TORONTO — While 42 Canadians have died of SARS since March, countless more continue to feel the psychological effects of the new pneumonia-like disease.

Anxiety and stigmatization plague health care workers, members of the country's Asian community and others, and governments aren't doing enough to address their concerns, psychologists at a meeting of the American Psychological Association said Thursday.

"The physical effects of SARS are relatively small compared to the psychological toll it's taking and the toll that it's taking on our health care professionals, because the nurses and the doctors aren't getting the support they need," Dr. Esther Greenglass said after a panel discussion on severe acute respiratory syndrome.

"Not only are they not getting proper equipment but nobody seems to care about their plight."

Greenglass's assertion was backed up by a survey being conducted by Toronto's Emergency Medical Service, which has found paramedics were worried about spreading SARS to their friends and family and only slightly less worried that the SARS outbreak would delay patient care or infect the workers themselves.

Although the SARS outbreak is officially over, paramedics in Toronto have been wearing protective masks, gowns and gloves when they work for more than 100 days, and are officially expected to still be wearing them. Only four out of the city's 800 paramedics got SARS, and all have recovered. But at one point this spring 400 paramedics were ordered into quarantine or "working quarantine," where they had to wear masks at home and work for 10 days, and eat nine metres away from anyone else.

The 40 paramedics who have returned the survey so far also said they felt strongly that their hard work and the risks they take with possible SARS patients were insufficiently recognized and, to a lesser degree, they were avoided by the public because of their contact with sick people.

Dr. Gerry Goldberg, the paramedics' staff psychologist who is conducting the study, said the workers experienced and continue to experience what he called the "Tim Hortons effect."

"They would go into a Tim Hortons and see the line parting in front of them because they were definitely being avoided by the public."

They also expressed concern about the possibility of another SARS outbreak and how it would affect them and their families in the future.

"Many of them said to me, 'I don't know if I want to continue doing this job because if I infect myself, that's one thing, but if I endanger my family, that's something else," Goldberg said.

"They wonder, six months later, can I blow out the candles on the birthday cake? Can I give my daughter a good night kiss? Those are things that are very real and bothersome to people."

The general public was also very anxious about SARS this spring, Greenglass said, and moreso in affected areas, like Toronto.

In an Internet survey conducted with the help of colleagues in Singapore, Greenglass found that the more worried a person was about SARS, the more they used emotional coping methods - prayer, avoidance of certain types of people and wishful thinking.

"That anxiety is not being dealt with because they're using techniques that are really designed for managing the symptoms not for solving the problem," said Greenglass, citing the need for more information about the disease instead of prayers.

Aside from not being very helpful to the anxious individual, coping tactics such as avoidance and wishful thinking can hurt others, Greenglass said.

"These kinds of emotional forms of coping lead to stigmatization: avoidance of Chinatown, avoidance of Asian people and the next step is labelling them, stigmatizing them."

Greenglass also criticized governments for what she saw as putting economic interests before health.

"I think that our governments at every level have focused on one thing only and that was economic losses," Greenglass said.

"I think their attention and their concerns should be placed rather on more responsible dissemination of information: where people can go to learn about SARS, how it's transmitted, how they can protect themselves and where they can actually discuss some of their own fears and anxieties with people who are experts in the area of infectious diseases."

The telephone hotlines set up by the province and daily media briefings with provincial, municipal and sometimes federal officials, Greenglass said, were not effective enough.