What the virus looks like in Toronto’s homeless encampments: a memoir

I spent the summer running mobile Covid testing clinics in Toronto’s homeless shelters and encampments. The experience showed me a city I’ve never seen before

I am a displaced person, uprooted by war and colonization, but also by love. My parents couldn’t be together in Sri Lanka because they come from opposite sides of the ethnic conflict there, so they moved to England in 1970. I was born two years later, and we later moved to Ottawa, where our home became a place of shelter for my father’s extended family, all refugees from the civil war.

Growing up around people who’d lost everything, I yearned for certainty. That’s partly why I became a doctor: put a cast on a broken leg and you’ve made a difference in someone’s life. I’m a neurologist, working between CAMH and Women’s College Hospital, but in March I received an email from the WCH assessment centre seeking physicians to help test for Covid-19. I signed up right away. Working at the assessment centre gave me a way to fight back against the problem. I have a master’s in public health, and I kept thinking of the mantra I learned in school: “Screen. Detect. Trace. Connect.” If I did this intensively, school would start again. Theatre would start again. Life would start again.

Before the pandemic, I’d never done a nasal swab. It requires some subtlety: you can’t just shove it in and out. Instead, you have to follow the lower nasal turbinates down into the back of the throat and twist the swab several times to pick up tissue and secretions. At first, we used thicker swabs, and there were a lot of nosebleeds. Some people say a swab is like swallowing too much wasabi; others say it feels like drowning.

After a few weeks, we began getting calls from women’s shelters asking for help with testing. There’s no easy way for someone in a shelter to self-isolate, so I helped spearhead a mobile unit to test people in vulnerable situations. For days, I was wrapped in PPE like a stale blue hot dog, transporting our gear—swabs, sanitizer, wipes, specimen bags—in plastic crates.

Before we arrived at each shelter, we made white labels for our sample tubes. Each label had a name, each name had a story. At one shelter, I noticed that half of the women had the same last name: Hope Jones, Justine Jones, Sarah Jones, Faith Jones. They were using pseudonyms, afraid that their real names might identify them to the people they were fleeing. At another shelter, a young Black woman walked by while I was testing and said, “No one is putting anything in my orifices.” For people who’ve survived sexual trauma, a Covid test is yet another invasion.

We also administered tests at some of the city’s homeless encampments—the tent communities that have popped up in parks and public spaces. These encampments predate Covid, but their numbers have swollen during the pandemic. Many shelter residents have moved into encampments fearing disease transmission or because the rigid rules in shelters are difficult to navigate. In these communities, supplies are donated—either by organizations like Sanctuary, the efforts of citizen groups like the Encampment Support Network Toronto, or individuals who drive up with tents or cases of bottled water. Some encampments have porta-potties, but many have no running water, and organizations like Anishnawbe Health offer mobile health care.

The encampment at the Church of the Holy Trinity was nestled in the shadow of the Eaton Centre. Pink naloxone kits, free for the taking, hung from the branches of a tree. The church supplied meals, and the encampment was divided into two clusters, around 40 tents in total. One cluster was a group of teens, young adults and even a pregnant mother and her partner. The other was led by Indigenous elders, asserting their rights to live on the land.

Testing began with a ceremony: elders smudged, sang and invoked Bear the Healer. We tested 60 people the first day, and there was only one positive case, an older man who called himself Z. He had no symptoms, but the diagnosis hit him hard, and he began talking about connecting with his estranged son to discuss his last rites. I sat with him for five hours while we waited for a van to take him to a hotel.

Another encampment we visited, in Liberty Village, was anarchic and energetic, full of movement. It had sprung up near a shelter, and residents were allowed to use the facilities there. I met a man named Jamal, who told me that he was closer to nature, rising and sleeping with the sun and moon, and he’d been able to overcome an addiction while staying in the encampment. As it turned out, nobody tested positive at this site. Perhaps Jamal was right about the natural healing.

By September, the government was allocating fewer resources for mobile clinics, so I was back in the assessment centre. My experience in the mobile unit made me realize how much I take my own shelter for granted. As a kid, I understood that anyone could become homeless in the face of civil war and violence. Covid has made me see that the same thing can happen in Toronto, that thousands of people here are displaced by economics, politics, trauma, mental illness. It’s not an accident that the same people who are homeless—many of them Black, Indigenous or people of colour—are the ones most likely to contract Covid. Maybe we’re not all in this together.

Testing at the encampment began with a ceremony: elders smudged, sang and invoked Bear the Healer