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A make-shift memorial is seen at a TTC stop on Dundas near Yonge where a man was found without vital signs in Toronto, Ontario, Tuesday, January 6, 2015.

On the days that two men died outside in frigid temperatures this week, Toronto's system to help protect the homeless proceeded as usual: Public health officials checked the forecast before 7 a.m. and, finding that overnight lows weren't expected to hit the -15 C threshold, did not issue extreme cold weather alerts.

Now, however, the men's deaths are raising questions about whether the system is serving the city's most vulnerable residents.

The city's "cold weather plan" provides additional services for homeless people when extreme cold weather alerts are declared, including two drop-in warming centres, more shelter beds, relaxed shelter restrictions and extra street outreach and transportation teams to try to get people out of the cold.

Mayor John Tory pre-empted public health officials by ordering the opening of emergency warming centres for homeless people on Tuesday, hours after the death of a 55-year-old man who was found wearing only a T-shirt and jeans in a transit shelter. On Monday, a 59-year-old homeless man was found dead in a run-down van.

"We're very sorry that these men died," said Howard Shapiro, the city's associate medical officer of health.

"We don't know at this point what the exact nature or the cause of their demise was so it's hard really to speculate about the cold," Dr. Shapiro added. "I think the other thing, too, is we don't know about what impact calling the alert would have on the outcomes for these men if one were in effect."

Alerts were not issued earlier this week because forecast overnight lows were warmer than the -15 C threshold when the decisions were made between 6 a.m. and 7 a.m. each day, Dr. Shapiro said.

The actual temperature late Monday and early Tuesday dipped to -14 C with a windchill of -21 C, according to Environment Canada data. Dr. Shapiro said that while officials consider windchill forecasts, the agency does not have a set guideline for what windchill value would trigger an extreme cold weather alert.

Mr. Tory earlier told reporters that the criteria for extreme-cold alerts "do leave an element of discretion, which I would assume would be exercised in favour of homeless people. … I would hope that those criteria are being applied as they have in the past. There certainly has been no hesitation in the past to declare a cold-weather alert."

After the mayor's order, Toronto Public Health released an afternoon communiqué saying an alert is "expected" Wednesday morning – an unusual move given that the notices are typically issued on the same day. Wednesday's forecast low is -17 C.

While the weather alert system has been in use in Toronto since three homeless people died of exposure in 1996, this year marks the first winter that the medical officer of health has been responsible for co-ordinating weather alerts. Previously, the city's shelter, support and housing administration division issued the notices.

On Tuesday, protesters descended on City Hall to demand action to better serve the city's most marginalized residents.

"The city has to do something. We are in a massive crisis right now. Two people died in the last 48 hours," said Zoe Dodd, a long-time front-line worker with the homeless.

Ms. Dodd noted that the second man died near the intersection of Yonge and Dundas streets. "That is one of the busiest corners of our city, it is the most well-lit. That person should have been housed. We are failing people in this city, not just by [lack of] shelter, but by lack of housing."

City homeless shelters were filled almost to capacity this week. On Monday, 4,087 of 4,398 beds were occupied, a rate of 93 per cent. Even before the recent cold snap, shelters had been filled for months, said David Reycraft, director of housing for the homeless at Dixon Hall.

The man found in the transit shelter on Tuesday had no vital signs when paramedics arrived at 5:24 a.m., said Kim McKinnon, a spokeswoman for Toronto Emergency Medical Services. While paramedics tended to him inside their ambulance, a police officer drove the vehicle to a hospital.

Police said the person who alerted them reported that the man was wearing a hospital bracelet.

Nearby St. Michael's and Mount Sinai hospitals said no patients were reported missing.

On Monday, a homeless man was pronounced dead after he was found in a west-end parking lot. The man lived in a dilapidated delivery truck that had been abandoned outside a shipping yard, police said.

"He was in contact with family the previous day. One of his cousins knew he was staying in the van and checked on him," said Detective Myron Chudoba.

Det. Chuboda said on the last visit by his cousin, the man appeared to be sleeping. However, the next day he was found dead.

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