The Globe and Mail - 08.04.2020

A6 | NEWS OTHEGLOBEANDMAIL | WEDNESDAY,APRIL8,

W

hen Elise Nagy called the
Hamilton General Hospi-
tal in late March to give
them a heads up about a patient
en route with an infection, she
said she was asked by the charge
nurse on the other end of the line
when her workplace – a super-
vised consumption site – would
be shutting down.
Ms. Nagy, a registered nurse, re-
plied that the supervised con-
sumption site would not be shut-
ting down. It is an essential ser-
vice.
The charge nurse was “upset”
by that, Ms. Nagy says, and asked
her why one of their patients was
“taking up” one of the hospital’s
designated isolated rooms for CO-
VID-19 cases.
“I was speechless,” Ms. Nagy
said in a recent e-mail to her high-
er-ups and shared with The Globe
and Mail. “She then proceeded to
tell me that their emergency beds
‘should be reserved for patients
who make better life choices.’ ”
In a phone interview last week,
Ms. Nagy said the response from
that nurse – and other similar re-
actions by paramedics respon-
ding to overdose calls at the clinic

• has been “really hard to swal-
  low.”
  She and other health-care
  workers who’ve been on the front
  lines of the opioid crisis in Hamil-
  ton fear the COVID-19 pandemic
  has amplified the stigma that
  drug users face when seeking
  medical help. They worry about

what effect this confluence of

public health emergencies is go-

ing to have on some of the city’s

most vulnerable residents.

“I don’t think it’s COVID that is

the scariest thing for [people with

addictions] right now,” Ms. Nagy

said. “I think it’s the extra lack of

resources and health care that

they have access to right now.”

In an e-mail response to The

Globe, Hamilton Health Sciences

did not address the specific ex-

change reported by Ms. Nagy. But

the health network acknowl-

edged the anxiety that these un-

certain times has caused for many

people and patient populations,

including those with addictions.

“No one should feel alone. Now

and always, we will continue to

provide the best care for all of our

patients and communities we

serve,” spokesperson Thomas

Perry said.

As is the case in cities across

Canada, many of the resources

available for people with sub-

stance use problems in Hamilton

have been closed down or scaled

back. The supervised consump-

tion site Ms. Nagy works at, for ex-

ample, has had its hours slashed –

even as the opioid crisis rages on.

Since January, Hamilton para-

medics have received more than

100 calls for suspected opioid

overdoses. In the last week of

March alone, there were more

than 55 drug-related emergency

room visits in the city – 27 of

which were suspected overdoses.

“A month ago, [the opioid cri-

sis] was sort of on everybody’s

mind and recognized as a huge is-

sue that we needed to do better

with,” said Tim O’Shea, the inter-

nal medicine and infectious dis-

ease consultant with the Hamil-

ton’s Shelter Health Network.

“But [COVID-19] has definitely

taken a lot of momentum away

from that discussion.”

As more and more community

programs have been forced to halt

operations, others are stepping in

to fill the gaps in the supports that

people have come to depend on.

For example, Dr. O’Shea has no-

ticed that access to harm reduc-

tion supplies “has definitely be-

come a problem. I’ve heard from

some of my patients that they’re

reusing needles where previously

they would never do that.”

While he has been able to keep

in touch with some patients, Dr.

O’Shea fears the most vulnerable

of them will fall through the

cracks. They do not have cell-

phones, and as more and more

public services are shut down,

he’s concerned they will have no-

where to go.

“They don’t know where to

find me,” he said. “And I don’t re-

ally have a way to get in touch

with them. ... There are certainly

some that I haven’t heard from at

all. And that is definitely a con-

cern.”

One crucial service that has

persevered through the pandem-

ic – even doubling their hours,

with help from the City of Hamil-

ton – is the AIDS Network’s Van

program, a mobile service that

delivers clean harm reduction

supplies to people across the city,

confidentially and in discreet lo-

cations of their choice.

