The arrival of a new, sometimes deadly strain of coronavirus to just outside Canada’s borders has health officials determined not to repeat the country’s stumbling response to the SARS epidemic 17 years ago. SARS, or Severe Acute Respiratory Syndrome, killed 44 people in Canada, the only country outside Asia to report deaths from that virus in 2002-2003. Government health officials say Canada is better prepared this time. There have been no confirmed new coronavirus cases in Canada, but “five or six” are under investigation, Canadian Health Minister Patty Hajdu said. Starting this week, Canada’s Public Health Agency added a screening question for visitors and began displaying messages in several airports urging travellers to report flu-like symptoms. “I feel assured that the processes that we’ve put into place, that we’ve learned since the experience of SARS, are actually functioning just as they should,” Hajdu said on Thursday. The Ontario government said doctors are now required to report suspected or confirmed cases of the new virus to local public health units. At least 18 people have died from the new coronavirus following an outbreak in the Chinese city of Wuhan, and nearly 650 cases have been reported globally, 634 of them in China. The first US case was confirmed on Monday in Washington state, bordering Canada. It is still too early in the outbreak to know how dangerous the virus is and how easily it spreads from person to person. But Canada erected its main defences after learning the hard way that it was ill-prepared for SARS, a different strain of coronavirus. “If there is a silver lining to (SARS), we are ready for this one,” said Dr. Isaac Bogoch, an infectious diseases specialist at the University of Toronto and Toronto General Hospital. “I won’t bat an eye if this is imported into Canada. The world really is a much different place than it was in 2002.” The SARS outbreak led to a rare travel warning for Toronto from the World Health Organization. As a result, tourists aborted trips and conventions were cancelled, at a cost to Canada of C$1.5 billion ($1.14 billion) in gross domestic product, according to the Conference Board of Canada think tank. Streets in some neighbourhoods of Canada’s largest city were deserted and Asians faced a public “shunning,” recalls Tony Clement, Ontario’s health minister at the time. Unlike during the SARS epidemic, if a patient shows up at a Canadian hospital now with flu-like symptoms after recent travel, they are isolated and given a mask to wear, Bogoch said. Doctors and nurses treating the patient are required to suit up in protective gowns, masks and gloves. Systems are in place for handling samples from patients suspected of being infected and for communication with other health agencies. MORE TO BE DONE But preparations this month have been uneven in hospitals across Ontario, said Vicki McKenna, president of the Ontario Nurses’ Association. Some hospitals have done recent fittings for nurse respirator masks, others have not. Some have posted signs in waiting rooms and begun additional patient screening, she said. “(Nurses) are themselves a little bit uncertain what’s happening in their organizations. There is not consistent messaging and that’s a bit worrisome,” McKenna said. Clement recalls receiving briefings from staff early in the SARS outbreak assuring him the situation was under control, before the spread accelerated. Canada should avoid drawing the same hasty conclusion with this coronavirus, he said. Airport screening is “better than nothing,” but people may display symptoms only days after infection, he said. Health officials should be quick to restrict hospital visits and patient transfers if the situation worsens, Clement added. It is critical that hospitals ensure all staff – including medical and cleaning workers – know how to properly don protective equipment, and address other precautionary concerns, said Gavin Macgregor-Skinner, director of training for the Chicago-based Global Biorisk Advisory Council. Those include dedicating separate hospital rooms for staff to suit up and to remove safety gear, disposing of infected materials properly and ensuring that isolation rooms have negative air pressure, which prevents air from contaminating other areas, Macgregor-Skinner said. A dedicated phone line for recent travellers with flu-like symptoms should be set up, he added. “A week ago, I wasn’t too worried about this one. But I am now,” he said.