Toronto reports 10 COVID-19 outbreaks at shelters, says rise in number of cases 'not unexpected'

City officials say they are working to contain COVID-19 outbreaks at 10 homeless shelters in Toronto that have left 66 unhoused people infected with the virus.

As of Tuesday at 2 p.m., Roehampton Residence, a shelter hotel, and the Salvation Army-Maxwell Meighen Centre, a shelter for men, have 16 cases each. Warden Woods Community Centre respite services has 11 cases. 

Seaton House, the city's largest shelter, was added to the list this week with one case.

The other shelters with outbreaks are Islington Seniors' Shelter, Dixon Hall, Costi Radisson, Homes First Society, Homes First Society Strathcona and Robertson House.

Dr. Eileen de Villa, the city's medical officer of health, told reporters on Wednesday that Toronto Public Health (TPH) provides support and advice to the shelters on infection prevention and control (IPAC) measures and management of outbreaks. 

As with outbreaks in long-term care homes, de Villa said the goal is to prevent the virus from spreading and to separate people who are infected from people who are not.

"We work in partnership with our colleagues in shelters," de Villa said during a city hall briefing.

"We provide advice to our shelter partners around their questions that have to do with infection prevention and control and we certainly support them in the context of outbreaks."

In an email to CBC Toronto, the city said the shelters are following public health protocols to curb the spread of COVID-19 and to keep unhoused people and shelter staff safe.

"While the growing number of cases is a concern, this is not unexpected given the level of community transmission we are seeing. We continue to work closely with Toronto Public Health and our shelter providers to ensure any outbreaks are responded to quickly to reduce further spread, including isolating COVID positive individuals at the Recovery program as needed," the city said.

Mary-Anne Bedard, general manager of the city's Shelter, Support and Housing Administration (SSHA), told reporters that the division has taken a number to steps to keep COVID-19 infection rates low in shelters.

"We've been implementing comprehensive lPAC measures since the beginning of the pandemic, holding regular and ongoing webinars across the homelessness sector to make sure that everyone is aware of the most recent advice from public health and is able to ask their questions," Bedard said.

"We've been having our quality assurance team conduct ongoing site visits to confirm compliance with IPAC measures," she added. 

"Staff and clients are required to wear masks when they're inside the shelters and maintaining two metres of physical distancing. "

The division is also distributing more than 100,000 pieces of personal protective equipment to shelters every week for staff. It is holding daily meetings with TPH and organizing on site testing of shelter residents to make sure the city is "on top of any infection as soon as it happens," she continued.

"We also continue to offer our isolation site and working very closely with the Inner City Health Associates to make sure that we are providing access to isolation and recovery for anybody who tests positive."

The city said the pandemic is "compounding" many challenges faced by unhoused people.

Many already have pre-existing health issues. Many are also struggling with reduced access to services, isolation from their communities, mental health issues that have gotten worse, negative effects of the opioid crisis, limited access to safe indoor space and a heightened risk of violence.

The city said these challenges are "especially true" for women in abusive situations, transgender, Black and Indigenous people.
 
"This is why the City continues to focus on permanent housing solutions to homeless, as we know that the best protection against the virus is also the best solution to homelessness — access to permanent housing with supports," the city said.

The city said after a positive case is confirmed in a shelter, TPH does a risk assessment of the setting, looking at the size of the facility and number of people it serves. 

"Decisions to test staff and residents are made in collaboration between TPH, shelter management, and health-care partners who perform the testing upon investigation," the city said.

When testing is completed, TPH receives the lab results for all shelter residents and staff members who have been tested. If a new case is confirmed, a case investigation is started.

TPH works with the shelter resident and staff to ensure that the person with COVID-19 goes into isolation and has place to isolate. Then it works with the resident and staff to identify close contacts.

The city says other measures to reduce spread of the virus in shelters include:

• Mandatory use of masks for staff members throughout their shifts as well as for shelter residents in all common areas.
• Ensuring beds are kept a distance of at least two metres laterally to meet the city's shelter standards directive and health ministry guidelines and encouraging physical distancing in all common areas.   
• Screening for symptoms at all points of entry into the shelter system and active daily screening and monitoring of all residents and staff for COVID-19 symptoms.
• Transportation to provincial assessment sites for testing, and if needed, providing isolation and recovery sites with supports for shelter residents who await test results or who test positive.

"Shelter, Support and Housing Administration (SSHA) and its partner agencies are in regular close contact and continue to work together to follow ongoing COVID-19 protocols to help minimize the spread of COVID-19. These measures are being followed to protect the safety of both clients and staff in the shelter system," the city says.

In 2020, SSHA spent a projected $165 million on its COVID-19 response. This amount includes opening new temporary sites to allow for physical distancing in shelters and provide space for people to move indoors from encampments. The city says SSHA anticipates it will need $281 million for its COVID-19 response in 2021.