Homeless people deserve dignity and our compassion
Here’s a remarkable thing about the pandemic and its effects on Canada’s most vulnerable people: the homeless population has sidestepped disaster.
Let’s not jinx it by calling it an outright success.
Yes, vulnerable, low-income people are hit harder, and the homeless population in big cities across Canada are indeed suffering from COVID-19 and paralyzed by the fear.
About 500 homeless people in Toronto have tested positive and the number continues to rise. There are outbreaks at 11 shelters. Front-line workers are stretched, bracing for more, while many of those who would normally stay in shelters are too scared to stay there any more, moving outside instead.
But still. Toronto is as bad as it gets for homeless people catching COVID-19 in Canada, experts say, and it could have been worse. Much, much worse. Something is actually working well here — a combination of good networking, hard work, responsive decision-makers and targeted federal money that arrived quickly and free of red tape.
There are lessons to be learned from what has worked — lessons that can be applied to protect other vulnerable segments of the population, and that could lead to significant advances in the fight against homelessness once the pandemic has passed.
In early February, before coronavirus had taken hold here, experts working with homeless populations in Canada saw it coming. Homeless people in Italy were hit hard. U.S. researchers predicted devastation in the United States.
With unreliable access to health services, crowded shelters, mental-health challenges and many underlying health conditions, Canada’s homeless population — 35,000 on any given night and about 250,000 over the course of a year — was like a bull’s-eye for the virus, says Tim Richter, president of the Canadian Alliance to End Homelessness.
“We feared it would be on the scale of the long-term-care population,” he said.
In Toronto, Andrew Bond, the medical director of Inner City Health Associates, bulked up his public-health team, developed some modelling and put together a strategy.
Central were two recommendation. One got traction, the other didn’t.
Bond pushed for isolation quarters — expanding shelter space, booking hotel rooms, taking over public buildings, and generally doing whatever it takes to keep residents two metres apart in clean, stable housing.
That model has taken off across the country, Bond says, and the federal government amplified the strategy by rushing money out the door.
In Ottawa, Ahmed Hussen, the federal minister of families, children and social development, had already prioritized homelessness in his new portfolio, and moved quickly in early March to send an initial $15 million from existing budgets to key organizations. He followed up with an extra $157 million in early April, with very few strings attached.
In an interview, he said the goal was to give local shelters the ability to pay for whatever they needed: space, hotel rooms, personal protective equipment, health professionals, Plexiglas.
“I think it has had a huge impact,” Hussen said. “It (the virus) is not as widespread as I suspect it would have been.” There were some bumps along the way and a lack of solid data for detailed conclusions, but there’s no doubt that moving hundreds of homeless people into their own spaces has proved quite effective.
But the second key recommendation from Bond’s group was so controversial that it was ignored until just recently. Test everyone in the homeless community, he said, even if they didn’t show symptoms.
He saw signs that asymptomatic people could spread the virus. And he also understood that homeless people often have many other symptoms that could obscure COVID-19. But only now is that recommendation being realized.
“We’re just now catching up,” he said — and just in the nick of time to manage a potential second wave.
For now, although there are no national figures on how many homeless people have tested positive or died from the virus, the national alliance noted shelter outbreaks in three different cities at the end of May — Toronto, Calgary and Ottawa. That’s down from a peak of six cities (not including Quebec) at the end of April.
Deaths are in the single digits.
Bond’s hope is that strategies that worked during the pandemic will become entrenched in Canada’s approach to homelessness, and fix it once and for all. Having a safe, private space of one’s own goes a long way toward improving a person’s health and welfare, he points out — and the COVID-19 experience has proven it.
“Housing is now emergency health care,” he says.
The federal government has already earmarked billions for affordable housing and has launched a national housing strategy. And it is pushing hard on homelessness, too. Bond wants to see Hussen pull it all together, think hard about the public-health aspects, take the success of the pandemic and run with it.
Some cities are already moving in that direction. Perhaps the stars for this precarious part of our society can align.