Coroner’s lab far from ‘CSI’
Ventilation system puts staff at risk Legionnaires’ probe highlights need
Ontario’s chief coroner works in a 30- year-old bunker- like Toronto building that’s so outdated it can’t safely handle infectious disease outbreaks.
For years, Dr. Barry McLellan has hoped someone would add a voice to his plea for updated facilities.
McLellan got his wish Monday when Dr. David Walker — chair of the expert panel appointed by the province to review the legionnaires’ outbreak — told the province it needs to replace the coroner’s autopsy suite on Grosvenor St., where the real medical detective work is done in Ontario.
Case in point: the recent legionnaires’ outbreak that infected 133 people. The coroner’s office could not perform the autopsies on the bodies associated with the outbreak because they were considered an infectious risk. The ventilation system and the design of the autopsy suite is such that airborne transmission can’t be prevented during autopsy. That puts staff at risk and anyone who works in the building. The coroner’s office sent the bodies to Toronto General Hospital for autopsy. They also did so during the SARS outbreak in 2003.
McLellan had the Grosvenor St. building examined to see if it could be updated and retrofitted. But the building is too old, the electrical, ventilation and size of the building is inadequate for what the province needs.
“ The recommendation is we move to a new site,” he said. They are planning to do so now but Walker’s report highlighted the need for a speedier process. When the first legionnaires’ victims were brought in they had to be sent to Toronto General Hospital because no one knew, at that point, what they had died from and if it was airborne. Toronto General has the facilities to handle a potentially infectious agent.
“ What Dr. Walker and his panel appreciated is that this building is not adequate to deal with an epidemic or pandemic when we are dealing with an unknown pathogen or a known pathogen where there is airborne transmission,” said McLellan. “As such we need to be in a new facility.” A state- of- the- art type of autopsy suite would have a negative air pressure ventilation system and could handle level 3 biosafety agents, such as SARS, that may be airborne. Some of the tools needed in autopsy could cause infectious particles to circulate in the air, such as the saw, he added. “ It depends upon the agent or the procedure as to whether or not simply opening a particular tissue is enough to create risk or whether or not it’s in addition to using the saw.” The autopsy suite looks nothing like the sets of hit Hollywood shows such as CSI or Crossing Jordan. It looks exactly like it did 30 years ago when the building was first constructed. Three
just to have a voice.
Empower the mayor to draft the city budget with the executive committee, send it to the various council committees for input, and then draft a final budget. Council would then have to vote “ yes” or “ no” to the budget, without any tinkering.
This recommendation is damaging. Imagine a system like this with a Mike Harris as mayor. Just ask yourself, would you have given these unfettered powers to a Tom Jakobek? Would Miller approve of Mel Lastman wielding such sway over council? Of course not. The budget is the most important document of council. Yes, the mayor should start off the process. Yes, he should apply rigour. But to have the mayor and his handpicked group draft the budget, hear appeals on it and then send it on to council without council having the ability to make changes is disrespectful in the extreme.
Councillors would have little or no ability to affect spending priorities — not when the same executive committee is in charge of the entire process, a committee motivated to stay in rank because if they don’t they could be fired and lose the higher pay associated with executive committee status.
Hire and fire the city manager. Even Miller admitted yesterday this was worrisome, as it seems to reduce the independence of the civil service.
Normally, you could have depended on city council’s progressive wing to decry these recommendations. But the very people who are supposed to protect us from such a dangerous system are its architects, actively promoting it for their own political gain. How else to explain Mayor David Miller’s position on this, aided by his normally progressive NDP allies?
They’ve turned a good idea, empowering the mayor, into a gross power grab. Royson James usually appears Monday, Wednesday and Friday. Email: rjames@thestar.