TORONTO — COVID-19 could soon "explode" within Toronto's homeless population as government actions to curb the spread of the illness have the opposite effect on those who live without housing, advocates and front-line workers say.
People who work with the city's homeless say more are on the streets because many drop-in and respite sites have closed, while others must limit their numbers inside. Meanwhile, clients cannot practise safe social distancing inside those sites, nor can they easily go the bathroom or wash their hands because many food banks, restaurants and coffee shops have shut.
"If anything, the attempt to social-distance the general population is worsening the situation for people experiencing homelessness," said Dr. Ritika Goel, a family physician who works with people experiencing homelessness.
"We're putting people's health at further risk."
Downtown Toronto, where many of the services for the homeless exist, is barren. With coffee shops and restaurants largely closed, grocery stores have become the main source of food, said Greg Cook, an outreach worker with Sanctuary Ministries Toronto.
But panhandling, an often necessary source of cash for many on the streets, has dried up, Cook said, making shopping at grocery stores more difficult. Furthermore, many retailers are refusing to accept cash due to fears of spreading the novel coronavirus, he said.
"The support system for the homeless has just collapsed," Cook said.
The effect has put more people out on the street looking for help, according to said Gaetan Heroux with the Ontario Coalition Against Poverty.
"Right now, we have hundreds and hundreds who are just wandering the streets and they can't even access their most basic needs," Heroux said.
"They can't even go to the washroom. They cannot wash their hands even if they wanted to comply with the government's guidelines."
The closure of the city's libraries has also hit the community hard, he said.
The city has recently taken some steps to address chronic overcrowding in its shelters, opening up eight new facilities with space for 350 people to help allow for social distancing.
The city announced the second positive case in the shelter system on Tuesday, but said there is no link between the two.
Advocates say drastic measures need to be taken to help the nearly 7,000 people who use the shelters every day.
"The overcrowding in terms of this virus is a death trap," Heroux said.
"They need to get people out of those shelters in this climate. There are empty hotel beds, and lots of space out there, from the convention centres to the hockey arena."
Many drop-in centres have either shut down or are only handing out food outside their doors, Cook said, in order to comply with the social distancing rules mandated by the province.
Cathy Crowe, a long-time street nurse, said the homeless population is particularly vulnerable to COVID-19 due to other underlying conditions that range from mental health problems to addiction issues and chronic heart and lung problems.
"This is about to explode — the situation is getting worse so fast," said Crowe. "There's a lot of fear on the street."
Goel, the family physician, agreed.
"It's a crisis that's been in the making for decades. Had we dealt with our homelessness crisis, maybe we wouldn't be here today," she said.
Toronto has set up an isolation centre for the homeless at a former shelter in the east end, where those with symptoms can await test results. Once it is fully operational, there will be 40 rooms available, the city said. There is another facility set up for those who need to self-isolate after travelling.
There are also plans to open a recovery centre for those who test positive, the city said.
The province has also announced it will provide $200 million to social service relief, but both the city and those on the front lines said they are waiting to hear where that money will go.
For now, Cook and his colleagues have more pressing concerns: balancing the needs of their clients versus protecting themselves against the virus. If the workers go down, then everyone loses, he said.
That's why staff at Sanctuary have split themselves into two teams.
"If somebody has symptoms, then all the staff doesn't have to go into quarantine," Cook explained. "If one team goes down, at least the other team is not affected."
This report by The Canadian Press was first published March 26, 2020.
Liam Casey, The Canadian Press