A banner that says "Housing for All" is carried at the beginning of a housing rally in Toronto. Image credit: Cathy Crowe

History will tell the story of the inequities worsened in the pandemic, not just in Canada but around the world.

A recent editorial in the prestigious British Medical Journal titled “Covid-19: Social murder, they wrote — elected, unaccountable, and unrepentant” makes the case that the term “social murder,” first coined by the philosopher Friedrich Engels to describe the political and social power held by the ruling elite over the working classes in 19th-century England, is more than a relic of a bygone age. It is very real today, exposed and magnified by COVID-19.

Executive editor Kamran Abbasi writes:

“A pandemic has implications both for the residents of a country and for the international community, so sovereign governments should arguably be held accountable to the international community for their actions and omissions on COVID-19. Crimes against humanity, as adjudicated by the International Criminal Court, do not include public health. But David Scheffer, a former U.S. ambassador for war crimes, suggests that we could broaden the application of public health malpractice ‘to account for the administration of public health during pandemics.’ In that case, public health malpractice might become a crime against humanity, for leaders who intentionally unleash an infectious disease on their citizens or foreigners. Others have argued similarly for environmental crimes.”

Here at home, governments have neglected huge segments of the population: long-term care and retirement residents, elderly people still living at home, people with health challenges receiving home care, the prison population, children in elementary and secondary schools, low-income communities and people who are homeless. Then there are the high-risk workers, considered essential, but not essential enough to be vaccinated.

The health and academic community have called the intentional neglect to long-term care residents social murder. Health coalitions are now trying to remedy that by mounting a campaign to include long-term care in the Canada Health Act. They write:

“Proposed reforms would bring long-term residential care into the mainstream of the Canadian health-care system. Federal legislation would, for the first time, establish a statutory obligation for the federal government to fund, and take some measure of ongoing responsibility and accountability for the sector. As has been true for the Canada Health Act, federal legislation on long-term care can also help shift societal expectations so that long-term care becomes understood as a necessary element of Canada’s commitment to providing health care to all Canadians, regardless of the setting in which such care is provided.” — Briefing note by the Canadian Health Coalition, March 22, 2021.

“The health care that long-term care residents depend upon every day is every bit a necessary as the care that hospitals and physicians provide. It is long past time to establish national standards to treat them that way. “– Steven Shrybman, partner Goldblatt Partners LLP, author of the legal opinion on national standards.

This is a hopeful campaign that we should all take part in. Check out your provincial health coalition contacts.

Surely, the term social murder must also apply to Canada’s public health malpractice with respect to homelessness.  

Toronto remains the epicentre of the homeless disaster in Canada, a national disaster that was declared in 1998 by the Toronto Disaster Relief Committee.

Public health officials and politicians have ignored decades of evidence from inquests, the SARS Commission report, the dangers of shelter conditions that resulted in outbreaks such as tuberculosis, Norwalk virus, bedbugs and Streptococcus A and shelves of research on the social determinants of health and inequities that call for social housing and more humane shelters.

Intentional public health neglect leads to disease and death.

A 2018 Toronto Public Health report showed the median age of death for people experiencing homelessness was 48 years. In comparison, the average life expectancy in Toronto is 81 and 85 years of age for men and women, respectively. People left unhoused not only unjustly die too young, they die of violence and preventable illness. This has been documented most clearly for 20 years at the monthly Toronto Homeless Memorial event.

The living conditions in shelters remain abysmal. The most basic necessity, a bedroom door to close, a bed, a locker, are not universal. Front-line workers have called for improvements by every means possible, including shooting secret video footage to expose dangerous and unhealthy conditions. Dri, formerly of Tent City, once said we would never allow dogs to be kept in such conditions, which is why over the years we have attempted to show these scenes to the public.

The pandemic collided with an existing public health emergency for homeless people. Encampments grew, people began to lose their housing and were plunged into homelessness. Thousands of homeless people were left in unsafe conditions pretty much guaranteeing their exposure to COVID.

The scale of homlessness, some 9,000 people affected, is so severe that the city now operates over 30 hotel/shelter programs as well as congregate shelter sites such as the infamous Better Living Centre (BLC) where plexiglass cells would purportedly protect people. BLC now has an outbreak of 15 cases.

As of March 23, there are 15 shelters in outbreak status with 290 people, including shelter workers, infected. Cumulatively Toronto has experienced 98 shelter outbreaks and 1,136 people have been infected. These are only shelter numbers and do not include other sites such as drop-ins or encampments. Many shelters are on their second, even third outbreak with variants of concern estimated to represent 50 per cent of cases. At least seven homeless people have died of COVID but even more have died in shelter/hotel fires, in encampments or due to overdose in the shelter/hotel.

Intentional neglect, social murder, whatever you call it, this is happening. Medical officers of health have now reluctantly declared a third wave. While Toronto and other cities begin the process of recovery and rebuilding there are no brave pronouncements by politicians or public health officials to reform and modernize the shelter system so individuals are guaranteed one room per person or family, or to call for the funding for renovations, suitable shelter site purchases, and improved air filtration systems and staffing.

The lack of imagination and purpose for a serious social housing rebuild post-COVID is most evident by the federal government and Toronto Mayor John Tory’s excitement around modular housing as a solution for a few hundred homeless people.

In addition, the federal government’s Rapid Rehousing Initiative is too little, too late. Its promise of 3,000 units across the entire country is surely negligent. There are more than 235,000 people homeless this year across the country. 

It took the Second World War and the activism of veterans to win a national housing program. In his book A Good War. Mobilizing Canada for the Climate Emergency, Seth Klein recounts in inspiring detail the scale of mobilization that happened after the war. The same can be true after a pandemic — for climate change, housing, long-term care and more.

Cathy Crowe is a street nurse, author and filmmaker who works nationally and locally on health and social justice issues.

Image credit: Cathy Crowe