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A Toronto shelter for refugees says 11 residents and a dozen of its staff have tested positive for COVID-19, the largest outbreak so far in a type of facility that health experts and activists have warned is an easy place for the virus to spread.

Patricia Mueller, the chief executive officer of Homes First Society, a non-profit that operates the Willowdale Welcome Centre in North York, told The Globe and Mail that two of the homeless people were in hospital.

“I am hoping that they are all okay,” Ms. Mueller said. “My heart is with them. I am so thankful to the caring, dedicated, courageous staff.”

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Toronto’s Medical Officer of Health, Eileen de Villa, said Monday that 25 homeless people had tested positive for COVID-19 in seven of the city’s shelters or drop-in centres as of midday Monday. But this number did not appear to include all of the positive tests at the Willowdale centre.

Meanwhile, the city’s efforts to move some of the 4,500 single adults in its most crowded shelters into hotel rooms have accelerated. On Monday, Toronto’s general manager of shelter, housing and support, Mary-Anne Bédard, said 1,000 people have been shifted from shelters to hotels. That’s up from the 313 initially reported last week. The city has said it has 1,200 hotel rooms at its disposal, and was seeking to lease more to allow for more distance in its shelters.

Advocates for the homeless said last week the city was moving too slowly to avert a catastrophe in the tight quarters of its homeless shelters, where excess capacity was scarce and maintaining the recommended two metres of physical distancing often impossible, with bunks as little as 75 centimetres apart.

As of late last week, the city had only publicly confirmed it had eight cases among the homeless, a population medical experts warn often suffers from underlying health problems that make them more vulnerable to COVID-19. However, a memo sent Saturday from the city to its shelter providers, and obtained by The Globe, referred to 17 cases.

While word spread last week among shelter workers and activists about positive COVID-19 tests at the North York refugee shelter, Toronto Public Health said Friday it could not confirm the information.

Ms. Mueller said only about two dozen full-time staff regularly work at the North York shelter, but they are managing the work for now with the absences of the 12 COVID-19-positive workers. About half of the agency’s overall 300 employees work at more than one of its 13 shelters cross the city.

Homes First has been screening residents for symptoms and stepping up its cleaning, as recommended by Toronto Public Health since early March. (A Homes First shelter worker at another facility also tested positive in late March, but has since recovered.)

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Newly arrived refugees are already housed in a separate facility for their mandatory 14-day quarantine period, before being sent to a shelter like Willowdale.

Residents at Willowdale sleep separated by dividers, and Ms. Mueller said adjustments have been made to ensure physical distancing in the 70,000-square-foot facility, a former hydro building.

Toronto Public Health has now recommended that staff who are not sick take a number of precautions, including wearing masks and self-isolating while at home – but says they should continue coming into work, a protocol for health care workers known as “home/work isolation.”

Ms. Mueller said she fears shelter workers and residents were being forgotten, even as they face similar front-line risks to those in hospitals and long-term care homes.

While her shelter workers are issued three masks a day, she said they remained at “the bottom of the heap” for access to personal protective equipment. She urged members of the public who can sew to make reusable fabric masks and donate them to shelter workers.

“Everyone is very concerned about all of our health care workers, long-term health care workers and residents … You ask what I’d like people to know? I’d ask them to be more deeply concerned about people that live in shelters and the people that work in them.”

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The group of medical professionals working with Toronto on its COVID-19 response for the homeless, Inner City Health Associates, announced plans Monday to use the expertise of the international charity Médecins sans frontières (Doctors Without Borders) for a new 400-person capacity “recovery centre” in downtown Toronto to handle an influx of homeless people who contract the virus.

Speaking to reporters, Ms. Bédard said she hoped the new centre would open soon. And she said the help from MSF – which normally offers medical assistance in warzones and developing countries – was welcome.

“I think it’s really important in a time like this that we look across the spectrum at all kinds of partners,” Ms. Bédard said.

With a report from Greg McArthur

Now that it is recommended you wear a face covering in dense public settings like grocery stores and pharmacies, watch how to make the three masks recommended by the Centers for Disease Control and Prevention. Written instructions available at The Globe and Mail

Sign up for the Coronavirus Update newsletter to read the day’s essential coronavirus news, features and explainers written by Globe.

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