The last time Erica Grant saw her 25-year-old son, Duncan, he was crying and saying he didn’t want to go back to his one-room apartment.
“He was asking me, ‘Mom, stay out here with me. I don’t want to go home, I don’t want to go home,’” Grant recalled of that evening on Friday, April 3 at the height of COVID-19 pandemic restrictions.
“He was scared of something.”
Grant lives at the Savoy, a single-room occupancy building operated by Atira Women’s Resources Society. Duncan lived nearby at the London, an SRO also operated by Atira.
Duncan’s words and the way he acted that evening stuck with Grant. She tried calling him the next morning, but his phone’s battery had run out. Next she tried calling the London’s front desk, and went there in person on April 5. But staff wouldn’t let her into the building to check on Duncan, Grant said.
Just two weeks before, Atira had put in place some of the earliest visitor restrictions in buildings it operates to prevent the spread of COVID-19.
On April 7, Grant called the London again repeatedly. Finally, she reached a staffer who knew her and was a friend of Duncan’s.
“I just said, ‘Hi this is Erica Grant.’” The worker’s voice was bright on the phone, saying “Hi mom!” to Grant.
“I said ‘Hey, I’m really worried. I’m really concerned about Duncan. Can you please see if he’s OK?’”
Grant said the employee “hung up and went running up to the third floor. She ended up phoning me back... and she goes, ‘Sit down mom, sit down mom.’”
Duncan had been found dead in his room. Now, nearly four months after he died of a suspected overdose, Grant is left wondering if things would be different if she had been allowed into the building.
“With this guest policy in place, none of us can be sure that our relatives are OK,” Grant said. “There are so many stories down here that are similar.”
How the pandemic triggered the visiting restrictions
British Columbians remember the weekend of March 14 and 15 as the dividing line between pre-COVID-19 normality and the sudden onset of pandemic restrictions. Those changes started with recommendations like staying at home as much as possible. Many businesses closed voluntarily to keep staff and customers safe, and because business had dried up almost overnight.
Soon, there would be official health orders brought down by B.C.'s provincial health officer, Dr. Bonnie Henry: personal services businesses like hair salons were ordered closed. Staff working at long-term care facilities were ordered to work at just one site.
After devastating outbreaks at several long-term care homes, where the virus was shown to be particularly deadly to elderly residents, the BC Centre for Disease Control put visitor restrictions guidelines in place that barred all visitors from facilities. Those restrictions were relaxed starting June 30.
In contrast, supportive housing providers in the Downtown Eastside acted on their own to restrict visitors, creating their own guidelines. Some, like Atira and PHS Community Services Society, still allowed “permanent guests” and informal caregivers, and have recently relaxed the restrictions to allow two designated visitors.
Others, like the Veterans Memorial Manor — operated by the Whole Way House Society — still have strict no visitor rules in place, despite recommendations from Vancouver Coastal Health to allow visitors.
Some residents have complained that the policies are unfair and have disrupted their lives unnecessarily, and Vancouver Coastal Health has warned the policies could lead to an increase in overdose deaths as people use drugs alone in their rooms. Other critics believe the policies led to an increase in homelessness and people congregating close together on the street in the Downtown Eastside.
But housing operators say they felt they had to act quickly to protect residents and staff in their buildings, many of whom have underlying health conditions. The Downtown Eastside has not yet had an outbreak of COVID-19, which many feared would have been devastating for the neighbourhood where so many already struggle with poor health.
Janice Abbott, the CEO of Atira Women’s Resource Society, thinks acting quickly to restrict visitors could have played a part in avoiding an outbreak.
“We all responded quickly. We all have tiny shared bathrooms, tiny hallways, tiny rooms,” Abbott said of Atira and other housing operators that run SRO housing.
“So who knows, that may have been one of the factors that prevented a widespread outbreak.”
Atira’s rules aren’t backed by law
To David Mendes, it’s a human rights issue. Mendes lives at the Savoy, and he said housing operators like PHS Community Services and Atira don’t have any legal grounds to restrict visitors. Abbott confirmed this was the case: Atira has no power to limit visitors under the provincial Residential Tenancy Act.
B.C.’s Residential Tenancy Branch published guidance for COVID-19 that said landlords have the power to “schedule or restrict the use of common shared areas” like lobbies and laundry rooms — but they don’t have the power to stop visitors from coming to someone’s apartment.
Mendes pointed out that the sign on the door of a building near his, which combines market rental with subsidized housing, simply recommended residents reduce visitors.
“And the note on our door said, ‘Absolutely no guests, no visitors,’” he said.
Mendes told The Tyee he sent Atira a letter saying they had no authority to enforce the no visitor rule, and has continued to have visitors to the two rooms he occupies on the top floor of the building.
