while it is true that 12 of those who died this week were more than 80, one was in his mid-50s.

So, why exactly was Toronto so cavalier about this remarkable event?

At first, I assumed it was because most people simply don't value the old, that once a person is consigned to a nursing home, he or she is assumed to be of no value and less interest.

This was certainly the subtext of statements from officials and politicians who, in effect, said the 17 were doomed to die anyway.

(We are all doomed to die anyway — but this is a larger story.)

But then the Lake George tragedy occurred, the one in which 21 elderly Americans aboard a New York cruise boat drowned.

That garnered great attention here. It made the front pages of all the Toronto dailies and dominated the television newscasts.

Yet, of the four major city papers, only the Star and Sun bothered to give front-page coverage to early reports of a mystery illness that was killing Canadian old people.

And after that, even as deaths mounted, governments focused not on the outbreak itself but on making sure that news of the mysterious illness didn't hurt the Toronto tourist trade.

The message from authority, dutifully reported, was that everyone was doing a great job and everything was under control.

In spite of the inconvenient deaths, Smitherman told reporters, it was "business as normal" in Toronto.

But is it really that normal when 17 people in a provincially licensed institution die during a one-week period?

Are we really supposed to just shrug it off and order another latte?