Frontline workers and residents in the Downtown Eastside say health officials’ silence about COVID-19 cases in their community is contributing to misinformation, confusion and fear and hurting prevention efforts.

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Erica Grant, who lives and works in the Downtown Eastside, said she was asked to work from home last Wednesday because there was a confirmed case of COVID-19 in the neighbourhood.

Other frontline workers at neighbourhood non-profits also told The Tyee about a positive case of the virus. Three of those workers said the person is self-isolating.

But Vancouver Coastal Health has repeatedly refused to confirm this with The Tyee and other media outlets.

Last week, the health authority’s medical chief Dr. Patricia Daly was asked if there were any confirmed cases in the Downtown Eastside. She avoided the question, only saying that there were no clusters.

“We don’t identify people who’ve been laboratory confirmed,” Daly said. “The message to all communities is that COVID-19 is spreading in your communities.”

Talking about numbers is “meaningless,” she added.

On Tuesday, provincial health officer Dr. Bonnie Henry said that an individual case wouldn’t be identified “unless it were related to an outbreak.”

But Grant, who works at the Carnegie Community Action Project, says that knowing of a confirmed case would be beneficial to her neighbourhood.

“If it was made official I think people would start to heed the advice of the health minister more,” Grant said.

The opioid epidemic and the Downtown Eastside’s lack of adequate housing mean people struggle to follow social distancing measures public health officials have advocated, she said.

Agencies working in the community have been bracing for the impact of COVID-19 in the community, warning it could spread rapidly through a population dealing with poverty and housing and health issues.

A Vancouver Coastal Health spokesperson said last week that a mobile outreach team is testing people with symptoms to allow them to remain in self-isolation, though testing is not widespread.

The silence on cases in the Downtown Eastside contrasts with details disclosed regarding outbreaks in long-term care homes, which have become sites of major outbreaks. Though Dr. Henry has said that cases and transmissions in shelters might be announced.

On Friday, Fraser Health proactively disclosed new cases when workers at two care homes in Langley and Surrey tested positive. Fraser Health said staff were on site at both care homes to communicate with residents and their family members.

Vancouver Coastal Health did not say why it isn’t taking the same approach to communicate information about cases in single-room occupancy buildings, where many residents share bathrooms.

The World Health Organization, in its guide for leaders on communicating information during outbreaks, suggests that “total candour” be the goal, consistent with individual rights such as patient privacy.

“The key is to balance the rights of the individual against information directly pertinent to the public good and the public's need and desire for reliable information,” says the guide.

“Information about outbreaks is almost impossible to keep hidden from the public. Eventually, the outbreak will be revealed. Therefore, to prevent rumours and misinformation and to frame the event, it is best to announce as early as possible.”

In Angel Gates’ Downtown Eastside building, residents are “freaked out” over rumours of three potential cases, she said.

One elderly resident was taken into hospital last week and a friend on Gates’ own floor got very sick and went into hospital as well. When he returned, he didn’t leave his room.

“I wouldn’t even go down the hall,” she said.

But on Monday, he emerged. And it turned out he only had the flu.

“It felt so close to home,” a friend of the flu patient, who also lives on the floor, told The Tyee. “Now, it feels like a conspiracy.”

If there’s a confirmed case in the building or the neighbourhood, Gates hopes the health authority will let people know.

“It’s not to make the person who has it feel bad,” she said. “It’s because we need to keep ourselves safe. It’s not just for us, and we’re really poor down here, especially now trying to make ends meet.... It’s important for the public too.

“We share our food. We share our forks. We share pipes. We share cigs. We share everything. So if someone has gotten it down here, it’s important that we know. This social distancing thing is really difficult here. We depend on each other. That’s how we get by in life.”

Much of the housing in the neighbourhood is in old buildings with single rooms and shared washrooms.

The challenges in following guidelines around social distancing were highlighted last Wednesday.

The ‘Ticking Time Bomb’ in the Downtown Eastside read more

That was cheque day, when monthly provincial income and disability assistance cheques are distributed.

In the Downtown Eastside long lines of people gathered at banks, ATMs and payday loan businesses. Outside Pigeon Park Savings people waited in tightly-packed groups for nearly two hours for the bank to open. When it did, dozens of people pressed against the doors, trying to get inside at the same time.

Staff from the bank were able to calm the group, and began letting people in only one at a time. Bank staff wearing protective masks and gloves ensured that everyone who entered used hand sanitizer to clean their hands.

Gates is trying to do her part to spread the word in her neighbourhood about the severity of the pandemic.

“People are still gathering in groups,” Gates said Monday. “They don’t think it’s real to them. So today, I’m going to go out at noon to hand out flyers and put up posters to let people know.”

Stigma diagnosis

If there is a case in the neighbourhood, one reason why the health authority might be holding back on announcing it is to avoid stigmatization, said Andy Yan, the director of Simon Fraser University’s City Program.

“The Downtown Eastside is already stigmatized,” said Yan. “It shows how social this is, not just biomedical. COVID-19 has a way of magnifying social chasms that already exist, to the point where they kill you.”

“Human health has always been used as a tool of stigmatization for race and class,” said Yan.

While Yan sees the need for patient privacy, he adds that letting people in a neighbourhood know about a confirmed case will help increase public intervention and build closer ties between locals helping one another out.

“Without [information], the public will write its own narratives, and they’re not necessarily going to be true,” he said.

* This story was updated on March 31, 2020 at 3:43 p.m. with new information.