Toronto hospitals see increase in cold-related injuries as shelter system fills up

More people experiencing homelessness have been coming to Toronto hospitals recently seeking shelter and suffering from cold-related injuries than in recent months this winter, according to one physician.

Dr. Raghu Venugopal, who works in several downtown emergency departments in Toronto, said some people experiencing homelessness are spending two days in the emergency room on the hallway floor, and others have gotten frostbite on their fingers and toes. 

"I saw a man who lives in his truck with his animals, and he had lit a kerosene fire in his truck and his hands had second-degree burns," he said. "People are doing anything they can to stay warm."

The Toronto Star reported on Saturday that St. Michael's Hospital has seen a rising number of people come to the emergency department with injuries such as frostbite, foot infections and hypothermia.

Dr. Venugopal said the cold snap has made the situation worse for many unhoused people and they are seeing more of these cases in emergency rooms.

"Sometimes they just have terrible trench feet, which is the combination of cold and dampness. We try to give them new socks. We try to give them new shoes," he said.

The increase highlights the human toll of several days of freezing temperatures combined with what advocates for those experiencing homelessness say is the inadequacy of the shelter system in Toronto.

There were about 7,700 people staying in Toronto's shelter system on Saturday night. A frontline worker and a woman living in the system say that shelters have been close to full this month and that warming centres are often at capacity.

New spaces added to shelter system

The city says it is doing what it can to get people indoors. Forty-nine new spaces were added to the shelter system on Saturday night, the City of Toronto's Shelter, Support and Housing Administration (SSHA) said in a statement Sunday. Of those beds, 30 were used. 

There were 7,721 people in shelters and 73 people were referred to shelters, the city said. City outreach teams encountered 17 people on the street but only one agreed to come indoors.

"Warming centres have been continually open for two weeks while the City continues to do everything it can to ensure people have a warm space to come into," the SSHA said.

The number of people in shelters is much lower than the estimated number of homeless people in the city. The city identified 9,000 people actively experiencing homelessness in Toronto at the end of November 2021, according to data released last month.

There were also 31 active COVID-19 outbreaks in shelters in Toronto as of Jan. 28, according to the City of Toronto website. 

Shelter system viewed as unsafe

Dr. Venugopal said that in his experience, many people experiencing homelessness prefer the street because they get robbed or harassed at shelters.

Jennifer Jewell lives in a temporary shelter at Bond Place Hotel near Dundas Street East and Yonge Street. She said she has been calling the city's central intake line for months trying to get a friend indoors after he was kicked out of a shelter four months ago. 

"Day to day, I don't know if he survives the night," she said, adding that he now has frostbite on his face from the cold.

"His hands are swollen and cracked. He can't use his hands very well."

She said he doesn't want to go into congregate settings — where multiple people sleep in the same space — because of the effects on his mental health and out of a fear of getting sick with COVID-19. 

The hotel where he is staying lacks staff and resources, she said.

"There's a lot of violence in this hotel space," she said. "And yet there are no supports, there's no mental health support, there's nothing here for people."

City needs to ask for federal aid: advocate

The shelter system was never large enough to cover the homeless population to begin with, said Tommy Taylor, a frontline worker and a member of the Shelter and Housing Justice Network.

"There was going to be no other outcome, with the severe staffing shortages and shortages of sites," he said.

"It's just a system that was not ready, despite so much advocacy and so much warning put to the leadership of the city that this was what we needed to prepare for."

Taylor estimates that there are close to 80,000 people on the affordable housing waiting list, at least 15,000 people on the supportive housing waiting list, and 9,000 to 10,000 people who are homeless on the streets. More permanent non-congregate housing should be the focus instead of a short-term "crisis response" mode, he said.

The city may need to ask for aid from the federal and provincial governments if it can't find money in its own budget to address the crisis, Taylor added.

"I would encourage city leadership to acknowledge the crisis, that we're in an emergency, and not be too proud to ask for the help that we need right now," he said. "Toronto is in desperate need on this front."