COVID-19 isolation and recovery sites evaluation: Lessons learned for systems innovation

Area of Science:

• Public Health
• Social Work
• Health Services Research

Background:

• The City of Toronto established COVID-19 Isolation and Recovery Sites (CIRS) in 2020 to provide supported isolation for individuals experiencing homelessness.
• This study examines lessons learned from CIRS to inform future policies for homeless populations.

Purpose of the Study:

• To identify innovative models and systems of care for supporting people experiencing homelessness.
• To explore opportunities for transforming care to be more just and compassionate.
• To assess the integration of existing services within the CIRS model.

Main Methods:

• Conducted 43 key informant interviews with diverse stakeholders, including clinicians, peer workers, and organizational leaders.
• Employed deductive content analysis to code and analyze interview data.

Main Results:

• The CIRS adopted a community-oriented model, reducing medicalization and enhancing service integration for the homeless population.
• Key success factors included clinical case management, harm reduction, peer support, and consistent funding.
• Future models require addressing power dynamics and fostering collaborative cultures.

Conclusions:

• COVID-19 Isolation and Recovery Sites offer a paradigm for rethinking shelter-based services.
• System-level transformation in services for the homeless necessitates strong vision, funding, political will, and stakeholder accountability.
• The pandemic presents a critical opportunity to implement successful crisis response elements into long-term policy.