Capital Daily is airing this letter to provide a platform for a group of healthcare workers concerned about the lack of support for some of the city’s most vulnerable residents.

To: 

Hon. Adrian Dix, Minister of Health 
Hon. David Eby, Ministry of Attorney General and Responsible for Housing
Provincial Health Officer, Dr. Bonnie Henry 
Island Health Chief Medical Health Officer, Dr. Richard Stanwick 
Mayor Lisa Helps, City of Victoria 

We are a group of front-line workers who provide care and services to people who are unsheltered, sheltered, or living in temporary and supported housing in Victoria. We write this letter to voice our concerns with the current surge in COVID-19 cases in this community, which is affecting the clients we work with and affecting us as workers. Last week, the public became aware of the situation. 

However, as frontline workers supporting this community daily throughout the COVID-19 pandemic, we have been concerned about the surge in cases for weeks. We have also witnessed a lack of coordinated and effective action in preventing and mitigating the spread of COVID-19. Since Labour Day weekend, over 220 people living in shelters, temporary and permanent housing have tested positive for COVID-19. 

Before this month, Victoria saw very little COVID-19 infection and transmission among people who are unsheltered, sheltered, or living in temporary and supported housing. However, this recent exponential increase in cases comes as no surprise to us. Over the course of the pandemic, we have consistently experienced top-down decision-making on the part of the health and housing authorities coupled with a lack of adequate planning and meaningful engagement with the community. We believe these decisions have set the stage for the dire situation we now face. 

At the beginning of the pandemic, the city and province supported sheltering in parks to support physical distancing in the absence of adequate shelter and housing spaces. This was, and remains, an important strategy for preventing the spread of COVID-19. When BC Housing opened temporary shelter spaces, sheltering in parks was no longer an option, and people were rapidly—and forcefully—moved to these spaces under a ‘public safety order.’ This process resulted in high levels of moral distress for workers who were not consulted in the development of this plan and high levels of stress within the community who were immediately surrounded by fences, given ultimatums, and displaced without any say in the adequacy of the assigned shelter.

At the time, we questioned if this strategy was really about public safety or reducing public visibility of the realities of our housing crisis amid a global pandemic. Those who did not make it onto the temporary housing list were given the option to set up 24-hour camping for shelter in some designated parks. We heard from those who continued to shelter in parks that this decision was motivated by the fear of contracting COVID-19 indoors and a general sense that congregate settings such as temporary shelters did not feel safe. In some parks, tent cities were created and were well supported by volunteers as well as health and social service agencies. Amid the third wave, the city reenacted the 7 pm to 7 am camping by-law. As a result, we saw hundreds of unsheltered people displaced for a second time in the pandemic. 

The connections we had established with people sheltering were lost—and our ability to provide care and services (including outreach vaccination) became significantly more challenging. Now, the reality on the ground is that every morning, unsheltered people are asked to pack up their belongings and move along, further isolating them from access to healthcare supports and their community. Again, this is hindering our efforts to provide care and services. Unsheltered people who have tested positive for COVID-19 have to go through this process every morning as well. 

As it currently stands, sheltering spaces for people who need to isolate are not currently available, weeks into the fourth wave. Meanwhile, the temporary housing sites created to provide shelter to those who were unhoused during the pandemic are in the process of being quickly shut down. The re-housing of over 60 residents at one temporary housing site has not been put on hold despite a growing COVID-19 outbreak, which means that inter-site transfers are still occurring, and only a fraction has stopped. We have seen the consequences of these practices in Canada before; in Quebec, for example, massive outbreaks in long-term care were linked to transfers of residents and staff between sites. 

We ask for urgency in addressing the above issues and taking some concrete actions, including: 

1. Display greater transparency in reporting cases to the public, to the community, and front-line workers, along with clear information on actions being taken and guidance. 

2. Declare an outbreak and implement a response consistent with the standards in long-term care with sufficient resources, staffing, spaces, and equipment. 

3. Stop the transfer and movement of people across sites and put a hold on the closure of temporary shelter spaces until the outbreak is declared over. 

4. Stop the daily displacement of unsheltered people and reinstate the 24-hour camping bylaw to allow people to shelter in place—and to access care and services.

5. Meaningfully engage with the community and local organizations with lived experience expertise on actions being taken and ways of improving access to COVID-19 vaccination. 

With urgency, 

Marilou Gagnon, RN, PhD
Professor, UVic School of Nursing

On behalf of concerned frontline health care and services workers of Victoria