A new COVID-19 facility for persons experiencing homelessness in Toronto

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COVID-19 always discriminates, targeting the frail, the weak, the poor and the vulnerable. Among these are persons experiencing homelessness. We reported earlier on the efforts to protect Toronto’s homeless population from COVID-19. We also emphasized the need to use sentinel surveillance and on-site testing for COVID-19. We continue with an update on work to provide health-care during the pandemic.  

RNAO's press release yesterday welcomes the announcement from Inner City Health Associates (ICHA) and partners that a dedicated facility for care and treatment of COVID-positive people who are experiencing homelessness in Toronto is imminent. We are thrilled with the news that Médecins Sans Frontières/Doctors Without Borders is bringing its global expertise in dealing with pandemics to Toronto to support ICHA’s efforts to scale up its vital role in providing health care to persons without housing.

While COVID-19 does not respect borders, it does discriminate if it is allowed to do so. Sadly, COVID-19 is and will continue to discriminate against those most vulnerable in our society: residents in nursing homes and retirement homes; correctional facilities, indigenous communities, and persons living in the shelter system. The latter are especially vulnerable because of the impossibility for physical distancing, which only the empowered authorities can urgently and decisively solve by securing adequate space for all. The protection of persons experiencing homelessness is a matter of individual and collective good. While they are confined to crowded shelters at night, during most of the day, our sisters and brothers are out and about. Thus, protecting them is important to ensure their health, that of staff, and that of our communities at large.

The program, funded by the province with municipal and community partnership, will provide health care to many who rely on Toronto's shelters and drop-in centres, bringing to life an innovative, nurse-led, collaborative care program that centres on the need for expert and dignified care of one of our most vulnerable populations. The provincially funded program has three component parts. The first component, CARE, is a risk stratification process that identifies those who are experiencing homeless that are in greatest need of isolation and protection because of pre-existing conditions and illnesses. The second component is a COVID-19 isolation facility for persons under investigation (PUI). The PUI facility is the result of essential interorganizational collaboration between the community health, hospital, public health unit and the City of Toronto. Fifty nurses have been recruited to provide care at the 200-bed facility in west Toronto, along with harm reduction workers from community partners.  

Today’s announcement of the third component of the program is of critical importance. There is clear urgency to bring a COVID-19 positive site online for those experiencing homelessness.  Those who test positive for COVID-19 at the PUI site and other facilities need a place to go to get the care they need. The COVID-19+ isolation centre is intended to be a safe place where people experiencing homelessness can be clinically supported and cared for without fear of spreading the virus to fellow residents and workers in the shelter system, where there is significant vulnerability to the virus. For more details see here and here.