By Jen St. Denis, The Tyee, Local Journalism Initiative Reporter

Three months ago, the part of Vancouver that includes the Downtown Eastside had the lowest number of COVID-19 cases in the city.

Growing COVID rate

But it now has the highest rate, according  to data from the BC Centre for Disease Control. The local health area,  which includes the Downtown Eastside, Strathcona and part of  Grandview-Woodland, also has the lowest incomes and lowest life  expectancy rate in the city. 

The growing rate of COVID-19 is a concern  for residents who live in single-room occupancy hotels in the Downtown  Eastside and Chinatown, and the housing providers responsible for  managing those buildings.

Since the beginning of the pandemic, people who live and work in the Downtown Eastside have feared an outbreak in shelters or SROs, where residents often have pre-existing health conditions and live on very low incomes. 

But there were few cases in the neighbourhood during the spring and summer, and many residents were more concerned with the soaring number of overdose deaths triggered by COVID-19 precautions.

But in September, COVID-19 cases in the neighbourhood began to tick upward.

Not easy to isolate in an SRO building

Alicia Williams lives at the May Wah Hotel,  an SRO building in Chinatown. She explained that “it’s pretty much  impossible to isolate in an SRO.” Each bathroom in her building is  shared by around 20 tenants, and residents also share kitchen facilities  and are not allowed to keep a hotplate in their rooms.

Williams stayed at her boyfriend’s place  while she was waiting for the results of a COVID-19 test this summer  after she had been exposed to a friend with the virus (she ended up  testing negative).

“I’m really lucky to have that kind of option in comparison with a lot of people l live with, like seniors,” Williams said.

Williams said some of her neighbours take  the virus seriously and wear a mask when they’re in common areas of the  building, but others don’t believe it’s a real threat. She has avoiding  going outside and, as the weather gets colder and wetter, dreads the  idea of riding the bus.

People who live in B.C. have been told to  wash their hands frequently, stay at least six feet apart from others  and wear a mask. As the number of cases have surged during the fall,  health officials have asked British Columbians to reduce the number of  people they have contact with.

But many of those measures are difficult or  impossible to do in the cramped and inadequate housing that is common  in the Downtown Eastside and Chinatown.

81 cases since September

Janice Abbott, the CEO of Atira Women’s  Resource Society, said buildings that her organization manages had zero  cases until September. But since the beginning of September, 81 people  have tested positive for COVID-19.

Of those, 32 have been staff who work in  buildings or other programs Atira operates, and 49 have been tenants.  Abbott said Atira has also tracked “clusters” of cases among tenants in  certain buildings.

“It feels like we’re getting some number of new cases almost every day right now,” said Abbott. 

Tanya Fader, director of housing for PHS  Community Services, said it’s a challenge to find space for SRO  residents to quarantine. She noted that cases in the Downtown Eastside  rose at the same time that cases in the rest of the province started to  go up, and after people had returned to downtown Vancouver to shop and  work after staying away for much of the spring.

Residents who test positive

Abbott said Vancouver Coastal Health has  quickly provided testing to buildings when someone tests positive.  Building residents who test positive can stay in a hotel operated by the  health authority. 

But sometimes there’s no  room in the hotels, some residents don’t want to leave their homes, and  some aren’t able to self-isolate because they have a condition like  dementia. In those cases, building staff do the best they can to keep  everyone safe, Abbott said.

Atira has gone so far as to buy portable  toilets to help some tenants self-isolate in buildings with shared  bathrooms. But Abbott’s fears have only grown as research has shown that  COVID-19 can be spread through airborne transmission. Many SRO  buildings are over 100 years old and have poor ventilation, with windows  that don’t fully open.

Strathcona Tent City

PHS also operates shelters and does  outreach work to a tent city in Strathcona Park. Shelters are operating  at lower capacity to try to prevent COVID-19 transmission, but that  means there are 379 fewer shelter spots open this winter compared to  2019, according to the City of Vancouver. 

At the same time, the number of unhoused  people has risen during the pandemic, as housing providers have limited  guests, people have lost work and services for homeless people have been  reduced.

Fader said she was concerned that more people will be left outside this winter.

“The longer that people are outside, the unhealthier they are,” Fader said. “We’ve seen that in pneumonia and influenza.”

A survey conducted by the B.C. government showed that low-income people and racialized people are bearing the brunt of  the pandemic, with steeper losses of income and work, more food  insecurity and more difficulty accessing health care.

The local health area that includes the  Downtown Eastside, Strathcona and part of Grandview-Woodland has a total  population of 71,000 people. As well as having the lowest incomes and  the lowest life expectancy among Vancouver neighbourhoods, the area also  has the highest rate of Indigenous residents and the highest rate of  seniors living on low incomes.

More transparency needed

Abbott is calling on Vancouver Coastal Health to provide more specific data about where cases are happening, echoing a call from the Union of BC Indian Chiefs in September when cases began to rise.

“I think more transparency is critical,  while at the same time recognizing the risk of stigmatizing people and  stigmatizing the community and the buildings,” Abbott said. “But  information is power, and people need to know what’s going on so they  can make good, informed decisions about what’s going on.”

Fader agreed that people need to be given  the information they need to be safe, but she warned that stigma can  also make it harder for people to get the treatment they need. Many  residents are already dealing with stigmatized conditions like addiction  and mental illness.

“We don’t want the Downtown Eastside to be seen as the source of contagion,” Fader said.