How to provide an effective primary health care in fighting against severe acute respiratory syndrome: the experiences of two cities

Objectives: This study was designed to compare the response and management of severe acute respiratory syndrome (SARS) by the family physicians of the Hong Kong and the Toronto health systems, and to provide evidence to improve health policy and practices in a newly emerging infectious disease. Methods: A questionnaire was sent to family medicine tutors affiliated with either the Chinese University of Hong Kong or the University of Toronto in 2003. The survey questions covered training for SARS, the use of screening tools, an anxiety scale, clinical practices, and demographic data, Results: 137 (74.8%) and 51 (34%) doctors from Hong Kong and Toronto replied to the questionnaire, respectively. Most (80-84.6%) had no training in infectious disease control and were not confident in dealing with SARS (68.1-73.5%). In Hong Kong, the screening tools provided by international agencies did not meet the local needs. In Toronto, lack of a centralized hospital admission policy and fully public laboratory probably resulted in appointment cancellation and dissatisfaction. There may be a need for deployment of personnel between institutions but loss of income was not a major concern. Conclusions: Sharing the "lessons learned" in different regions during a SARS outbreak will help prepare for the next epidemic.