Treating homeless communities amid a global pandemic
Royal College Professor-in-Residence for 2020, Jeffrey Turnbull, MD, FRCPC, is working with staff at Ottawa Inner City Health to keep homeless people safe during the COVID-19 outbreak.
After searching for an appropriate venue to isolate and treat confirmed and suspected cases of the virus among the homeless, Inner City Health has adapted a community centre near the Byward Market in downtown Ottawa, where new patients are arriving every day.
“The main problem with managing COVID-19 in this community is that homeless people have nowhere to self-isolate,” said Dr. Turnbull. “We’re working to keep them isolated and segregated at the community centre, for the sake of their own health and the health of the wider community.”
Unique and shared challenges of caring for the homeless
Hospitals are sending homeless people to the centre who have been tested for COVID-19 and are either known to be positive or are awaiting results. “One major challenge is that so many of these individuals have health conditions such as chronic lung disease or heart disease,” said Dr. Turnbull. “It can be hard to tell whether their symptoms are due to COVID-19 or an underlying condition.”
In addition to the unique challenges of working with homeless communities, nurses, physicians and personal support workers at Inner City Health face the same shortages of personal protective equipment as many other health practitioners and front-line workers. “We have no assurance that we’ll have the equipment we need,” he said. “If I can’t protect my staff, we can’t protect our patients. We’re feeling pretty desperate.”
More than 1,000 people sleep in Ottawa’s homeless shelters every night, often in crowded conditions, which means the likelihood of disease transmission is high, said Dr. Turnbull. “I have no idea how busy we will get at the community centre. We’re taking it day by day.”
Balancing new and existing duties at Inner City Health
Aside from a potential deluge at the isolation site, Inner City Health treats 280 patients per day at its nine Ottawa sites. “Everyone is working beyond their capacity,” said Dr. Turnbull. “Before COVID-19 hit, it was all-hands-on-deck dealing with the opioid crisis. I didn’t think things could get any busier.”
Dr. Turnbull is a founder and the medical director of Ottawa Inner City Health, which provides health care to Ottawa’s homeless and street communities. The former chief of staff at The Ottawa Hospital, he left to spend more time working with Ottawa’s homeless community. Dr. Turnbull has long pursued an interest in poverty and its effects on peoples’ health in Canada and internationally.
“As we enter into this difficult time, I would like to ask all Fellows to bear in mind those around us who are most vulnerable: the homeless, the frail elderly, Indigenous people,” said Dr. Turnbull. “I want to encourage Fellows to reach out as much as possible and help.”