Thread by @RitikaGoelTO

Nine homeless shelters in Toronto have outbreaks with 69 known cases. Public messaging has told us all to stay home. But what if you have no home? We are told to stay 2 metres away from people. But what if you sleep less than 2 metres away from other people every night? #COVID19

These are just the cases we know. While people in shelters are considered high risk for transmission and therefore a priority to test, people exp homelessness are also the least likely to be able to go to an assessment centre, stand in a long line, and await results. #covid19

People staying in shelters are more likely to have mental illness, cognitive concerns or use substances and at baseline have negative experiences with the healthcare system. If we really want this population to be tested, outreach is the only realistic way. #Covid_19 #topoli

And despite their best intentions, @TOPublicHealth seems overwhelmed so shelters seem to be hearing of positive results for their clients days later by which time lots of virus has had time to spread. #Covid_19 #sdoh

This crisis is decades in the making. Crowded shelters, lack of affordable housing as baseline. Not moving everyone out as prevention. Lack of rapid contact tracing and immediately implemented outreach testing as mitigation. The result should surprise no one. #Covid_19 #sdoh

We’ve talked lots about how no one is safe. How everyone is equal. But no. People will die, and it will be a direct result of the systems we have created that do not consider everyone’s lives equal. #Covid_19

There are about 7000 ppl in toronto’s shelter system, with about 3000 in hotel/family shelters at baseline. The 4000 in singles shelters are most at risk. As of now only 490 have been moved to hotels. That leaves 3500 still living in congregate settings. Why? #sdoh #COVID19

We have created programs for homeless folks who are covid positive to go to self isolate, but we wouldn’t need these if everyone had been housed. And those programs are facing massive pressures and people are getting backed up into hospitals. Am expensive solution. #COVID19 #sdoh

Perhaps this will give us the motivation we need to finally address the homelessness crisis. If all the hospitals in toronto banded together to say this was an unacceptable solution to people simply not having housing, what an incredible statement that would be. #COVID19 #sdoh

We have heard of just one hospital alone getting 25 people from just one shelter show up for testing 2 days ago. More things like this will happen. The ripple effect is huge. And the Boston experience suggests once there is an outbreak we need universal testing in the shelter.

To compound matters, our system at baseline relies on volunteer run Out of the Cold programs - 13 of 16 were shut down when #COVID19 started to protect the volunteers, but not fully replaced so even getting a bed is hard. More people turning to the street. And shortage of staff.