Health officials have repeatedly said those experiencing mild COVID-19 symptoms should remain home until they need medical attention.
But for those without a home, a positive case of the virus means hospitalization regardless of how severe the case may be.
As part of the City of Toronto’s response to COVID-19 in the shelter system, isolation locations have been set up in two locations for those awaiting test results. The City along with health partners and the province have plans to open a recovery site for COVID-19-positive patients.
But a memo obtained by Global News from one of the health partners said the isolation locations aren’t equipped to care for homeless patients who test positive for the disease.
The lack of a dedicated recovery location resulted in the need for hospital care for a patient experiencing homelessness.
“The isolation site is not equipped or safe to house individuals who are confirmed COVID-positive through their illness and recovery,” said the memo.
Discharging a patient to the street or shelter system, it noted, would contravene the medical officer of health’s orders.
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“We are therefore required to transfer this patient to acute care,” it said.
Dr. Andrew Bond, medical director of Inner City Health Associates, confirmed the veracity of the memo. While the City has acquired hotel rooms for isolation, Dr. Bond said the rooms are not adequate for the amount of attention a COVID-19-positive patient would require.
“We know that people experiencing homelessness have much higher rates of having poor outcomes with respect to COVID,” said Bond, who added these include rates of respiratory illness and deterioration rates.
“Having people in very closed off rooms with lightly-staffed models puts people at great risk of having events happen to them that were otherwise predicted, but we’re not able to observe or monitor and support them.”
Bond said that hotels are also not equipped to provide the correct isolation protocols for COVID-19. The solution of keeping those who are experiencing homelessness who test positive, he said, is the best-case scenario for what is available now.
“It’s not the ideal situation, we all would prefer to have the dedicated facility,” said Bond.
Mayor John Tory agreed that the use of hospital beds for those whose condition may not require it was not the best approach.
“We are working on it, there are some issues with some of the people involved, but I think we’ll have something that’s a satisfactory answer in the next day or so,” said Tory.
For its part, the City said no one in Toronto’s homeless community that tests positive for COVID-19 would be discharged, regardless of how light their symptoms might be.
The City of Toronto’s head of communications, Brad Ross, said that a location has been acquired for the recovery site and should be online soon.
Bond said he expects it could be in operation sometime next week, noting everyone involved with opening the location has been working around the clock to make it happen.
“It’s a really complicated operation, not one almost any of us have contemplated having to do.”
Bringing together the large number of people involved as well as the resources and funding has only been part of the battle, he said.
“To invent this new model that is appropriately to scale to ensure that we have the ability to respond through the duration of the pandemic is a very, very heavy lift to go from nothing to realized vision,” said Bond.
While the recovery site has been no easy task to accomplish, earlier in the week homeless advocates levelled criticisms at the city response during the pandemic.
Despite efforts to open more locations to increase physical distancing in shelters, some have pointed to sleeping arrangements at shelters not complying with the preferred two-meter minimum.
The speed in which people are being moved to city-acquired hotel rooms has also identified as an issue.
The head of the City’s shelter, support, and housing administration department, Mary-Anne Bedard, said the City was moving people as fast as it could. But Bedard said there were logistical issues which were slowing the process.
“We are moving people as quickly as we can and that it is an on-going priority for the city,” she said.
The number of positive cases of COVID-19 within the shelter system earlier in the week was eight, but Toronto Public Health was unable to confirm by deadline if that had risen on Friday.