‘People are stranded:’ A downtown hospital is seeing a rise in cold-related injuries as shelters struggle to find spots

2022-01-29 1:54:00 PM

‘People are stranded:’ A downtown hospital is seeing a rise in cold-related injuries as shelters struggle to find spots

Covıd-19, Coronavirus

‘People are stranded:’ A downtown hospital is seeing a rise in cold-related injuries as shelters struggle to find spots

Physicians and outreach workers at Toronto’s St. Michael’s Hospital are alarmed by the number of homeless people coming to the emergency department .

Hospital staff say the crisis has escalated in the last two weeks due to a critical lack of space in the city’s shelter system, hit hard by theThe extreme winter temperatures gripping the city, combined with at-capacity shelters, mean more homeless people need emergency care after prolonged exposure outdoors. And more in the unhoused population are seeking shelter in the ER as a place of last resort, hospital staff report.

“People are stranded out there,” Pavey said. “The conditions for the last couple of weeks have been pretty brutal. That comes with a lot of risks and a lot of poor health outcomes for people.”warned the shelter system was “in near collapse”As of Jan. 27,

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read JOIN THE CONVERSATION Physicians and outreach workers at St. Michael’s Hospital are seeing an alarming rise in the number of homeless individuals coming to the emergency department seeking shelter and suffering from severe cold-related injuries, including frostbite, painful foot infections and life-threatening hypothermia. Vinita Dubey, associate medical officer with Toronto Public Health, said indicators such as the number of institutional outbreaks and virus levels in wastewater show a local “plateauing” of the infectious Omicron variant. Hospital staff say the crisis has escalated in the last two weeks due to a critical lack of space in the city’s shelter system, hit hard by the Omicron variant . Two were found in a van with a man who now faces charges. The extreme winter temperatures gripping the city, combined with at-capacity shelters, mean more homeless people need emergency care after prolonged exposure outdoors. Dubey said in an interview Thursday that cellphone data shows Torontonians have recently spent more time at home than at any other point in the past year. And more in the unhoused population are seeking shelter in the ER as a place of last resort, hospital staff report. 19, the High Commission of India in Ottawa said in a news release.

“They quite literally have no place else to go,” said LP Pavey, an outreach worker in St.” Dr.S. Michael’s emergency department. On a recent night, when the temperature plummeted to almost -20 C, 12 people were in the ER — not for medical care but to get warm and ask for help finding shelter, she said. “We still have the highest number of hospitalizations we’ve had in the whole pandemic, and a nursing shortage, and a lot of people who are very burnt out,” making the health-care system fragile, Banerji said. “People are stranded out there,” Pavey said. Four others, who were believed to have been with the group, were found dead in a field in Manitoba. “The conditions for the last couple of weeks have been pretty brutal. Kieran Moore, Ontario’s public health chief, who on Thursday told reporters that “We have to understand that we have to learn to live with this virus,” when eliminating it entirely no longer seems possible. Autopsies of the four were done on Wednesday by Manitoba's chief medical examiner and confimed that the family members died of exposure to extreme weather conditions.

That comes with a lot of risks and a lot of poor health outcomes for people.” In recent weeks, at least two underhoused patients were treated in the emergency department for life-threatening hypothermia. Health officials are watching a new Omicron subvariant known as BA. "This has been going on [for] years. One of those patients died, said Nicole Champagne, an emergency department social worker. “It’s been devastating. Dubey didn’t know if it has infected any Torontonians.” Earlier this month, housing advocates warned the shelter system was “in near collapse” amid the Omicron wave. "A lot of smugglers will give the false pretence that it's safe and easy to cross unlawfully," said Jamie Holt, acting special agent in charge of U. Investigators believe the case involved human smuggling and would like to speak to anyone who may have helped or seen the family while they were in Canada.

The fast-moving variant has triggered dozens of outbreaks in shelters and caused staffing shortages. Experts say there is no data yet to suggest if BA. Housing advocates and outreach workers say this has led to fewer staff monitoring intake phone lines and fewer available spots in the system already struggling to keep up with demand. As of Jan.1 COVID-19 strain that infected some Torontonians one year ago. "The smugglers have a very specific way of doing things. 27, there were 368 COVID cases and 35 active outbreaks in Toronto’s shelter system. When asked about the number of staff off work in the last week due to COVID, the city’s Shelter, Support and Housing Administration (SSHA) said on average “there were approximately 17 per cent staff absences. But Khan is concerned that low vaccination rates in parts of the world could trigger new variants, as could continuing high infection rates in Ontario.