One recent evening, AIDS Net-

work outreach worker Kaitlin La-

batte and volunteer Jessica Ran-

dall stopped to chat as they res-

tocked the van after a busy after-

noon shift.

They’ve tried to adjust their

practices to meet the COVID-

guidelines. For example, clients

can no longer climb into the van

to peruse the supplies. They order

what they want ahead of time

over the phone, and the items are

passed through the window.

Ms. Labatte said they already

had stops lined up for the coming

evening shift that day. She feels as

if it’s been busier since the pan-

demicbegan, but it’s hard to tell.

“It’s never really slow,” she said.

Other grassroots organizations

are also finding ways to fill gaps

where they can. Grenfell Minis-

tries, a local harm outreach orga-

nization founded by Rebecca

Morris-Miller, has launched an

overdose prevention hotline that

people can call if they need to use

drugs alone.

The line, which is monitored by

harm-reduction volunteers who

can talk with the drug user, or

even just listen, while they take

drugs to ensure they’re safe, start-

ed as a pilot project on Feb. 1. But

when the effects of COVID-

started to become clear, it took on

a sudden urgency.

The call line is available from

noon until 10 p.m. on weekdays,

and from noon until midnight on

weekends, to anyone in Ontario.

Call takers are trained online,

which Ms. Morris-Miller said has

been convenient during a time of

mandatory social distancing. So

far, she said they have been get-

ting roughly half a dozen calls a

week – but calls have slowly start-

ed to increase during COVID-19.

It’s not a perfect system, she ac-

knowledged. “Not everybody has

a phone, we know that. This is a

step down from the safe injection

site for sure – but it’s also a step up

from nothing, which is where

we’re going to be if things keep

getting closed down.”

Ms. Morris-Miller is pleased

with the rapid response that has

occurred in the face of COVID-19.

She knows it’s necessary. But to

some degree, after years of beg-

ging for help with the opioid cri-

sis, she said, it hurts.

“I can see very clearly now, how

fast thegovernment will make

change, how fast they will take

something seriously, if it can af-

fect them,” she said. “Watching

how fast they can act when they

want to, or when they feel like it’s

something that they feel is impor-

tant, is traumatizing.”

I’veheardfromsomeof

mypatientsthatthey’re

reusingneedleswhere

previouslytheywould

neverdothat.

TIMO’SHEA

INTERNALMEDICINEANDINFECTIOUS

DISEASECONSULTANTWITHTHE

HAMILTON’S SHELTER HEALTH

NETWORK

BrandonKober,co-manageratHamiltonUrbanCoreCommunityHealthCentreConsumptionandTreatmentService,andregisterednurseEliseNagyareseeninHamiltononApril3.
Ms.Nagysaysthat,amidthepandemic,thelackofresourcesandhealthcarefordrugusersisworrying.GLENNLOWSON/THEGLOBEANDMAIL

Advocatesworryaboutcoronaviruspandemic’seffectondrugusers

MOLLYHAYESCRIMEANDJUSTICE

Fire departments in British Co-
lumbia have asked Provincial
Health Officer Bonnie Henry to
reconsider her recent order re-
stricting firefighters to only the
most life-threatening calls, say-
ing the unintended consequenc-
es put citizens at serious risk.
The new protocol, which came
into effect this month, means
that firefighters are not respon-
ding to most overdose calls dur-
ing the COVID-19 pandemic be-
cause they are not classified as re-
quiring the most urgent re-
sponse.
Overdose deaths have spiked
in Vancouver recently. City data
obtained by The Globe and Mail
list eight suspected overdose
deaths in each of the past two
weeks – the most in a week since
last summer. The figures have
not been confirmed by the BC
Coroners Service.

The Globe reported on April 2

that B.C. firefighters were ordered

to respond only to the most im-

mediately life-threatening calls,

such as cardiac arrest – events

that are colour-coded as purple.

