A Pop-Up Vaccine Site in One of Canada’s Most Impoverished Neighborhoods

The gritty neighborhood is located in one of the dreamiest and most picturesque cities in Canada, in about 15 blocks, which are among the poorest and poorest in the country.

As the epicenter of Canada’s opioid crisis, the area has become a powerful symbol of urban poverty, addiction and social marginalization in one of the world’s richest nations, but also of resilience, community and progressive social policies.

Men and women inject illicit drugs in alleyways a few steps from Gastown, an area filled with gastro-pubs and upscale restaurants. Also in the neighborhood is North America’s first supervised injection site, where people, under the supervision of nurses, inject opioids, crack, and crystal meth, and are provided with clean, free syringes and other supplies.

Since the beginning of this year, downtown Eastside has also hosted a landmark program in which the local health authority provides free vaccinations for Covid-19 to the homeless and people living in emergency shelters or assisted living in the neighborhood. It has set up mobile vaccination tents, reached out to people on food lines, and even offered $ 5 for those who received the vaccine.

At a time when Canada’s relatively slow adoption of vaccinations has caused anger and frustration, some residents have complained that their tax dollars are funding vaccinations for the homeless when they do not have access to vaccines themselves.

But dr. Althea Hayden, the public health officer who oversees the program, told me that providing vaccines to the city’s most vulnerable people was a public health imperative: people in the neighborhood would be four times more likely to be hospitalized or to die when they signed Covid-19 as a general population. Many had weakened immune systems, faced major challenges in self-isolation, and were at higher risk of developing the disease and spreading it to others.

“Vulnerable communities are people who suffer disproportionately from the effects of a communicable disease and get worse outcomes,” she told me. “I was expecting more of a backlash, but people seem to understand why this is important.”

British Columbia faced two health emergencies: a deadly pandemic and deaths from overdose. In 2020 alone, there were more than 1,724 deaths from overdose in the province, or an average of 4.7 deaths per day, according to the British Columbia Coroners Service.

The vaccination program is being carried out as British Columbia’s healthcare system is under heavy strain due to the pandemic that is taking hospital stays to new heights. As of Friday, the province had registered 123,000 cases of Covid-19, of which 1,550 people had died.

Updated

April 23, 2021, 8:08 p.m. ET

The virus now appears to have been largely contained in downtown Eastside. In mid-February, the neighborhood had around 75 cases of coronavirus in a week, according to the local health authority. About 7,500 residents were vaccinated today, and the number of cases has dropped to about five this week.

This week, Alana Paterson, a photographer for the New York Times, took her camera out to document the vaccination program in action. She was a Vancouver resident herself and told me she was encouraged by how dedicated nurses had managed to build trust in a community with a strong distrust of authority. Some residents had told the nurses they were too scared to get vaccinated.

On Wednesday, at a makeshift vaccination popup in the heart of the neighborhood, Alana saw dozens of people lining up to get vaccinated, some slumbering in folding chairs. A man with a green mohawk and tattooed arms sat patiently in his mask while he received the vaccine. Another was so drunk that he could hardly get up. The nurses gave him a bottle of water and a lollipop, and after his shot, he put a hand sanitizer in his water bottle and gobbled it up.

In the surrounding streets, Alana said, she saw people holding drug needles, some in their pockets or in their shoes. Others lay high in the fetal position on the sidewalk. At one point to prevent overdose, a visibly pregnant woman injected herself. Three nurses came in and called a doctor to take care of them.

At the vaccination popup, a man in working clothes reacted with anger when he was turned away after a nurse found he was ineligible for living in a condo in a more elegant, upscale area.

“I walk past these people every day,” he protested. “That’s rude.”

However, health workers said restricting vaccination to vulnerable people was the task of the program, while it was also necessary to avoid chaos and deter vaccine tourists from other parts of the city.

“Vaccination here is necessary to avert a public health disaster in the city as they are part of the community,” Alana said, adding that the coronavirus invasion would be like a bombing and there would be no way around to control it. “

Dan Bilefsky is a Canadian correspondent for the New York Times based in Montreal. He previously worked in London, Paris, Prague and New York. He is the author of the book “The Last Job” about a gang of aging English thieves called “The Bad Grandpas”. @ DanBilefsky

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This week’s Trans Canada section was put together by Ian Austen, the Times’ Ottawa correspondent.

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