As Vancouver’s Downtown Eastside deals with the highest number of new COVID-19 cases per capita in Metro Vancouver, another illness is also making the rounds.
A community advocate is warning the public after a concerned doctor contacted her about a dysentery outbreak that, according to the medical director of the Vancouver Infectious Diseases Centre (VIDC), has sickened at least 24 people and sent at least 16 people to hospital.
Karen Ward told Global News the doctor — who she agreed to keep anonymous — messaged her on Twitter to tell her about the outbreak, because he was concerned that Vancouver Coastal Health (VCH) hadn’t issued an alert to the public.
Ward said the doctor had been told she was a good person to contact in order to get the word out, but added she was shocked to be given that kind of information over Twitter.
“I was like, oh my God, this is public health now? Public health was notified of these cases when they presented at the E.R. and they didn’t tell anybody. And that is nuts,” she said.
“And then this doctor decided (to reach out) — he was so worried about this because it’s so spread so fast, obviously.“
Dr. Brian Conway with VIDC told Global News the outbreak was caused by shigella, a bacteria that causes watery or bloody diarrhea, nausea, and significant stomach cramps. In severe circumstances, he said it can also be deadly.
“It is usually transmitted in unsanitary conditions, it’s transmitted from person to person, and it can be transmitted from contaminated food,” he said.
“And if a number of cases are identified at the same location or in a few locations, it’s important to understand how it got spread to improve sanitation, so the transmission is reduced and that there aren’t any more cases that are developing.”
Vancouver Coastal Health didn’t provide Global News with an exact number of confirmed infections, but a spokesperson said it has received reports of isolated cases around the Downtown Eastside over the past few weeks.
Last week, the health authority became aware of a cluster of 10 people who needed to be hospitalized for shigellosis at St. Paul’s Hospital.
The health authority said it immediately began communicating with its partners, conducting food services inspections and notifying housing and service providers in the neighbourhood.
It said public health is continuing to investigate the sites and sources of transmission and is seeking to identify more cases.
“VCH would also like to advise the public that robust hand hygiene is the best intervention to avoid contracting or transmitting shigella,” the health authority said in an emailed statement.
“VCH is committed to ensuring anyone who is diagnosed with Shigella receives the quality care and treatment they need.”
Conway said he understands privacy is a concern and that public health authorities have to follow strict protocols in issuing alerts to the public about infectious diseases.
“That being said, there is a need to intervene as effectively as possible to limit the spread of disease,” he said.
“Protect privacy, but it’s not an excuse to do the right thing to prevent the transmission of a potentially deadly infection such as (shigellosis). ”
Ward agreed more needs to be done to warn residents themselves of the risk so they can take the appropriate steps to keep themselves safe.
“It’s dangerous to people who have multiple exposures to risk so and also don’t have appropriate bathrooms, you know,” she said.
Limited access to bathrooms in the Downtown Eastside is an issue that’s come up during the COVID-19 pandemic.
In June, Conway co-authored a paper in medical journal Future Virology on the impacts of COVID-19 on homeless populations in Vancouver. The paper identified access to hygiene facilities as one of the major points of concern for those groups.
“Overnight, they were deprived of lifesaving services. They lost access to food, to showers, to washrooms, to laundry, and to other emergency services that they counted on to survive,” Conway told Global News in September.
Ward said not much has changed since then.
“We got a few more trailers to put around, like three more trailers — it took forever — but I mean, these businesses say ‘all these people are having to go use the bathroom and getting all mad at us and stuff’… just let them use the bathroom,” she said.
Limited access to basic hygiene has contributed to both of the infectious diseases circulating through the neighbourhood right now, according to Conway.
“In the case of shigella, poor hand washing would be a situation that if there were an outbreak poor hand washing would lead to its more rapid spread,” he said.
“It underscores the fact that probably you’re having difficulty in adhering to public health recommendations in the Downtown Eastside.”
The lack of movement on this issue, in the midst of a pandemic, is unacceptable in a city like Vancouver, he added.
“We should have been intervening on the Downtown Eastside to limit the spread of COVID that we’re now seeing, to limit the terrible deterioration in the opioid crisis and the deaths that we’re seeing more than five per day in the province,” he said.
“I think this is just another example of what can happen if you allow such conditions to to persist.”
Ward also drew parallels between the way public health is handling communications in this outbreak, and in the COVID-19 pandemic and the overdose crisis — all three of which have had serious impacts in the Downtown Eastside.
“This is why we’re on the 1,786th day of the overdose emergency, because they treat us like incompetent children who they make decisions for and don’t give people information,” she said.
“That is why everyone dies. I blame public health a lot.”
B.C. declared the overdose crisis a public health emergency on Apr. 14, 2016. Since then, more than 8,700 British Columbians have lost their lives to illicit drugs.
Ward said health authorities need to treat that crisis — and other public health issues, like the shigellosis outbreak — with the same urgency as they treat the COVID-19 pandemic.
“How dare they say, ‘Oh, you need to go to an overdose site,’ and then not have overdose sites? How you can say ‘use with someone’ and then not allow people to have guests or say ‘access safe supply’ and then their own doctors don’t prescribe? It is ridiculous. And they have the power and the financing to do all that.”
Conway said he wished as well that victims of the overdose crisis were afforded the same solemnity that public health officials grant victims of COVID-19 — suggesting that in the same way we take a moment at each daily COVID-19 briefing to honour the lives lost in the past day, so we should do the same for victims of the overdose crisis.