This means no longer attend-

ing red events, the tier below pur-

ple, which include drowning,

choking, chest pains – and most

overdoses. Firefighters are dis-

patched only if technical assist-

ance is required, or if paramedics

expect to be delayed by more

than 20 minutes.

The order is aimed at limiting

first responders’ exposure to the

new coronavirus and the amount

of personal protective equip-

ment needed.

On April 3, the mayors of 14

municipalities sent a joint letter

to Deputy Health Minister Ste-

phen Brown outlining their con-

cerns.

“We are very fortunate to have

such strong leadership as Dr.

Henry’s during these unprece-

dented times,” read the letter,

printed on the letterhead of Delta

Mayor George Harvie.

“However, we are concerned

that Dr. Henry may not be fully

apprised about the serious unin-

tended consequences of this de-

cision to limit our firefighters to

only attend purple events and to

only be ‘considered’ for red

events if [BC Ambulance Service]

is delayed more than 20 minutes.

This delay or non-response puts

our citizens at serious risk.”

The letter says it is “alarming”

to see the types of red-coded

events fire departments will no

longer be attending, and requests

that Dr. Henry reconsider the or-

der or, at a minimum, refer the

discussion to BC Emergency

Health Services and the BC Fire

Chiefs COVID-19 Task Force to

provide alternative solutions.

The 14 signatories are the may-

ors of Delta, New Westminster,

Port Coquitlam, Port Moody, Bel-

carra, Richmond, West Vancouv-

er, Pitt Meadows, Burnaby, An-

more, Langley, White Rock, and

the city and district of North Van-

couver.

On April 6, Vancouver Fire Res-

cue Services (VFRS) acting fire

chief and general manager Kiran

Marohn wrote to Mayor Kennedy

Stewart and council outlining the

department’s concerns, focusing

on overdose deaths.

“Since the emergence of the

opioid crisis in the City of Van-

couver, VFRS has been on the

front lines providing critical care,

saving lives and reversing the

outcomes of potential overdos-

es,” she wrote.

“In the two weeks leading to

these changes, we have seen a

higher number of overdose

deaths than usual. This is not the

time to reduce responses to these

events.”

Statistics included in the letter

showed that from March 2 to 5,

prior to the change, VFRS was

dispatched to a total of 44 sus-

pected overdose events. From

April 2 to 5, it was dispatched to

15.

Acting Fire Chief Marohn add-

ed that “we still believe we are

better positioned to provide

timely service to our communi-

ties than the BC Ambulance Ser-

vice,” and that firefighters are

equipped with all necessary per-

sonal protective equipment.

Asked about the unintended

consequences of the directive on

Saturday, Dr. Henry said it came

out of discussions with the emer-

gency operations centre and that

“fire services were not wanting to

respond to health calls” because

of COVID-19 risks.

VFRS Fire Chief Darrell Reid

said in a post to Twitter shortly

after that the service did not ask

for major reductions in dispatch-

es to medical calls and was not

expecting the announcement.

Asked again about the change

on Tuesday, Dr. Henry said it was

initiated in consultation with

“some of the fire services, but pri-

marily with BC Emergency

Health Services,” to reduce the

use of personal protective equip-

ment and the number of first re-

sponders who could potentially

be exposed to COVID-19.

Dr. Henry said the protocol

“unfortunately was misunder-

stood by some when it first came

out” and “was not a reflection, as

it seemed to have been interpret-

ed, of the value of fire services

and other non-paramedic first re-

sponders.”

Richmond Mayor Malcolm

Brodie said Tuesday that the city

was concerned with the new pro-

tocol and had not heard any up-

dates since the letter was sent.

B.C.firefighterspush backonnewpolicy

Protocolnowrestricts

themfromattending

overdosecalls,among

others,inbidtolimit

exposuretoCOVID-

ANDREAWOOVANCOUVER

Overdosedeathshave

spikedinVancouver

recently.Citydata

obtainedbyTheGlobe

andMaillisteight

suspectedoverdose

deathsineachofthe

pasttwoweeks–the

mostinaweeksince

lastsummer.