MacDougall Heather
Department of History, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1 Canada.
J Hist Med Allied Sci. 2007 Jan;62(1):56-89. doi: 10.1093/jhmas/jrl042. Epub 2006 Oct 11.
This article compares the Toronto Health Department's role in controlling the 1918 influenza epidemic with its activities during the SARS outbreak in 2003 and concludes that local health departments are the foundation for successful disease containment, provided that there is effective coordination, communication, and capacity. In 1918, Toronto's MOH Charles Hastings was the acknowledged leader of efforts to contain the disease, care for the sick, and develop an effective vaccine, because neither a federal health department nor an international body like WHO existed. During the SARS outbreak, Hastings's successor, Sheela Basrur, discovered that nearly a decade of underfunding and new policy foci such as health promotion had left the department vulnerable when faced with a potential epidemic. Lack of cooperation by provincial and federal authorities added further difficulties to the challenge of organizing contact tracing, quarantine, and isolation for suspected and probable cases and providing information and reassurance to the multi-ethnic population. With growing concern about a flu pandemic, the lessons of the past provide a foundation for future communicable disease control activities.
本文将多伦多市卫生部门在控制1918年流感大流行期间所扮演的角色与其在2003年非典疫情期间的活动进行了比较，并得出结论：只要有有效的协调、沟通和能力，地方卫生部门就是成功控制疾病的基础。1918年，多伦多市的卫生官员查尔斯·黑斯廷斯是控制疾病、照顾患者以及研发有效疫苗等工作的公认领导者，因为当时既没有联邦卫生部门，也没有像世界卫生组织这样的国际机构。在非典疫情期间，黑斯廷斯的继任者希拉·巴斯鲁发现，近十年的资金不足以及诸如健康促进等新的政策重点，使得该部门在面对潜在疫情时变得脆弱不堪。省级和联邦当局缺乏合作，给为疑似和确诊病例组织接触者追踪、隔离和检疫以及向多民族人群提供信息和安抚的工作带来了更多困难。随着人们对流感大流行的担忧日益加剧，过去的经验教训为未来的传染病控制活动奠定了基础。
