First major outbreaks among homeless Montrealers lead to expanded red zone, new hotel-shelter

Outbreak among homeless Montrealers Old Brewery Mission CEO James Hughes looks back on a very tough year ending with an unprecedented outbreak.

Montreal — Several COVID-19 outbreaks among homeless Montrealers have led to such high infection numbers that the city’s system for homeless patients is being rejigged, with dozens of people to be moved between sites in the coming days.

First, an entire pavilion of the old Royal Victoria Hospital, with about 125 beds, is being designated a “red” self-isolation zone.

A second downtown hotel will also be turned into a shelter for homeless people who are COVID-negative, along with Place Dupuis, the one that opened this fall.

“We’re adding a second hotel where [there] will be homeless,” said Quebec Health Minister Christian Dubé on Tuesday.

“We’ll have a floor at the [decommissioned Royal Vic] hospital that will be dedicated to red zones for homeless people,” he added.

“That’s unfortunate,” he said of the situation, “but that’s the best thing we can give them right now.”

These changes mark yet another rejigging of services for the homeless in what was already an emergency system transformed and stretched very thin over the last year—and as the number of homeless people grows.

With yet another new site being opened, workers to run it will need to be found from among various public and community-sector agencies, said Sam Watts, CEO of the Welcome Hall Mission, which has been staffing the Royal Vic wing and the Place Dupuis shelter-hotel.

“The community groups are really doing all we can do, and we’re stretched to our limit as well,” he said.

“I think in the pandemic we've already doubled our operations. There's a limit—I don’t think we can triple them.”

DOZENS OF NEW RED-ZONE BEDS NEEDED

For the last few months, a Royal Vic pavilion—called the Ross Pavilion, tucked up high on the mountain—has been used as a shelter divided up into green, orange and red zones.

The green section was for people who were negative, orange was for those awaiting test results, and red was for positive cases.

A series of outbreaks at shelters and day shelters just before Christmas led to the surge of new cases, said Watts.

The old red zone could accommodate 25 people, but it was never close to full until now, Watts said.

The “occupancy in that red zone [was] never much higher than five,” he said. “Now in the last few days it's full, and we're seeing test results we don’t like to see.”

Positivity rates of people tested from shelters and day shelters have been 30 per cent or 40 per cent—whereas normally a positivity rate over 5 per cent will start to sound alarms.

To make room, the people who had been staying in the Royal Vic’s green zone need to be moved elsewhere.

“There's going to be another hotel,” said Watts, though it hasn’t been announced yet which one it will be.

“We’re working on a plan that will be finalized tomorrow that will involve moving about 60 to 70 people out of the Royal Vic and into a variety of places that will be more suitable to them at this stage of the pandemic,” he said.

Unfortunately, “one size does not fit all. Not everybody's going to go to the same place,” he said. “You’ve got figure out who is best to go where.”

Health Minister Christian Dube also briefly described this plan in comments on Tuesday. He mistakenly suggested that a floor of a functional hospital would be dedicated to a new red zone, naming the Montreal General, but health authorities later clarified that he meant the Royal Vic.

The Royal Vic hasn't been used this year for any medical purposes. It’s essentially a shelter, allowing people to self-isolate if they’re positive but not experiencing serious symptoms, the way most people would do at home. Anyone who is seriously ill goes to hospital.

Dube added that the talks to find more space are ongoing.

“This is one discussion we will have with Mrs. [Montreal Mayor Valerie] Plante because this is an issue that is really important to her,” he said.

“I don’t think it’s a monetary issue—we just need place[s] for them.”

HOMELESSNESS GROWING, WITH HEALTH RISKS

The Royal Vic was first designated as a COVID-19 red zone last spring, early in the pandemic, as the city braced for a potential wave of cases among homeless people. But that wave never materialized—the site was never much in use at that stage, Watts said.

Over the summer, the Royal Vic shelter became the mixed green-to-red system. Various other services were added across Montreal in the meantime, including the huge hotel-shelter, and new beds turning Chez Doris into a nighttime shelter, for instance.

No one knows exactly how many people are living in homelessness in Montreal, said Watts, but “I'm quite comfortable saying that homelessness has increased” this year, amid the financial problems caused by the pandemic, he said.

Two years ago, during the city’s last point-in-time count—which provides the best statistics available on Montreal homelessness—there were about 1,000 people living on the streets, and another 2,100 who were in touch with social services or shelters, with no addresses of their own, Watts said.

So far, the outcomes of homeless COVID-19 patients have been mixed, he said. Many people have recovered, and while some have died, Watts said the deaths he knows of were of people with “serious co-morbidities” that increased their risk of complications.

However, many people who are homeless also have extra health problems that do create this higher risk, he said.

The last few weeks have also made it clear they’re vulnerable to being infected in the first place since social distancing is next to impossible at small shelters and in many other types of spaces they use. Many people who are homeless are also in the habit of sharing cigarettes or other items.

For people who want to help, “the best thing they can do is support financially the resources that are at work,” Watts said.

“We do get government funding to do this, but the majority of our funding comes from private donors.”

For people who want to donate goods instead of money, the only items that are really helpful are warm socks and gloves, Watts said—doing “random acts of charity” isn’t usually as helpful.