‘It’s pretty devastating’: Two outbreaks give a glimpse of the dangers — and lingering questions — around group living in a second wave of COVID-19

·4 min read

When Louise Coutu’s phone buzzed over Thanksgiving weekend, at her cottage in Tiny, Ont., she felt a sinking feeling as she scanned the message. It was the manager of a women’s shelter run by the Society of Saint Vincent De Paul of Toronto, where Coutu is the executive director.

Could she call them right away?

One of their residents, a woman in her 80s who’d gone to the hospital for a separate issue, had just tested positive for COVID-19. She’d been living in a room with three other women. One, who was younger, often helped the older woman out. She, too, later tested positive, despite not showing any symptoms. The first woman has battled her case in hospital, while the second was sent to an isolation facility.

The shelter still isn’t sure how COVID-19 made its way in.

Days after that fateful text, another landed in Coutu’s inbox: this time, from the manager of a group home the organization runs in Scarborough. Two residents and a staff member had COVID-19.

As the organization battles the two outbreaks at once, its experience offers a glimpse of what congregate settings are facing during Toronto’s second wave of the pandemic.

That the first shelter case was detected during a separate hospital visit, and that the second case was asymptomatic, was troubling to front-line shelter worker Tommy Taylor. He believes the city needs to create a system for mass-testing its shelter sites during the second wave.

“It’s concerning to show how prevalent this might be out there amongst our population,” he said.

Shelter system director Gord Tanner said broader-scale testing of shelters earlier this year didn’t identify a large number of cases. Shelter users were screened for symptoms upon arrival and while on-site, though he noted that the chance of asymptomatic cases was a “real challenge.”

Vinita Dubey, associate medical officer at Toronto Public Health, responded to an inquiry about mass testing by saying tests were a provincial responsibility. TPH worked with Ontario Health and the assessment centres to facilitate group testing if they were close contacts of a positive case, Dubey said.

All seven residents of the group home, plus staff, were tested without anyone showing symptoms, Coutu said.

She said that public health had suggested the tests in advance of a flu clinic at the end of October, and after a staffer at one of their other sites tested positive.

The diagnoses had been hard on their residents, Coutu said, as their disabilities made it more difficult for them to fully grasp why they were kept away from everyone. Staff were struggling, too.

“I think like all of us are facing, you really don’t know what’s going to happen. You know you have your policies, and your procedures … but when you hear it, it’s pretty devastating.”

On top of the rising cases, temperatures are dropping, which typically means more people will be looking for shelter space.

Taylor worries about the system’s capacity. Shelter staff were used to cramming in people to make space for as many as possible in the winter, he said. The need for distancing during COVID-19, which roughly halved the system's capacity, means that will be more difficult.

Last week, an Ontario court ruled that the city hadn't made best efforts to ensure distancing in its shelters when it said it had, back in June. The judge ordered the city to resume weekly reports on its progress, and on Oct. 19, the city reported full compliance with distancing rules.

The city’s winter shelter plan calls for 560 spots to be added in the coming months, plus new warming sites and plastic barriers in dual occupancy rooms.

The fact that two of the four women in one room didn’t get sick, Tanner said, showed that physical distancing made a difference in their more congregate-style shelters.

But Taylor said there are still unanswered questions. What do shelter workers do if someone shows up with a runny nose or a slight cough? Would they be moved to isolation, tested right away?

It’s a situation Tanner said the city anticipates becoming more common through the winter, noting that the city would have to keep a close eye on the capacity of the isolation site.

As of Thursday evening, he listed 24 people awaiting test results, and eight confirmed cases, with capacity for 75 people in each category. Those could be shelter residents, but also those who’d been staying outside, in hospitals or prisons, or couch surfing.

As for the woman hospitalized, Coutu said as of Thursday evening she was doing well, and would likely be discharged soon.

She’s hoping both outbreaks are declared over by sometime next week — “and it’s back to sort of normal.”

Victoria Gibson, Local Journalism Initiative Reporter, Toronto Star