TORONTO – It took all of Bruce England’s strength to sit up in bed. He felt aches and pains all over his body, shortness of breath and a fever simmering through his forehead while he rested in hospital.
He recalled a day two weeks earlier when he’d seen a very sick patient while on the job. His staff had followed all the proper protocols and gave the patient medication. Still the patient wasn’t responsive, so they called England in.
It was March 2003. He was superintendent of Toronto’s office of emergency management.
“It was the first time in my career I ever stopped what I was doing and went to address a crew to see their concern,” England recalls.
“I went back to do a little research and document our conversations … and it struck me as odd, something was amiss.”
It was just days later that he felt the onset of a nasty flu. By then, the city was in full swing managing the SARS outbreak.
England called the city’s emergency hotline for staff to report his illness. Within minutes, paramedics carried him onto a stretcher and whisked him away to hospital.
“I remember hearing the sirens coming in the background and I thought that was strange and in a couple of minutes I was surrounded by people in encapsulated suits,” he said.
It’s been a decade since England was infected with SARS, but he’s still feeling the effects.
Chronic fatigue. A compromised immune system that’s more vulnerable to pneumonias and colds. A feeling of numbness in his feet and hands. Some post-traumatic stress.
“I got the flu between Christmas and New Year’s. I’m still fighting it,” he told Global News.
Researchers chronicle health of SARS survivors
This week marks the 10-year anniversary of the first case of SARS in Canada as the pandemic made its way into the country.
The respiratory virus ultimately claimed 900 lives worldwide and another 8,500 people became infected. In Toronto, 44 people died from the disease including three health care workers.
But many hundreds survived the virus – most of them health care workers.
Dr. Paula Gardner, a psychologist at St. John’s Rehab in Toronto, has been documenting the health of survivors, post-SARS.
“They’re still, after 10 years, experiencing problems. Issues such as fatigue, muscle and joint pain, shortness of breath and some newly developing problems such as neuropathy, numbness in the feet and hands,” she said.
And those are just the physical scars.
Studies looking at patients seven years post-SARS have shown 41 per cent of patients report depression and post traumatic stress disorder.
Depression has been linked to other kinds of respiratory diseases – COPD or chronic obstructive pulmonary disease, for example – but not at such high levels.
That feeling of depression also deepened as the years progressed.
Some patients show symptoms associated with Post Traumatic Stress Disorder or PTSD.
“There’s a certain category in trauma symptoms that involves hyper-awareness of danger, irritability, jumpiness, difficulties with concentration and sleep disturbance,” Gardner told Global News.
Research looking at SARS patients in Asia has also found high levels of depression and PTSD.
The uncertainty of the lingering effects may be what’s causing this anxiety, Gardner guesses.
“This is not a disorder or a disease that’s known. It’s still brand new, it’s still being understood and followed,” she explained.
Doctors can’t promise their patients that they understand what’s going on, or give them a heads up on what to expect.
Meanwhile, patients question when their symptoms will dissipate, if ever.
Typically, it might take a year to recover from a severe pneumonia. That hasn’t been the case for some of Gardner’s cohort of subjects.
About 40 to 50 per cent of her sample was unable to return to work.
“These are professionals, this is an identity they had,” she explains.
The overwhelming tiredness changes their lives.
“We’re not just talking about feeling a little bit tired each day. This is a disabling fatigue,” Gardner says.
Some patients take on an activity for nearly 20 minutes and need to return to rest.
“So this affects their lives profoundly. There’s going to be a lot of grief about that.”
In England’s daily life as a retiree, he’ll spend a few minutes playing with his grandchildren before he gives up because he’s out of breath.
“With the neuropathy, the numbness, I’ve broken my toe, I didn’t know. You take your sock off and your toe falls over,” he said.
“Or when you’re cooking and you pick up a hot dish or frying pan and it burns your hand, you smell the burning flesh and you don’t feel it.”
Right now, Gardner is set to follow up with these survivors at the 10-year mark.