I can tell you what we do at Osler.
We are a larger organization with more staff and more bandwidth. We have a pandemic plan that our emergency preparedness committee is in charge of, and it is reviewed on an annual basis. The pandemic plan includes not only the work that needs to be done inside a hospital but also the partnerships that need to be developed outside with EMS, regional governments and the Ministry of Health when such a pandemic strikes. We do it annually and we review it annually.
As I mentioned, we may be at a bit of an advantage because of our proximity to the airport, but we do have simulation exercises with the local fire departments, local police and the Greater Toronto Airports Authority for various types of issues, whether it be an airplane crash, major trauma or an issue like this one, with the risk of an infectious agent.
I have worked in towns of 1,600 and towns of 2,000 in the past, and I think that with smaller hospitals, it all depends on the administrative bandwidth that they have. Being an accreditor for Accreditation Canada, I often accredit hospitals across the country, and I find that in smaller hospitals, just because of the the workload they have, they may not be reviewing the protocols on an annual basis or even every two or three years. They may just be acting when things like this happen.