Keep warming centres open 24/7 for rest of winter, Board of Health urges city

Toronto’s Board of Health is urging the city to keep its warming centres open 24/7 for the remainder of the winter season.

The board of health voted overwhelmingly in favour of the motion Monday afternoon during its monthly meeting.

The motion, jointly presented by councillors Ausma Malik, Ajejandra Bravo and Gord Perks, also asks city council to declare a public health crisis based on the “systemic failure of all three levels of government to provide adequate 24-hour, drop-in and respite spaces.”

In a statement released following the meeting, a spokesperson for John Tory said that the mayor “supports a pragmatic approach based on the best advice from our city staff” when it comes to helping Toronto’s most vulnerable.

The spokesperson, however, noted that last year roughly half of the times that warming centres were opened it was done in the absence of an Extreme Cold Weather Alert, which is the automatic trigger for the opening of the centres.

“We rely on our professional city staff to open warming centres when they are needed, and frequently they open these locations ahead of public health officials declaring an Extreme Cold Weather Alert,” the spokesperson explained, adding that "while warming centres and shelters are lifesaving interventions in the short-term, fundamentally the solution to better overall health is in sustainable, affordable, supportive housing."

Monday’s vote comes after Malik, Bravo, and Perks wrote a letter to the Toronto Board of Health (BOH) in which they expressed concerns about the “sharp increase in the number of people experiencing homelessness” and the city’s inability to “support the number of residents in need, placing extra pressures on the city's drop-in and warming centres.”

Perks said the ball is now in the court of Toronto’s mayor.

“I think today the problem has been put squarely in front of Mayor John Tory. He has extraordinary new powers to write his own budget, and he has a choice to make,” he said.

Speaking with reporters, Toronto’s Medical Officer of Health Dr. Eileen De Villa said temporary measures, like warming centres, have a role to pay in the short term, but overall more must be done to address the bigger picture.

“The very act of being, the very state of being homeless or under housed is a negative impact on health, under any temperature,” she said.

Deputants urge city to act

A dozen deputants, many of whom shared difficult first-hand stories about how the cold has harmed those they love and care about, spoke during Monday’s meeting.

Dr. Jacqueline Vincent, a psychiatry resident at St. Michael’s Hospital, asked why it acceptable to continuously holding discussions about basic human rights like people not freezing to death on the streets instead of doing something about it.

“Please do what you can to help make help patients keep their fingers and toes and feet intact. Please do what you can to prevent me from seeing more patients like the one I did just a couple of weeks go whose feet were so badly frostbitten they could not walk for days,” she said.

“Please help my patients keep themselves and their belongings warm and dry during cold winter says.”

Dr. Stephen Hwang, an internal medicine physician at St. Mike’s and the director of Unity Health’s MAP Centre for Urban Health Solutions, expressed how he’s become “increasingly concerned” about the health and wellbeing of unhoused people in Toronto this winter.

Hwang, who along with colleagues published a research paper on the effects of hypothermia on people experiencing homelessness in Toronto, said he often faces the “impossible dilemma” of discharging his patients to the street and the cold “after having laboured so hard and so long to help them recover from a serious illness.”

He also said his hospital, like others across the city, is seeing an increase in the number of people visiting the emergency department “simply seeking a place to get warm.”

Another one of the speakers, Victoria Joseph, shared the story of her son’s journey with bipolar disorder and homelessness.

“I do not want him to fall through the cracks with Toronto homelessness,” she said. “He needs a chance to get his life back. … I need help for my son.”

Prior to the Board of Health meeting, Healthcare Providers Against Poverty (HPAP) and the Shelter and Housing Justice Network (SHJN) held a joint press conference with Bravo outside Toronto City Hall to demand an immediate commitment from city council to raise the temperature threshold for opening the warming centres to 0 degrees and keep them open from Sept. 15 to June 1.

Organizers also called for an end to encampment evictions and the destruction of survival gear.

Their demands were supported by almost 1,700 residents, organizations, health care providers, and front line workers who signed an open letter.

“We are frustrated that the city has not done enough to help the most vulnerable among us,” HPAP’s co-chair Tanveer Mandur said during the press conference.

Mandur, a resident physician specializing in psychiatry, said Toronto is facing a humanitarian crisis as people experiencing homelessness are suffering preventable loss of life, limb and injury due to the cold.

HPAP member Dr. Samantha Green, a family physician in Regent Park and an assistant professor at the University of Toronto, said since becoming a doctor a decade ago she witnessed people being injured or dying from the cold every winter.

“It is disappointing and shameful that 10 years on I am demanding the same thing from the city: open adequate shelter space and invest in affordable housing,” she said.

Mayor Tory responds to vote

Late Monday afternoon, Tory’s office released a statement in which they reiterated that his “primary concern in winter months, and all year, is to make sure the City of Toronto is continuing to support our most vulnerable residents.”

“(The mayor) continues to work with City Council and City staff to explore all options to support homeless residents, and create pathways out of homelessness with long-term supportive and affordable housing,” they said, noting in 2022 the city assisted 3,900 people move into permanent housing.

His office also said that he “supports the work the Economic Development and Community Development Committee is already doing on this file.”

"Last week, the Economic Development and Community Development Committee asked City staff to conduct a review of emergency warming centres and report back on how they can be improved. ECDC also encouraged staff to, as much as possible, use their discretion taking all weather conditions into account when opening warming centres," they told CP24.

A Tory spokesperson went on to say that the City of Toronto has expanded its shelter system from 6,000 beds before the pandemic to roughly 9,000 beds in this year’s proposed budget.

They further noted that the city has “done the work” in partnership with other levels of government, “to get supportive housing built to help thousands of people move from shelters and into permanent housing.”

As for the opening of warming centres, Tory’s office said city staff decided when it is best to open these sites and often do so ahead of when public health officials declare an extreme cold weather alert (ECWA).

“As Dr. Eileen de Villa said today, in the last cold season, for roughly half of the occasions that the warming centres were opened, it was done in the absence of an ECWA (i.e. there were other reasons for which opening the warming centres was deemed appropriate by Shelter, Support & Housing Administration),” they noted, adding “fundamentally the solution to better overall health is in sustainable, affordable, supportive housing.”

“The Mayor supports a pragmatic approach based on the best advice from our City staff and Dr. de Villa. He will continue to have discussions with both about this issue to make sure the best system possible is in place to keep people safe.”