Without resources, Nova Scotia's homeless are more at risk for COVID-19

Physical distancing, self-isolating and proper hygiene — three key rules of living in Nova Scotia during the COVID-19 pandemic.

But what if a person doesn't have the resources to follow those public health rules?

It puts the person at risk for contracting and spreading the virus — something an infectious disease researcher at the QEII Health Sciences Centre says is likely for Nova Scotia's homeless and those with inadequate housing.

"We tell people day after day to stay home and to wash their hands," Dr. Lisa Barrett, who is also a professor at Dalhousie University, told CBC's Mainstreet Thursday.

"And if you don't have four walls, a roof and a door to close, your ability to self-isolate and to stay at home — even just to stay at home and follow the directions that our premier and our chief public health officer give us — are incredibly impaired."

Shelters across Nova Scotia remain open but Barrett said people experiencing homelessness don't have their own sleeping space or bathroom, two places the virus could spread.

She said one of her patients said he felt bad he couldn't adequately physically distance himself from others.

"A patient of mine looked at me the other day, and he said … 'Hey, Doc, I like this thing that's going around, the step-up-not-out thing. But you know, I feel kind of bad. I can't do that. What happens if I get sick? What if I make other people around me sick because I can't stay somewhere?' And I had absolutely no good answer for him."

On March 22, Premier Stephen McNeil declared a state of emergency that required Nova Scotians to stay in their homes unless purchasing essentials and physically distancing themselves from others, while also maintaining good hygiene.

But Cindy MacIsaac, the director of Direction 180, a Halifax opioid treatment program, told Mainstreet that good hygiene is not possible for everyone.

"Housing is intrinsic to good health.… It is the most important piece," MacIsaac said. "You don't have good sleep hygiene if you don't have a house, you don't have good personal hygiene. You feel hopeless."

She said Nova Scotia already has a housing crisis and the COVID-19 pandemic adds another layer to it.

"Given the context of the current pandemic, we're undershooting with measures," MacIsaac said. "It could be catastrophic, if something doesn't happen with immediacy."

On Thursday, McNeil extended Nova Scotia's state of emergency for two more weeks as COVID-19 cases in the province rose to 193.

When asked about vulnerable populations that are experiencing homelessness, McNeil said the province has been working with the federal government to address physical distancing in homeless shelters.

"We know these are vulnerable populations. There will be an announcement made in the coming days," McNeil said.

Time's up

But MacIssac says time's up.

"It's cold, it's rainy. Last week was horrible. It's not OK," she said.

"We know some of our members in the community that are reporting some symptoms and there's concern around that. We really need to work as fast as possible."

MacIsaac said if people experiencing homelessness are given housing, that housing needs to be maintained after the pandemic is over.

"I hope to God, whatever measures are put in place during COVID-19 for the homeless, that they are sustainable, because it would be a horrible thing to give people housing, and then at the end of this crisis to put them back out on the street," she said.

"And so whatever measures are put into place, they have to think about the long-term effects."

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