He said it was important for him to continue to be able to have guests because he is the co-founder of the Canadian Association for Safe Supply, and he needs to use his apartment as an office and meeting space for that organization. He said he has enough space in his rooms to social distance.
Mendes also has a problem with the way the policies have been communicated to tenants: he said many residents are under the impression that the no visitor policies were required by the province or health officials, when they’ve really been put in place by the housing operators themselves.
According to a photo provided to The Tyee by community activist Karen Ward, one building — the Avalon, also operated by Whole Way House Society — claimed the no visitors restriction was required by the City of Vancouver. That’s not correct, city staff confirmed.
City communications staff told The Tyee that staff have now contacted the Avalon to ask them to change the sign to ensure it “accurately reflects information from the B.C. Residential Tenancy Branch.”
A big rise in overdose deaths
While the Downtown Eastside largely escaped a COVID-19 outbreak, overdose deaths have skyrocketed during the pandemic. That’s an alarming trend for B.C., which has had success in reducing overdose deaths during a toxic drug crisis that started in 2016.
Overdose deaths began rising in March as pandemic restrictions took hold, with 112 deaths recorded province-wide by the coroner — higher than previous months, but below the number seen in March 2019.
In April, there were 117 deaths, a 39 per cent increase compared to April 2019. In May, the number of deaths shot up to 171, a new historic high. In June, that record was shattered again with 175 fatalities recorded, and drug testing showing “extreme fentanyl concentrations” in the illicit drug supply, according to the BC Coroners Service.
In April, Vancouver Coastal Health warned housing operators that restricting visitors is dangerous because the policy may lead to residents using drugs alone, with no one to intervene if they overdose.
Visitor ban not tied to ODs, say SRO operators
But both Atira and PHS Community Services say they’ve been closely tracking fatalities in the buildings they operate, and the evidence in their buildings doesn’t show that visitor restrictions have caused an increase in overdose deaths.
“I haven’t heard of even one person who wasn’t normally a solo user unfortunately dying in their rooms,” said Tanya Fader, director of housing for PHS, adding there has not been a noticeable overall rise in overdose deaths in PHS-run buildings.
Fader said her organization has worked to get 300 residents into safe supply programs, and has increased the safe consumption areas available in buildings, where users can take drugs while being watched by a staff member.
Abbott said it was a similar story in Atira’s buildings.
“We didn’t see any uptick in deaths at all after we put in the visitor restrictions, but we started to see an uptick in the last couple of months,” Abbott said.
Abbott said the no visitor restriction may actually have contributed to reducing the number of deaths in Atira buildings, because around a third of all people who die of overdose in the buildings are guests, not residents.
However, a survey conducted by Atira this spring about the visitor restriction policies showed that 32 per cent of tenants who use opioids are now more likely to use alone, compared to the 17 per cent who said they were more likely to use with someone else present.
Regarding Duncan Grant’s death, Abbott said she was confident the staff at the London followed proper procedures. Abbott said staff did physically check on him, although she couldn’t provide information about what day or how many times that was done.
Mixed signals from health authorities
In April, Vancouver’s chief medical health officer, Dr. Patricia Daly, told city council that fatal overdoses had shot up in the Downtown Eastside during the pandemic, and she would prefer that housing operators allow guests because the risk of transmitting COVID-19 was low, but the risk of overdosing was very high.
Mendes and Abbott both say the drug supply has become more toxic during the pandemic, and it’s a factor in the rising death rate.
Fader said it was sometimes difficult for housing providers to weigh the advice being given by the provincial health officer and Vancouver Coastal Health.
“You have Dr. Bonnie Henry on one side, trying to prevent the spread of COVID, and then you have Dr. Patricia Daly emphasizing the overdose response and obviously both things are important and key to our residents and our program participants,” she said.
“It’s a juggling act, it’s trying to strike these balances that can be quite nuanced.”
The Atira tenant survey found that 49 per cent of the 100 tenants surveyed said they felt safer from violence and crime because of the visitor restrictions; 54 per cent said their building had become less noisy; and 54 per cent said their building was cleaner.
But 50 per cent of residents surveyed said visitor restrictions should not continue, while 42 per cent wanted some restrictions to continue.
Abbott acknowledged that the high volume of visitors to the Downtown Eastside buildings Atira operates was a challenge even before COVID-19. Some visitors are violent, some have come to collect drug debts, and the large number of visitors can disturb tenants and cause wear and tear to aging SRO buildings.
She said she and other housing providers are closely watching this summer’s rise in COVID-19 cases, and it’s possible Atira will once again put visitor restrictions in place if cases keep rising.
But Mendes draws a direct line between the rise in overdoses and visitor restrictions.
“Organizations like ours have been warning for four years not to use alone.”