This issue of The Dark Report brings some of the first details about how the SARS outbreak in the Canadian Province of Ontario is causing widespread, sustained disruption to hospitals, laboratories, and office-based physicians, particularly in the Toronto metropolitan area.

When the earliest SARS patients showed up in Ontario hospitals, international healthcare alerts had yet to be issued. Alarmingly large numbers of healthcare workers were exposed and became infected because they had been around SARS patients with relatively little protection. When public health authorities recognized the emerging pattern of infection, they acted swiftly to control the further spread of SARS and learn more about the disease.

I recommend that laboratory executives and pathologists pay careful attention to the still-unfolding story of SARS in Toronto and its eventual aftermath. SARS is a case study for how both bioterror and contagious diseases can emerge at unexpected moments—threatening the health and economic well-being of major cities overnight. In Ontario, SARS placed healthcare workers in hospitals and other settings at risk.

In March, entire hospitals were closed and their staffs put in quarantine for a minimum of ten days. Hospitals ceased elective surgeries and were allowed to treat only patients in"life-threatening" circumstances. A major international medical meeting of 12,000 attendees was cancelled because of concern about SARS exposure and transmission.

The clinical lab's vulnerability to the unknown aspects of SARS was revealed in an unexpected way. A microbiologist who was director of one hospital's infection control team traveled to another hospital to observe and treat a SARS patient. This microbiologist became infected with SARS and, upon returning to her own hospital, exposed all six members of the infection control team, of which three members subsequently contracted SARS.

The emergence of a new disease such as SARS fulfills the many predictions of healthcare experts. To help lab directors and pathologists understand this phenomenon and develop appropriate management strategies for their own laboratories, The Dark Report is devoting extensive coverage to the Toronto outbreak. The economic and emotional turmoil unfolding in that town is another timely warning that infectious disease outbreaks can hit any town at any time.

Toronto Hospital Labs Cope With SARS Impact

Hospital workers fall ill as health system races to control spread of the new disease

CEO SUMMARY: Canada has become one of the world's hot spots for SARS. Concern about the unexpected number of hospital workers who contracted the disease triggered a halt to all but the most life-threatening patient care needs in many hospitals in Ontario. The manner in which this disease is transmitted is causing lab administrators in Toronto to rethink hospital infection control and microbiology activities.

Commercial Labs React To Ontario SARS Outbreak

Canada's largest laboratory company swiftly responds to fast-moving disease

CEO SUMMARY: Ontario's SARS outbreak has affected commercial laboratory companies in the province. Because so many healthcare workers were contracting SARS, laboratory directors at MDS Diagnostic Services took swift action to protect both patients and laboratory staff—to prevent exposure and transmission of SARS as well as to insure that no labs would be lost because of quarantines.

LabCorp's Mac Mahon Provides Insights About Lab Marketplace

LabCorp positions itself to offer more anatomic pathology services

CEO SUMMARY: Pathologists will be particularly interested in what Thomas Mac Mahon has to say about the evolution of laboratory medicine. As Chairman, President, and CEO of Laboratory Corporation of America Holdings, he has several surprising predictions to make about the future of laboratory medicine. In this exclusive interview, conducted by The Dark Report's Editor-in-Chief, Robert L Michel, Mac Mahon talks about the impact of 2002's laboratory acquisitions, specialty esoteric testing, and why more hospital laboratories are entering the laboratory outreach business.

SARS Challenges Met With New Technology

Clinical labs gain important insights about dealing with new infectious disease

CEO SUMMARY: When SARS began to spread around the globe, the United States was fortunate to escape the type of outbreak which still dogs Hong Kong and Toronto. Had SARS cases appeared in the U.S. a week earlier, the first affected cities would have experienced widespread concern, reduced tourism and economic activity, as well as severe disruption of normal hospital and laboratory activities.

INTELLIGENCE:

Consumer-Driven Health PLans Are Growing In Number

Another ISO Lab: Beaumont Reference Laboratories