At least 30 people using homeless and refugee shelters in Toronto have tested positive for COVID-19, officials said Tuesday.

The largest outbreak was reported at Willowdale Welcome Centre, a shelter for refugees in the city's north end, said the CEO of Homes First Society, the organization that runs the facility.

"I'm worried about our clients, I'm worried about our management team, I'm worried about our staff, they're quite frightened," Patricia Mueller said.

She said 11 residents and 12 staff members have tested positive for COVID-19 at Willowdale. Seven more cases — three residents and four staffers — were also reported at two other shelters run by the company, which operates eight shelters in total across the city.

Mueller said two of the residents are in hospital for "precautionary reasons," but no one is in serious condition.

Willowdale Welcome Centre, a refugee shelter in North York, has the highest number of confirmed COVID-19 cases among all homeless and refugee shelters in Toronto. (Homes First Society)

The residents who show symptoms are being taken to test sites and then to an isolation centre until their results are known, she said.

From there, those who test positive for COVID-19 are taken to a recovery centre if they do not need hospitalization.

The city said an interim recovery centre was set to open Tuesday.

City investigating 3 shelters

Dr. Eileen de Villa, Toronto's medical officer of health, said the city has opened investigations into three of the shelters where people have tested positive for the disease: Willowdale Welcome Centre, Dixon Hall and Seaton House, the city's largest shelter.

The city's shelters have been notoriously overcrowded for years with about 7,000 people sleeping in them every night. Right now, the city is moving many residents from shelters to other centres that have been set up to help with density at the shelters.

The city has also bought or leased several hotels that are slowly opening up for those in shelters.

More than 1,000 shelter residents have moved into hotels, permanent housing and shelter spaces in recent weeks, said Counc. Joe Cressy, who is the chair of the city's board of health.

"While COVID-19 doesn't discriminate, we know that it is disproportionately dangerous for those who are homeless and in the shelter system," Cressy said.

"Our task, if we do this right, is not to provide immediate relief to prevent COVID-19 in the shelter system, but to create permanent housing solutions to end homelessness."

'Social distancing is a complete impossibility'

Mac Scott, an immigration lawyer, said one of his clients is staying at the Willowdale refugee shelter and is terrified.

"It's very crowded," he said. "It's overpacked and social distancing is a complete impossibility," Scott said. "She's having a really bad time," he said.

Mueller, however, said the shelter is now following physical distancing guidelines, although she admitted that wasn't the case a few weeks ago.

She also said the shelter is not accepting new residents, mostly because refugees are no longer allowed to come into Canada during the pandemic.

Inner City Health Associates, a group of more than 100 physicians working in the shelter and drop-in system, said a major international group will help run a COVID-19 recovery centre for the homeless.

The organization said Doctors Without Borders will bring their extensive experience dealing with infectious disease outbreaks around the world to the 400-bed shelter, which is expected to open soon.

Drop-in centres now closed or access restricted

Services for the city's homeless are difficult to find during the pandemic as businesses and restaurants, which would usually allow someone to eat and use the washroom, have closed.

Many drop-in centres have either closed or restricted access.

On Monday, more than 300 doctors and nurses sent a letter to the city and province urging immediate action to move everyone currently in the shelter system to hotels.

"Unless there is ongoing rapid action, we will see preventable deaths and outbreaks with broad public health implications during this pandemic," they wrote.