In spite of a Covid-19 outbreak affecting dozens of residents and staff at what was once Canada’s largest homeless shelter, Seaton House, the City of Toronto’s Public Health unit and Shelter administration say they have no plans to change policies, procedures, or reporting practices.
In April 2020, Brian Cleary (pictured above) developed symptoms consistent with what he knew of Covid-19 symptoms. Brian told staff at the City of Toronto run 100-bed Junction Place homeless shelter, where he was staying, that he felt he should get a test right away. Staff, as Brian recalls, told him not to worry, it was probably just a cold. Junction Place had just opened the November prior (2019) as a way to ease the burden on Seaton House, which formerly had over 500 residents in various programs. That number has been reduced to around 200 due to Covid-19 and as the City had already begun a “George Street Revitalization” project.
Prone to anxiety and understandably worried, Brian called Telehealth Ontario and was told he most definitely should get a test. He says he requested a mask to make the journey – staff were wearing them at the time already – but was told that it was his responsibility to procure one on his own. “I had chalked little rainbows on my walls, which staff had seen and were okay with, but now it didn’t really seem like that was so true,” Brian told me by phone on Thursday.
“Doctors and staff at St. Joseph’s hospital where I was tested seemed pretty worried about sending me back to Junction Place, but after a long time with seemingly no good options they decided to send me back since I had already been [at the shelter] with symptoms a few days.”
Luckily for all involved, the test came back negative a few days later.
When the George Floyd story broke in May in Minneapolis and protests ramped up in June, Brian drew on his wall with chalk again, he says.
“We can’t breathe too.”
Staff were less amused this time, and he promptly found himself without a bed and needing to find another place. He landed at Comfort Hotel out by the airport, a shelter hotel run by Christie-Ossington Neighbourhood Centre (CONC).
Fast forward to more than ten months after the World Health Organization’s declaration of Covid-19 as a global pandemic, and hundreds of cases in Toronto shelter system having led thankfully to just six deaths.
One might reasonably assume that protocols had hardened and old fashioned luck would not be required to prevent a massive and potentially deadly outbreak in City run or financed shelters, particularly in places that remain congregate in setting, even if capacity has been dramatically reduced after lobbying by the public and a high profile lawsuit won by a coalition of organizations including Sanctuary where I work (full disclosure: I acted as a lead witness in that lawsuit where the judge found in October that the City had not, and still has not, fully complied with basic physical distancing in the shelter system).
Reasonable assumptions be damned.
A full scale outbreak at Seaton House is underway and the picture painted by a dozen and a half sources who have spoken with or passed documents to myself or my colleagues at Sanctuary is equal parts gobsmacking and enraging.
The sources include multiple from each of the following categories: current residents, current or former Shelter, Support & Housing Adminstration (SSHA) run or funded shelter staff, SSHA funded Shelter management, SSHA or similar bureaucratic City sources, and medically credentialed or medically related personnel, past or present, from at least three organizations that work directly with or have direct knowledge of Seaton House care.
I am allowing several of these sources not to have their names used for this article to protect them from the possibility of reprisals, including potential loss of job or being cut off from information vital to their work. Key sources have indicated that they spoken with me in spite of such fears knowing that I would find a way to get important information out publicly without betraying their confidence.
I presented a detailed accounting of the story these sources have told together to the City’s media officials on Tuesday, who quickly acknowledged my email and asked for an extension until Thursday at 4pm to check over “a lot” of information and to coordinate a response to the half dozen questions I put to them.
The City’s responses from the Shelter administration side are largely boilerplate answers which can be found in other press releases and City websites. There is no need to reproduce most them here as they largely recount what is said other places. Answers from Toronto Public Health to a few of the questions were more on point. Any directly relevant point from the City are encapsulated in brackets after the point put to the City in my detailed accounting.
-The first positive case at Seaton House for this outbreak was lab confirmed on January 19 [City maintains January 21]
-Multiple staff tested positive soon thereafter
-A few days after the 19th, a second resident was reported via an appropriate avenue to have symptoms consistent with Covid-19, but that resident spent three to five more days on site, until after a positive result was lab confirmed on January 26
-As of Monday (Feb 8) afternoon, there were more than 30 residents and more than 20 staff who had tested positive [TPH still says it was just 37 as of February 9. The website update on February 11 raised the number to 43.]
