Michelle Stapleton sat by the window of a Toronto homeless shelter on a recent morning, relief etched on her face. The shelter at 545 Lake Shore Blvd. W., is home to more than 150 people and like other facilities for the homeless in the last year, COVID-19 had cropped up inside.
Stapleton had feared the worst, due to struggles with asthma and chronic obstructive pulmonary disease (COPD). With COPD comes an increased risk of hospitalization and death if she contracted the virus.
“I don’t want to die. I’m human, I want to be able to survive,” she said. “I have family… I don’t want to be dead in a hospital, and not have them know what happened to me.”
But that fear began to fade on Friday, as Stapleton and some 50 other residents of the Homes First Society shelter were given the first of two doses of the Pfizer vaccine. There are still some barriers to safeguarding the city’s homeless — from distrust in the medical system to catching those who are transient during the day and return to shelter at night. But several residents, as well as staff and medical workers, said Friday felt like finally turning a corner.
“It means that I can move on,” Stapleton said minutes after receiving her shot, as others in an observation area sipped on boxes of juice. “I can fight this thing no matter what. I don’t want to catch it, I don’t want to have it, but now my body will be able to fight it.”
Until February, Ontario’s homeless were left until the second phase of vaccine rollout for injections. Facing pressure from advocates and physicians, who cited research showing Ontario’s homeless are five times more likely to die and 10 times more likely to need intensive care from COVID-19, the group was bumped to phase one.
The day of the clinic on Lake Shore, Toronto had 204 reported cases of COVID-19 across 12 sites in the shelter and respite system. While some sites are able to keep occupants in individual rooms, the Homes First shelter has a dormitory-style layout. With distancing measures in place, manager Gary Muirhead said its capacity went from 275 beds to 175.
The shelter was nearly at its capacity on Friday, with around 160 beds filled. At the start of the day, 64 people — shelter occupants, agency staff and homeless Torontonians from other sites or encampments nearby — had consented to receiving the first shot of the Pfizer vaccine.
By day’s end, 102 were delivered, 51 to the shelter’s residents — less than a third of the population on-site. Dr. Andrew Bond, medical director of Toronto’s Inner City Health Associates, said while an exact threshold was unclear, they would likely need to vaccinate between 70 and 80 per cent of a shelter’s population in order to effectively guard against future outbreaks.
“I think we will absolutely get there. I don’t think we’re going to get there today,” Bond said, around halfway through Friday.
The barriers to hitting that mark were twofold: many shelter occupants had left the facility for the day and wouldn’t return until the clinic was over, and there were longstanding issues of distrust among the homeless in the health-care system.
“Certainly, there is some guardedness that’s out there,” Bond said.
In some cases, residents sharply rebuked staff who tried to discuss the vaccinations with them – saying they just weren’t interested. Others were curious, but visibly nervous. In one case on Friday, a resident accepted a vaccination after questioning a medical worker for an hour.
Rita Belli was among those who approached the Pfizer injection with trepidation. She’d just started a new job in a nearby deli, and feared any side effects that could require her to call in sick. She was also troubled by hearing conflicting information. “I was hearing that a lot of people had allergic reactions, then I heard no, only some or very few had a reaction,” Belli said.
She ultimately decided to receive her shot, after being assured any side effects would be brief.
To some, having priority vaccine access was surprising. “A lot of the time, we end up feeling kind of forgotten about, shrugged off or snubbed off. But this isn’t the case,” said resident Timothy Pyke, adding that health workers had been trying to address concerns on-site for several days.
Bond sees the current moment as critical, as COVID-19 variants believed to spread more easily have erupted in the shelter system. He called the first variant outbreak a “flash point.”
“This was either going to take a turn for the worse, or take a turn for the better. It was really heartening, and just really uplifting, to hear that there was this responsiveness to make a change.”
Inside the shelter, residents were conscious of rising case counts beyond their walls. Matthew Livingstone pointed to the more than 1,300 new cases in Ontario that day, expressing relief at the extra protection. “It makes me feel better. A little more confident, I guess,” he said.
Others, too, said the day felt like a turning point. “After how bleak of a year it’s been, how disproportionate and how cruel the impact of COVID has been on people living in shelters, living outside, trying to survive throughout this whole thing … you can be the biggest skeptic, but it’s hard not to walk away from here and from the work and see the hope,” said Dr. Andrew Boozary, executive director of health and social policy for University Health Network.
Stapleton, meanwhile, urged others in the shelter system to heed a simple message.
“Get vaccinated. Get vaccinated, so that we can have a chance to fight.”