The protective gear worn by Toronto nurses treating SARS patients may not be sufficient to prevent them from getting the deadly disease, a respected microbiologist who is helping lead the city's battle against the virus said on Wednesday.

Dr. Donald Low, chief of microbiology at Mount Sinai Hospital, said there is evidence that some procedures, such as inserting breathing tubes into patients, are extremely risky, and the transmission of the Severe Acute Respiratory Syndrome virus can occur even when all precautions are taken.

Two of the new SARS cases in the past week occurred in nurses who were inserting breathing tubes into a SARS patient. SARS nurses in Toronto wear, at a minimum, two layers of gloves, a mask and a gown.

Health officials meanwhile said on Wednesday that Toronto's latest SARS outbreak was tapering off, with the number of people in quarantine falling to about 1,000 from about 5,000 on Tuesday.

Low made his comment as hundreds of angry and exhausted nurses set up picket lines in front of a suburban hospital and demanded better gear, a safer working environment and more input into the handling of the outbreak.

"Clearly, the experience in Toronto is that these people are at an increased risk of acquiring SARS," Low said. "People just don't understand the kind of risk they (nurses) are putting themselves at working in these wards."

Low said nurses in SARS units could soon be wearing equipment resembling space suits to protect themselves. One hospital already requires such suits for nurses treating SARS patients, he said.

But even space-suit-like gear may not be the best thing to prevent infection, said Dr. Andrew Simor, chief of microbiology at Sunnybrook and Women's College Health Sciences Center in Toronto. "We do not know for sure if that is the answer or not," Simor told a news conference.

DOUBLE PAY FOR NURSES

Recognizing the risk, four hospitals in Toronto have said they will double the pay of nurses working with SARS patients. Senior nurses could get C$66 ($49) an hour.

Yet for some, extra pay is not enough.

Doris Grinspun, executive director of the Registered Nurses Association of Ontario, said nurses are overworked, need time to rest and require more training in infection control.

"More money alone will do nothing," she said.

In an open letter to health-care workers, Ontario Health Minister Tony Clement said: "We are aware of your concerns ... we are taking appropriate steps to help prevent the spread of SARS and other infectious diseases. I want you to know that we are listening, that our government will keep listening to you."

But he did not calm the fear nurses have that they might be ordered to work in new SARS wards being created in the city despite new evidence of risk.

"The (SARS) cluster is tapering off but we need to be hypervigilant," said Dr. Colin D'Cunha, Ontario's chief medical officer of health. Twenty people are in critical condition, he said, adding that an additional 221 people are being monitored for possible infection.

Health officials said no cases were reported from the nearly 1,700 pupils and teachers who went into quarantine at a high school and that five more cases being investigated at a hospital were not SARS. Two possible cases in the town of Parry Sound, north of Toronto, and one in Ottawa also turned out not to be SARS.

Toronto, with 32 SARS deaths, is the only place outside Asia where people have died of the respiratory disease. There were 79 probable and suspected cases of SARS in Toronto on Wednesday, up from 77 on Tuesday.

The disease has killed 772 people worldwide.

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