A man who stayed at the Salvation Army’s shelter in downtown Hamilton has tested positive for COVID-19, raising the spectre of the virus spreading through the city’s vulnerable homeless population.

He was transported from the Booth Centre on York Boulevard in a special vehicle to Bennetto Community Centre, which the city has set up in the North End as an isolation space for homeless people who test positive for coronavirus.

“We will continue to follow the local health authorities’ recommended approach and guidance for prevention and protection to ensure the comfort and safety of our clients and staff,” the Salvation Army said in an emailed statement Monday.

The municipality and partner agencies are doing their best to ensure shelter users are shielded from the potentially deadly virus, said Paul Johnson, director of the city’s Emergency Operations Centre. “The bottom line is that the system that we set up works.”

But Keeping Six, a local organization that advocates for homeless people and drug users, has urged the city to do more. “And, in fact, it now becomes more urgent that people should be moved into conditions that will allow them to socially distance and isolate. And that is not shelters; it is hotels,” member Lisa Nussey said.

As of Monday afternoon, Hamilton had 91 cases of COVID-19 overall, up from 70 announced Sunday, as test results continue to come in.

Shelter users are particularly vulnerable to the virus due to the close sleeping quarters with cots set up in dormitories and other common areas. A dorm at the Salvation Army’s 82-bed Booth Centre can have upwards of 20 beds set up in rows.

“The reality is that creating physical distance and employing infections prevention strategies inside an emergency shelter is very challenging, but we are certainly doing our very best to create the best conditions that we can,” said Katherine Kalinowski, chief operating officer of Good Shepherd, another social-service agency that runs local shelters.

Shelters have screening in place to help detect potential COVID-19 cases, and if necessary, the expertise of Shelter Health Network professionals to conduct further assessment, Kalinowski said.

Operators have also adapted to the extraordinary circumstances, offering bagged lunches instead of sit-down meals.

It’s difficult to practise physical distancing in a shelter, said Carol Cowan-Morneau, Mission Services executive director.

“However, each shelter has set up separate spaces for people while they are waiting to be tested or waiting test results,” she said.

“Our staff are working with public health and the Shelter Health Network to manage and reduce exposure risks. Of course, this could change quickly as the illness spreads within our community. The staff of our shelters are doing an amazing job and deserve the highest recognition for their dedication, caring and professionalism.”

The Salvation Army said it’s taking a “variety of measures” to limit exposure of clients and staff to coronavirus: physical distancing; using gowns, gloves, masks and goggles when staff are in close contact with clients; diligent handwashing and/or hand-sanitizer practices.

Dr. Elizabeth Richardson, the city’s medical officer of health, said homeless people are “definitely one of the vulnerable populations” health officials worry about as the virus tightens its grip on Hamilton.

People who experience homelessness can have existing chronic health problems that make them more at risk, Richardson said.

Nussey said the homeless community faces the additional, “intersecting” threat of COVID-19 as it lives through the already brutal opioid-fuelled overdose crisis.

The city needs to “take action that is outside of the box” as the pandemic’s impact unfolds, pointing to how a men’s shelter in Kitchener recently shifted its operations to a hotel.

Tracing the contacts of shelter users who test positive for COVID-19 will be a tall order: “How do you find people? They don’t have phones. It’s not like you call them up or send them a letter, or knock on their door.”

The city has roughly 400 hotel rooms available should it need them during the coronavirus crisis. However, Johnson said “decanting” all shelter occupants to hotels would take up that entire supply and involve a “massive and monumental” operation.

As it stands, the city is moving some people into hotel rooms to ensure shelters don’t become too crowded, he said. This approach also offers the flexibility of closing a shelter if it can no longer operate and shifting its occupants and workers to hotel rooms, Johnson added.

He likened the Bennetto centre to a “bare-bones shelter” where homeless people who have tested positive can receive support and medical care. Cots, linens and food are supplied. If a patient’s condition worsens, they’re sent to hospital.

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Among 18 new cases of COVID-19 in Hamilton announced Sunday is a Good Shepherd employee.

“I’m happy to report that person is doing very well and we’re anticipating their return to work,” Kalinowski said, adding front-line workers are “critical” but “not always recognized in that really important role.”

She also said the crisis should “shine a light” on a historical lack of investment in the homeless-serving sector.