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H1N1 outbreak could be 'dangerous' for Canada's homeless: advocates

Provided by: Canadian Press
Written by: Andy Blatchford, THE CANADIAN PRESS
Oct. 25, 2009

MONTREAL - In one of Canada's first sweeps of H1N1 inoculation, street nurses will be ducking in and out of alleys on Vancouver's Downtown Eastside, vaccinating the homeless, the downtrodden and the drug-addicted.

On the other side of the country, H1N1 syringes will be popped into the arms of the down-and-out at some of the bigger shelters in Montreal and Toronto.

But many of those who work closely with the homeless hope the efforts will be enough to keep H1N1 from striking a population segment that's among society's most vulnerable.

"It's a very dangerous situation," said Cathy Crowe, a street nurse and member of the Toronto Disaster Relief Committee.

Crowe wonders what shelters will do if their clients are indeed infected with H1N1.

"If somebody who's homeless gets sick, where do they recover for three or four days if they don't end up in hospital?" Crowe asked.

Crowe, who described the cramped quarters of shelters as prime turf for the spread of illnesses, said governments must act fast to set up recovery facilities for those who are ailing - and contagious.

"It's a Petri dish for disease - we've witnessed waves of Norwalk virus, waves of tuberculosis in the past, flus, (and) bed bugs," Crowe said.

She knows of at least one shelter in Ottawa that will offer an entire floor for flu recovery, but said most organizations don't have that capacity.

"Across the country it's just a mishmash," she said of H1N1 strategies to protect the homeless.

Montreal's Old Brewery Mission has stocked up on masks, installed more hand-sanitizer dispensers and launched an information campaign for clients on how to prevent the spread of H1N1.

It will host a vaccination clinic in early November, the mission's director says.

But he fears an H1N1 outbreak could move swiftly along the Old Brewery's many rows of bunk beds.

"We have the largest, single homeless dormitory in Canada, a room of 72 beds - that's a lot of human beings to put together at any time," said Old Brewery director Matthew Pearce.

"So, from a flu point of view, you can imagine what a challenge it's going to be to keep things healthy."

Pearce said a serious outbreak of H1N1 could force the Old Brewery into the difficult decision of closing beds - in an attempt to separate the infected from everybody else.

"We're not a medical facility and ought not to be thought of as one," he said.

"In the event of a pandemic, we would want the hospitals to take care of sick people ... we don't have facilities to isolate people."

In Toronto, the homeless population will receive doses of the vaccine at the same time as the general public, the city's health department says.

Liz Janzen of Toronto Public Health said the homeless didn't prove to be more susceptible to H1N1 during last spring's outbreak.

"Regardless, it's a matter of days difference between the priority and the general population for us," said Janzen, who expects immunization for the general population to begin the first week of November.

Back on Vancouver's Downtown Eastside, one of the poorest neighbourhoods in the country, community health centres will begin offering the vaccine to locals early this week - ahead of the general population.

The area is home to many intravenous drug users and people with underlying health conditions, said Anna Marie D'Angelo of Vancouver Coastal Health.

"People living there have a high risk for complications with H1N1 for all those reasons - so they are a priority group," said D'Angelo, adding they will be vaccinated at the same time as pregnant women, young children and people with chronic medical conditions.

Six volunteer outreach nurses are expected to start pounding the pavement and visiting local hotels for the skid-row "inoculation blitz" around the beginning of November.

D'Angelo said the Downtown Eastside street nurses have been administering seasonal flu shots in the same way for the past few years - including more than 2,500 people in 2008.

James Pratt of the Greater Vancouver Shelter Strategy said this type of proactive approach is good way to reach those who seldom show up at shelters or drop-in centres.

Preparations are underway to protect marginalized populations, but the concern remains prevalent, Pratt said.

"People have their fingers crossed."

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