-Testing for one full floor was not scheduled until February 1, the 14th day after the first positive test and after I had brought pressure to bear on going public with the size of the outbreak
-Testing for the remaining floors was scheduled for Thursday, February 4
-Mask wearing enforcement in public/congregate location within Seaton House is virtually non-existent [The City linked to its directive for masks in Shelters, not promulgated until September 4, 2020 and asserts that it “is followed at Seaton House” contrary to the insistence of four of my sources, including two clients.]
-TPH/City reporting is not including all lab tested positives in their thrice weekly (now again each weekday) reporting, but rather there is a wait until contact tracing and/or isolation are completed or significantly underway [TPH notes that it takes time to process results as that is “the responsibility of the provincial government.” A written source from TPH that I received strongly indicates that a positive result is not enough to put someone into City reporting data, and a later answer by TPH suggests that they await “our detailed investigation” which may reveal that “there is no epidemiological link to the site or between cases.”]
-There have been at least three other SSHA shelter, respite, or hotel sites with outbreaks (at least 1 case) within a 2 kilometre radius of Seaton House where those outbreaks were not reported publicly on the City website (the specific sites where I had such knowledge from my sources was relayed to the City’s Media Relations team) [In a change that has never been otherwise announced from previous policy, TPH acknowledges that it now takes two cases in a fourteen day period for an outbreak to be declared, but also notes that if they determine the cases are not related or do not have an “epidemiological link to the site” then an “outbreak is not declared.” Per TPH, “[T]his is consistent with provincial guidelines.”]
-Toronto Public Health (TPH) investigators have fairly wide latitude in whether to decide that an SSHA site that has at least one case is in in outbreak and therefore to recommend that the shelter, respite, or hotel not accept new intakes [TPH insists that it is following provincial guidelines consistently]
-The total number of SSHA run or funded sites with at least one case of Covid-19 in the last approximately two months may be more than double what has been reported publicly on the City’s website
One medical source familiar with the City’s contact tracing in the shelter, encampment, and related sector described a recent situation, not at Seaton House, where a single very unwell individual without a mask was largely responsible for a double digit outbreak. The source said the sector – clients, staff, and management – struggle with no clear guidance on best practices for those who have exceptions to masking by-laws or simply refuse to follow those rules but still require provision of basic human needs like housing and food.
Tommy Taylor, a shelter worker who has worked at four different shelter sites over the course of the pandemic stated that “to me and my colleagues there is no apparent set procedure or protocol to follow. It’s really hard to decipher. We have been in situations where somebody has tested positive and we didn’t find out until a week later and the outbreak wasn’t declared on any sort of data sets or even to staff until the following week. So that’s a two turnaround from when somebody was positive. So you’ll of course have had everyone that was around them coming and going and staff not aware. There have been other situations where a staff member would test positive but no outbreak was ever declared.”
It is a dangerous game the City of Toronto has been playing in the Shelter system for years and now with Covid-19 cases. In the case of Seaton House, the chickens appear to be home and roosting.
Perhaps most importantly, the City confirmed that per TPH “at this time, ‘sentinel’ testing has not been recommended in shelter settings.” Quite the opposite, clearly. Rather than catch cases early on, the City and TPH’s Covid-19 strategy is wholly reactive, taking up to two weeks to test even after cases begin to spread rapidly.
As for Brian Cleary? You can read the full, excellent statement here that he was prepared to give at a scheduled, then cancelled, press conference in front of Seaton House for this Wednesday to launch a letter signed by more 43 organizations demanding action from all three levels of government to better address the kinds of concerns raised in this article and beyond. After weeks of waiting for promised housing to come through, Brian did not feel he could leave his shelter hotel to come to the conference for fear he would not get his keys and be able to move in. The wheels came off the whole thing that day anyway. Brian realized that a one bedroom basement apartment without a window (or proper fire escape of any other sort, not legal in Toronto anyway) in a building slated for demolishment and rebuilding in the coming months or years would not suit his anxiety.
He backed out of the deal. Now a combination of shelter management and the realtor involved are trying to stick Brian with a $750 bill for a deposit he never signed for and which was not noted in the document he provided me to be non-refundable.
So goes the battle in Toronto the Good.