The H1N1 pandemic outbreak of 2009–2010 provided a unique set of circumstances from which to evaluate the readiness of homelessness sectors across Canada to deal with infectious outbreaks. In Toronto, the previous occurrence of SARS meant that policy-makers, social service managers and front-line workers had already faced the challenge of working through a major public health crisis. Even before SARS, managing public health issues was not a new concern for the homelessness sector of Toronto, as outbreaks of tuberculosis, lice and bedbugs have occurred within that context (Basrur, 2004; Tuberculosis Action Group, 2003). This chapter examines the homelessness sector’s experience of the H1N1 pandemic outbreak in Toronto. Mixed methods research was conducted with key stakeholders, social service providers and homeless individuals in the city to gain a better understanding of how the sector prepared for, experienced and recovered from the outbreak.
Through this research, many of the structural issues facing Toronto’s homelessness sector were apparent. Although this study examined the H1N1 outbreak in particular, these issues are arguably not limited to a pandemic. For instance, the study showed chronically high rates of service reliance among Toronto’s homeless population, limited capacity for public health and pandemic planning within the sector, congregate service designs that create close proximity between clients, and the many challenges service providers had in accessing and retaining necessary supplies. These structural issues are discussed throughout this chapter, with research findings and recommendations being provided. While this research was conducted in Toronto — and thus represents findings particular to that city — the themes and recommendations should be of interest and value to municipalities across Canada.