The recent outbreaks of Severe Acute Respiratory Syndrome (SARS) in Toronto shone a harsh light on the inadequacies and outright failures of neoliberal public health policies and practices. It also showed clearly the extent to which neoliberal governments prioritise business security above the health and social security of workers. Even more than this, however, the SARS crisis revealed the ways in which the pressures of capitalist social relations make people ill.

Public health officials first received warnings of SARS in early February 2003 and a full-blown crisis was emerging by March. By late-April Ontario’s Tory Premier, Ernie Eves, had not even recalled the legislature (which had been on hiatus since Christmas) to devise a plan for dealing with the various aspects of the crisis. For weeks the Tory plan appeared to consist of little more than saying to “wash your hands” or “eat in Chinatown.” Governments only responded after the embarrassment of the late-April World Health Organization (WHO) travel advisory and the threat of losses for tourist industry owners. Even then the responses were largely in terms of public relations.

The SARS outbreak — like the Walkerton tragedy before it which saw several people die and hundreds become sick after privatisation and cuts to water inspection contributed to e-coli contamination of the town’s drinking water — revealed the damage done to the health care system by the Tories.

The privatisation of front-line health services played a major part in the provincial government’s inability to keep up with the SARS outbreak. Likewise, cuts to health care put systems under greater strain and left fewer resources to pick up the extra work (resulting in delays for people requiring other services). Clearly public health requires a large increase in resources.

No Help For Workers

The problems caused by the lack of public health resources were compounded by the failure of any level of government to compensate workers who had to go under quarantine and those who were not quarantined but thought they had symptoms and should therefore stay home from work. That this failure played a part in the spread of SARS in Toronto, and in the spread of panic over SARS, was highlighted when an infected nurse from Mount Sinai Hospital took public transit on April 14 and 15 because she could not afford to miss o work.

Similarly, nothing was forthcoming to assist tenants facing eviction or people unable to make utility payments due to SARS layoffs or work cutbacks. Governments failed to offer assistance to workers suffering layoffs and reduced hours in industries negatively affected by SARS. As late as May 27, Hotel Employees and Restaurant Employees (HERE) Local 75 was still requesting meetings unsuccessfully with federal Industry Minister Allan Rock and Human Resources Minister Jane Stewart. Local 75 president Paul Clifford noted: “There has been no additional funds fromsenior levels of government directed towards hospitality workers. No EI [employment insurance] funds, no waiving of the two-week waiting period for EI, no relaxing of EI regulations and many workers and their families are going under”.

More than two months into the outbreak the federal Liberal government finally waived the two-week waiting period for claims. Unfortunately they did nothing to relax eligibility regulations, a factor which is particularly relevant given that many hospitality and restaurant workers are part-time workers and therefore not eligible to receive EI payments. As well, it should be pointed out that EI payments do not cover full wages, even for the already low paid workers in hotel and restaurant industries.

That each level of government was more concerned with helping tourist industry bosses rather than workers was clear in who received compensation or subsidy packages. Provincial money has come as subsidies to capitalists, especially those involved in entertainment industries such as Mirvish Entertainment (producers of such spectacles as the Lion King and Mama Mia) and Rogers (owners of the Blue Jays baseball team and notorious for not paying their cable installers). Exclusive restaurants and hotels also received subsidies. For the most part the federal Liberal government, which precipitated the crises in health care by gutting health transfers to Ontario by $6 billion, offered such “symbolic support” as holding a cabinet meeting at an exclusive Toronto hotel (to and from which federal figures were chauffeured with great haste).

Other responses were little more than gimmicks, including the proposal to pay the Rolling Stones $10 million in public money to put on a “free” concert. Ironically this was the same amount as the total federal relief package to compensate laid-off and quarantined workers and affected small businesses.

Public Relations, Not Public Health

Even worse, the provincial government’s rush to proclaim the crisis over following the WTO advisory seems to have played a major part in a renewed outbreak at the end of May. The nurses’ unions reported publicly that before to the second outbreak their warnings to the government that it was too soon to let up on SARS went unheeded. Clearly public relations rather than public health was at the forefront of Tory concerns.

By mid-June, the province had still failed to increase resources and staff. At St. Michael’s hospital 30 extra health care workers were required for SARS duty during the second outbreak. Even double-time wages were not enough to entice many workers to put themselves at risk given the inadequacies of resources that remained. The hospital responded by threatening mandatory work to deal with the SARS cases. Finally, during the second outbreak, after weeks of serving stress-filled overtime shifts and suffering some of the city’s highest infection rates, nurses put forward a demand for “danger pay” through their union

During the second outbreak more than 7000 people were quarantined. Incredibly, compensation packages have not been made available, apart from removal of the two-week waiting period for EI claims.

Anger over the Tories’ part in mishandling the outbreak may play a part in the provincial elections. Tellingly, Premier Eves cancelled his election announcement, which had been planned for the week in which the second outbreak occurred, lest the election become a referendum on Tory health care policies. Still, anger over the Tory bungling of the SARS crisis is running high, extending into their support base in the regions surrounding Toronto. Finally, following great public outcry and appeals by health care workers, the Tories conceded an inquiry into government handling of SARS was necessary.

SARS is only one example of outbreaks related to environmental destruction and the intersection of ecological damage and poverty. Researchers have traced the emergence of SARS to the Dongyuan, China market cages where exotic animals are held for sale. It appears the virus transferred from animals to food handlers serving wealthy customers in exclusive hotels.

SARS also spread through workplaces, especially through mass production facilities such as the Matsushita Electric Industrial Company factory, the Ricoh Electronic Technology Company factory and the Motorola Inc. factory, all in Beijing. Again, sick people who were forced to go to work brought illness to their co-workers.

Thus, while the corporate media in Canada insist on referring to the “Chinese origins” of SARS, thereby furthering a depiction of disease as foreign and allowing for surveillance of Asian people, SARS actually has its beginnings in exploitation, class division and the pressures of capitalist work.

Which Virus Gets Attention

Other recent outbreaks in Toronto, such as tuberculosis, Norwalk virus and Hepatitis A, have received less attention because there is a sense among governments that these diseases are confined to poor and homeless people and not likely to spread to the population at large. SARS had such an impact because it affected suburbanites, consumers and, potentially, tourists.

Street nurses Cathy Crowe and Kathy Hardill note that the TB outbreak in Toronto shelters in 2001 was predicted by front-line health workers as early as 1994 yet the city and province did nothing to change the conditions that led to the outbreak: overcrowded shelter conditions and a lack of affordable housing and community-based programs such as drop-in centres and unsatisfactory nutrition. Almost 40 percent of shelter residents have been exposed to TB.

The conditions that underlie the spread of TB are really the same as those that underlie the spread of SARS: the insecurity of capitalism which forces people to spend much of their lives working for wages lest they face the consequences of homelessness and hunger.

Many workers know that they are a pay check away from being homeless and too many of us are faced with the decision to pay the rent or feed the kids. Lack of access to and control over the necessities of life and the compulsion to work to survive undermine the capacities of individuals and communities to make their health a priority.