Could ‘quarantine hotels’ work here?
Many homes in Toronto have multi-generational families in small spaces
Cheryl Prescod knows it’s sometimes impossible to follow the advice of public health officials.
They recommend using a different bathroom, and staying in a basement, or at least another room, to protect loved ones from COVID-19.
But the executive director of the Black Creek Community Health Centre, located in one of the neighbourhoods hardest hit by the disease, according to new data released by Toronto Public Health, often hears from people who just can’t do that.
“Not everyone has a different room to self-isolate in,” Prescod said.
There are a lot of “multi-generational families, lots of folks in one apartment,” she added. “We don’t want to over-stigmatize the community, but it’s a circumstance and reality.”
The idea of “quarantine hotels,” providing free accommodation to people jammed into too small apartments, is something that’s already being done in New York City. It’s one possible solution to support those in isolation and help stamp out COVID-19 in neighbourhoods that have been disproportionately hit by the disease. Toronto and the GTA remain hot spots, accounting for about 65 per cent of Ontario’s coronavirus cases, even as the curve flattens elsewhere in the province.
The city has started conversations with its emergency operations centre and the federal government about the idea, said Toronto Board of Health chair Coun. Joe Cressy, now that they can see from geographic data released Wednesday that while COVID-19 is in every neighbourhood, the burden of the disease is not equally distributed.
“We have identified that it is an area that needs to be addressed,” he said, adding funding and co-ordinating with other levels of government will be key.
The city started with an approach that focused on the most vulnerable, he said, leasing hotel rooms to provide for homeless people.
They’ve also developed a model for those in supportive housing settings, who may have their own room but share a kitchen and bathroom, and who need to self-isolate, Cressy said. They are still waiting on funding from the province for that. The province launched a $200-million Social Services Relief Fund in March to support vulnerable people during COVID-19, a spokesperson for the ministry of municipal affairs and housing noted.
Airbnb is offering free or subsidized stays to health-care workers, as are some hotels. And accommodation is available to travellers who need to do a 14-day quarantine through the federal government, a spokesperson confirmed. But there’s nothing available for people with small homes or apartments that make self-isolating impossible.
Toronto’s medical officer of health Eileen de Villa cautioned Wednesday when releasing the neighbourhood data, which the city mapped by the first three letters of postal codes, that it doesn’t mean the areas with the most COVID-19 cases are unsafe. Or even that people became infected there.
They could have gotten the disease in another part of the city, at work for example, and brought it back.
The numbers show that the hardest hit areas overall per 100,000 residents, including outbreaks, are in the far northwest of the city. Neighbourhoods that, on average, also have higher proportions of lowincome, racialized people and new immigrants.
Black Creek is the neighbourhood with the third-highest rate of infection per 100,000 residents, at 695, when excluding outbreaks at long-termcare homes and other institutions. Nearby Maple Leaf and Weston are the worst and second worst hit, respectively, with 732 and 706 cases.
What’s clear, Cressy said, is that COVID-19 hurts the most vulnerable.
“Disease has always preyed on poverty,” he said, adding factors such as access to housing and nutritious food, and type of employment all play a part.
“COVID-19 has taken advantage of these health inequities and indeed exposed these health inequities,” he said.
In New York City, the office of emergency management made 11,000 hotel rooms available for health-care workers and people who need a safe space to isolate other than their own home, said Avery Cohen, a mayor’s office spokesperson. So far, there have been more than 10,000 stays.
In recent days, the city announced it will make another 1,200 hotel rooms available through an initiative called “Take Care” that will also provide “wraparound” support from community organizations and regular check-ins from trained contact tracers. The goal is to expand to 3,000 rooms by late summer.
“Separating will help keep you and your loved ones safe — but it isn’t always easy,” said Mayor Bill de Blasio in a news release.
“From providing free hotel rooms to delivering meals, your city is here to bridge the gap, and has your back each and every step of the way as you recover.”
In British Columbia, free accommodation is also available on a case-by-case basis to COVID-19 positive individuals, or their family members or roommates, to make safe self-isolation possible, said a ministry of health spokesperson.
Typically people self-isolating at home have mild cases of the disease. But it’s something Toronto physician Ariel Lefkowitz said has come into play when discharging more serious COVID patients to recover.
“It definitely impacted how long people had to stay in hospital, which of course has wideranging effects on the rest of the hospital,” he said.
Many of these patients were also working low-paid high-risk jobs as grocery clerks or delivery people, and didn’t have access to proper personal protective equipment. Social workers were able to find some of his patients hotel rooms, but the cost was often too high, he said.
One man desperately wanted to go home to be with his pregnant wife, but had to stay in hospital longer because the apartment was too small and they only had one bathroom.
“The truth is I would rather somebody stay in hospital than go somewhere where they’re going to put other people at risk, where they’re going to put their loved ones at risk,” he said.
“I think free, safe housing where they have access to food and other things they need to live safely while isolated would be a hugely impactful thing.”
Prescod agrees, and would also like to see other measures like free masks, and better communication of public health messages in different languages.
“We have to expand our thinking a little bit out of the box,” she said.
The people of Black Creek and nearby neighbourhoods have already come together to deliver hot meals, groceries and hygiene kits to vulnerable people.
“It’s a really resilient and caring community and people want to take care of each other,” she added.
But there are barriers and “we need to figure out how to remove some of them.”
Here are four ideas from other places to help stop COVID-19 in Toronto’s hardest-hit neighbourhoods:
> Neighbourhood contact tracers: New York City has hired 1,700 people to join the Test & Trace Corp, a small army of contact tracers to track down everyone who’s been in contact with positive cases. Seven hundred have been hired from neighbourhoods hardest hit by the virus. Forty languages are spoken across the corps, according to the mayor’s office.
> Special taxis: In Japan, the non-profit Nippon Foundation has covered the cost of 100 special taxis just for COVID patients with mild symptoms so they don’t risk infecting someone else on the way to the hospital, said a spokesperson.
> Community testing centres/mobile testing: New York City is also providing community testing in neighbourhoods hardest hit by the virus, so that people don’t have to find their own way to a larger site in a different area. Pop-up testing units are already being used in Scarborough and the province says they’ll be coming to other hard-hit neighbourhoods soon.
> Support with isolation: NYC is also providing “wraparound” support for COVID patients with mild symptoms who need to self-isolate, to make it easier, through a partnership with15 community-based organizations.
Two hundred “resource navigators” will be on the ground this week to help residents with access to meals, medicine and laundry, and the program will be expanded over the month of June, according to the mayor’s office.