” SSHA said due to mitigation measures announced this month, including redeploying city staff to “meet high-priority needs,” the absences in the shelter system were “minimized to approximately 10 per cent and these absences have been decreasing over the past week." 'It's a horrible experience': Former refugee hurts for 4 people found dead near Manitoba-U.” On Thursday afternoon, while in conversation with the Star, Champagne was trying to find shelter spots for four patients discharged from the emergency department but with no safe place to go. “As we reopen we have to remember that these (COVID-19 restrictions) are living things and may need to be tweaked if we get into trouble again,” Khan said. She said the hospital’s outreach staff had been calling the shelter intake lines since 7 a.m.”. One woman was taken to hospital because one of her hands was to be partially amputated., faced long waits to speak with a shelter worker and multiple dropped calls.

“I have another cellphone in my pocket right now on hold with the intake line while we’re talking,” Champagne said, noting the discharged underhoused patients were taking up needed acute care beds. “Even the warming centres … they are at capacity as well. Investigators believe the deaths of four people found in Manitoba near the United States border are linked to a larger human smuggling operation. So we can’t even get them into a basic warm building to stay, let alone a bed.” On Jan. 14, the city announced it was opening two community centres as additional 24-hour respite centres that provide 89 additional physically distanced spaces. People migrate for two main reasons: to seek out better economic opportunities or to be reunited with family, he said.

SSHA told the Star the respite centres will continue to operate and that its four designated warming centres currently have capacity for 166 people. SSHA also said the city will continue to supply N95 masks to shelters “on a 14-day schedule until the need subsides.” The city announced on Jan. Smuggling operations can be as small as five to 10 people working together in different countries, he said. 13 it was providing 310,000 N95 masks to shelter clients . At St.

Michael’s Hospital’s emergency department, about 20 per cent of its patient visits are by patients experiencing homelessness, said Dr. Deepak Ahluwalia, a Canadian immigration lawyer working with asylum seekers in California, said the Emerson crossing is frequented by smugglers and migrants who know its remoteness makes it inaccessible to patrol officers. Carolyn Snider, chief of emergency medicine at the hospital, a part of Unity Health Toronto. And while the ER does see an increase in the number of underhoused individuals seeking care in the winter, the recent spike caused by Omicron hitting the shelter system alongside frigid temperatures is different, she said. “We’re seeing more patients. through Canada. They’re staying longer because there is nowhere else to send them.

And they’re coming in sicker, with more cold-related injuries.” Hospital staff are seeing cases of “trench foot” in underhoused patients." 'They died so brutally' Once migrants have made contact with a smuggler through an ad or word of mouth — and provided payment — they usually receive general instructions about their journey, Ahluwalia said. The serious condition is caused when feet are cold and wet for too long. “Their socks are wet, their feet have been in the cold and snow, and their skin is macerated from that,” Snider said, adding that if left untreated patients can get serious infections. On a recent shift, Snider spoke to three patients experiencing homelessness who needed medical care but had no stable or safe housing options. "They know that once they put you across, their job is done.

One was sleeping on a warm grate behind a building, another was seeing shelter at Union Station, she said, noting people are struggling to find places to stay warm. Staff have also this month seen more cases of frostbite. Snider said the extremely painful injury is different from frostnip, a less serious injury more likely to be experienced by the general public. "It's just sad that four people died, and they died so brutally and so tragically. Dr. Stephen Hwang, director of the MAP Centre for Urban Health Solutions, said the recent experiences of St.

Mike’s staff offer a window into what is happening in the shelter system and points to the immediate need for more warming centres and more shelter beds. He noted that some city shelters experiencing a COVID outbreak are directed to not accept new clients for public health reasons, a decision that may be causing additional harm. According to SSHA, some locations can continue accepting clients with appropriate protections and under guidance from Toronto Public Health. And while in some cases shelters may need to close for a short time, “all efforts are being dedicated to ensure access to safe indoor spaces for people in need,” SSHA said. Hwang, a physician at the hospital and a researcher who studies homelessness and health, said given the current shelter pressures and extreme cold, he hoped city staff would see the importance of offering a person shelter from the cold.

“The need for more shelter beds right now in the city, we are seeing it from a health-care perspective. But we know people in the community are seeing it every day as well. We are all very concerned.” .