Sunnybrook outlines security plan in wake of coronavirus

Following the diagnosis of Canada’s first case of Novel Coronavirus (2019-nCoV) at Sunnybrook Hospital in Toronto, Bruna Mariano, manager of security services at Sunnybrook Health Sciences Centre, confirmed that they did not go into a perimeter lockdown of the security as they previously had done with SARS.

The first case of 2019-nCoV in Canada was identified in a Toronto man who had recently travelled to Wuhan, China, the epicentre of the outbreak. Mariano, who has worked at Sunnybrook for 24 years, said, “We are going by the ministry of health and public health [guidelines]. We’ve had a lot of training with infection control on donning on and donning off equipment, and the proper ways of doing it, so we don’t spread the virus. There was more education after SARS.

“When we had SARS here in 2003, we had two floors here of patients,” she said. “And back then, we actually had paid police officers on site just to calm down visitors and so on. At one point with SARS we didn’t allow any visitors to come into our facilities. We were just secured. We didn’t want anybody to come in at that point because we didn’t know too much about SARS,” she continued.

Two screening tools that are being used at Sunnybrook are: if you’ve traveled to China recently or if you’ve come from Wuhan.
“Much of our screening protocol is what we went through with SARS. And with SARS, we didn’t really know whether it was spread through human contact or droplet or airborne. And then we went through that second phase of SARS. The coronavirus is more controlled,” said Mariano.

Education
Mariano stresses that education is key to pandemic planning.

“It is training with our emergency preparedness. We go through Code Orange drills here. If it were a pandemic, it would be part of a Code Orange drill as well as it would be an external disaster coming in with multiple victims or people prone to this type of sickness or pandemic.”

Mariano said, “You don’t want your staff to fear going to a patient care unit. You want your staff to feel safe. You want to be working in a safe environment.”

Education is crucial in combatting fear and keeping a comprehensive pandemic protocol up to date, she said. Mariano meets with her security staff every Thursday, which sometimes includes experts from other areas in the hospital, such as infectious disease control.

Screening stations
The location of disease screening stations within the hospital must be chosen strategically, said Mariano, in order to reduce the risk of unsecured entry points.

“Is it just [the ER]? If it’s not just [the ER] and you have another main entrance or another entrance into the facility or if it goes widespread, how are you going to work with screeners at the station? Security is there to secure the perimeter. But, at times, they are also there to deal with aggression. With SARS, we had a significant amount of aggression at the doors because visitors were antsy,” said Mariano.

How to best deploy your security staff has been something that Mariano has planned for since the SARS outbreak in 2003. “Where would you get your other resources if you didn’t have enough? It could be your team that has been affected by this pandemic. So, do you have enough casual staff to fill in?” she said.

“I think Ontario has come a long way from SARS. I think we learned a lot. I think the Ministry of Health and the public health learned a lot as well,” said Mariano. “I’ve been in communication with our risk team, our infection control team and right now they’re the ones that are the experts on this virus. They know whether or not this is spreading and to add more precautions. Now, we’re not at that stage. If it did go to that stage, we’ll know what we went through with SARS.”

For Toronto’s two confirmed cases of 2019-nCoV, the patients are currently in self-quarantine at home following the first case being discharged from Sunnybrook Hospital on January 31. This is a regular occurrence for those with communicable diseases.

To date, there are four cases of 2019-nCoV in Canada, including the recently discharged patient and his wife, a Western University student in London, Ont., as well as one case in Vancouver who voluntarily placed himself under self-quarantine.

“Where there is a suspected case of coronavirus, many times the patient will be self-isolated at home (based on their condition).” said Jeff Young, president of pür protection group, a Vancouver-based independent consulting firm that specializes in health-care security and risk.

When an outbreak occurs in a controlled location like a cruise ship, “those people are kept in isolation in place on the ship until cleared/confirmed to reduce the likelihood of the disease spread,” added Young, who spoke to Canadian Security via email.

“In hospital network settings, the network may designate one of its hospitals and co-locate suspected and confirmed coronavirus patients to that hospital location,” he said.

Young also identified some key points to keep in mind when planning for a pandemic:
1. Access control points
2. Patient movement within hospital to/from designated unit/ward
3. Visitor management
4. Media management
5. Ward/unit security/confidentiality
6. Legal quarantine responsibilities

Lessons learned from SARS and other health emergencies have helped with coronavirus preparation in Toronto, said Mariano, but vigilance is still required. “I don’t think this is over yet. I’m sure there are going to be more cases spread open. But, I think we’re OK. I really do.”