Canada was already grappling with a homelessness crisis before the COVID-19 pandemic. When strict physical distancing measures came into effect to protect people from the spread of the virus, people experiencing homelessness were left in a very dangerous situation.

“Physical distancing is not a concept that works for people who call the streets or crowded shelters home,” says Simone Thibault, Executive Director of Centretown Community Health Centre in Ottawa, where visits from street-involved individuals have spiked since the start of the pandemic. She explains that washing hands frequently, keeping physical distance, and calling a healthcare professional when feeling sick is simply not realistic when someone has no home or is in a crowded shelter. The challenges are multiplied when individuals are dealing with substance use issues.

The best estimates from the State of Homelessness in Canada 2016 report say there are roughly 235,000 people who experience homelessness across the country in any given year. At community health centres across Canada, outreach workers, administrators, doctors, nurses, allied health professionals and other staff have been working around the clock to find solutions that further protect Canada’s homeless while respecting COVID-19 safety precautions for everyone.

North End Community Health Centre’s mobile clinic brings care and support to Halifax’s streets.

“For many homeless people, we are their first and only point of contact for help. We look after them for their medical needs, food, and finding shelter, and even then, we’re not able to reach everyone,” explains Marie-France LeBlanc, Executive Director at North End Community Health Centre in downtown Halifax. “When the World Health Organization declared a pandemic in early March, we realized right away that we would have to get creative to reduce their risk for COVID-19.”

With little initial guidance and protocol from public health authorities around addressing COVID-19 among homeless individuals, community health centres needed to take immediate action to prevent possible devastation. North End Community Health Centre responded by bringing testing for COVID-19 to the streets using their mobile clinic – a van outfitted with medical supplies to care for those unable to physically visit the health centre. “Redirecting the mobile clinic to focus on educating the homeless about COVID-19 and to test for the virus meant we could protect people who are at great risk and in urgent need of support,” says LeBlanc.

In certain parts of the country, sites are being set up to provide shelter to the homeless who require self-isolation due to COVID-19.

In Winnipeg, the community health centre Main Street Project has adapted many of its day to day outreach and support efforts to the new challenges of COVID-19. The CHC is working with partners to open 39 isolation units in a shared shelter space and they have equipped another 76,000 square-foot building with 190 new cots that will allow them to support their homeless clients in maintaining physical distancing during the pandemic.

Edmonton’s Expo Centre is readied to welcome homeless individuals that will be cared for and supported by Boyle McCauley Health Centre

In Calgary, health authorities are relying on the healthcare and social support expertise of community health centres, namely The Alex Community Health Centre and CUPS Calgary. They have outfitted a local hotel with “assisted self-isolation units” for homeless individuals who are infected with COVID-19 or who are awaiting test results, providing medical and social support at the temporary site.

In Edmonton, Boyle McCauley Health Centre is co-managing operations at the city’s 500,000-square-foot Expo Centre, which has been converted into a shelter, care, and support centre for large numbers of homeless community members.

“For us, we are always addressing a state of emergency for many people,” says Simone Thibault, speaking of day-to-day realities on the frontlines. “It took a global pandemic for many Canadians to realize it.”

Across Canada, Community Health Centres (CHCs) provide primary health, health promotion and social support services to individuals and families often with a focus on vulnerable and isolated communities. Outreach and harm reduction workers approach homeless individuals and groups to check-in on their overall health and wellbeing. Many CHCs have meal programs and provide safe injection, hygiene and emergency kits, and help connect the homeless to shelters and housing.