If you’re powerless or homeless, COVID-19 has you in its sights. Cohn,

A pandemic imprisons people at home as in nursing homes. But a pandemic is also a prism, revealing the world around us in a new light — if only we look.

Working remotely from home and watching from a safe social distance can make the problems of COVID-19 seem that much more remote. For the homeless, however, there is no home to retreat to, and nothing remote about the virus.

For Cathy Crowe, COVID-19 is unfolding at street level — too close for comfort.

As a lifelong street nurse, she always understood the human

f homelessness — prepandemic. But nothing prepared her for the upheaval as the virus took hold:

“Unanticipated chaos and crisis and disaster,” she says matter-of-factly, pointing to the names of 28 victims added last month to a memorial for the homeless.

Shelters for Toronto’s homeless became hot spots — lacking masking and distancing — prompting a mass exodus into tent encampments in public parks or rented hotels. Suddenly, the hidden homeless have been transplanted into full public view, a health-care problem transformed into a political challenge.

Other victims of COVID-19 aren’t just the homeless but the powerless. Trapped in densely packed highrise apartment buildings, they are jammed into desperately overcrowded public transit on their way to front-line jobs where they work to help the rest of us.

What makes this virus so vexing and virulent is that it impacts different people differently and unpredictably — yet systemic discrimination has predictable impacts on marginalized and racialized communities.

For Paul Bailey, head of the Black Health Alliance, the so-called “social determinants of health” — housing, poverty, education, income inequality — are now the social determinants of illness in mid-pandemic. Activists who couldn’t get a hearing in the best of times, pre-pandemic, are demanding action in the worst of times.

“I don’t think it’s just about respect, I don’t think it’s just about getting community voices heard,” Bailey told a panel on public health and democracy that I moderated for the DemocracyXChange at Ryerson University last week.

“How do we push politicians, or push folks that are in charge of our public health system, to implement what they already know?” he asked. “Who’s responsible?”

Good questions. Along with Crowe, Bailey pointed to the problem of transit overcrowding that threatens the working poor trying to earn a living while staying alive.

“There’s been a ton of conversation about the 35 Jane bus, and the overcrowding during rush hour,” said Bailey, who lives and works in the Rexdale area. “We’re trying to raise the alarm.”

Infection rates are much higher than in the rest of Toronto, but the TTC’s response was to tell people — many of them essential workers — to wait for the next bus, however long that takes, he said.

“If you ask me, transit up there is like a vector for disease

ansmission,” Crowe added, in much the same way as overcrowding has exposed homeless and marginalized people. The largest outbreak at a community centre in North America took place at the Willowdale Welcome Centre, she noted.

Homeless shelters are “congregate” living centres — a term typically used for nursing homes — except that they lack even the basic safety protocols found in long-term care. For most of the summer, Toronto failed to enforce mandatory masking and distancing in sleep areas — at once “patronizing” and imperiling shelter residents, Crowe argued.

Getting the attention of influencers, policy-makers and decision-makers is even more challenging because the lines of communication at city hall “collapsed in the beginning of COVID unexpectedly … it’s been a shock.”

Susitha Wanigaratne, a social epidemiologist at the Sick Kids Research Institute, framed the problem as a democratic challenge. In a pandemic, the working poor lack power more than ever.

Recent immigrants are typically precarious yet essential workers exposed to the virus on the front lines. They deserve and must demand “the power and the autonomy to not go to work if they’re sick.”

Prior to COVID-19, the Progressive Conservative government rescinded new protections for paid sick days, and restored the right of employers to demand a doctor’s note. Premier Doug Ford belatedly waived doctor’s notes, but only during the pandemic.

One reason marginalized and migrant communities feel powerless and voiceless is the void in data collection and the absence of action. Even if governments gather race-based data, people won’t be any further ahead if politicians are not held accountable once the results are in.

At street level, “we have a democratic deficit — it’s very severe,” added Crowe.

The challenge for activists is that they find themselves in an echo chamber, preaching to the converted, mused Bailey. The question is how to be heard beyond meeting halls and Zoom rooms, so that their voices count — not just their

Homeless shelters are “congregate” living centres — a term typically used for nursing homes — except that they lack even the basic safety protocols found in long-term care

votes.

For two decades, his Black Health Alliance has demanded that race-based data be collected. Now, collective will is what’s needed.

“Fundamentally what we’re dealing with is a system, and maybe a democracy, that doesn’t want to respond to people in targeted but equal ways,” Bailey told our panel. “We know that a one-size-fitsall approach to this pandemic won’t address the situation.”