In case of a flu outbreak, sick clients from Ottawa's two other downtown shelters will be sent to the Salvation Army Booth Centre on George Street. (CBC)Swine flu could be very deadly if it spreads through Ottawa's homeless shelters, which are crammed with vulnerable people in poor health, say those who serve the homeless population.

"We know we would have very high death rates," said Wendy Muckle, executive director of Ottawa Inner City Health. "We also know that with the numbers of people that we have who could be infected, we would decimate the health care system."

Ottawa Inner City Health is a non-profit organization started by groups that serve the homeless. It is funded by Ontario's Ministry of Health.

Muckle said shelters in Ottawa have been working on a pandemic plan for three years, and believe they have a good system in place to minimize the spread of the disease.

Otherwise, it could quickly sweep through the homeless population, whose members have high rates of HIV, hepatitis, diabetes, chronic respiratory problems and other existing health conditions that weaken their immunity to contagious diseases.

'Perfect storm'

James Ralph, who currently lives at the Salvation Army Booth Centre, said if the virus gets into the shelter, "it will probably spread like wildfire." (CBC)"You have a real concentration of people who are particularly vulnerable to this disease, and as well, people in the shelters live in very close quarters," Muckle said. "So you have that perfect storm that we are concerned about in the health-care world."

Louise Beaudoin, a nurse at Ottawa Inner City Health, said the shelters typically house 10 people in bunk-beds in each small dormitory room.

"Sanitary it's not," she said. "They have to take a shower, but they always wear the same dirty clothes, they all eat in the same big kitchen, they're always in groups."

James Ralph, who currently lives at the Salvation Army Booth Centre, agreed that the risk posed by swine flu or H1N1 is high. "If it gets in, it will probably spread like wildfire."

He said the trick is to make sure the disease doesn't gain a foothold in the first place. Residents now sanitize their hands when they come in, and staff encourage them to take showers and stay clean, Ralph added.

"Everybody knows how serious it can be," he said, noting that there have been some deaths in Ottawa already.

Screening system

Wendy Muckle said sick clients can be isolated in their rooms in the special care unit. (CBC)If a flu outbreak does happen, a screening system is in place. Ottawa's two other shelters will send sick clients to the Salvation Army Booth Centre on George Street near the Byward Market, while the Booth Centre will send its healthy clients away to the other shelters, the Ottawa Mission and the Shepherds of Good Hope, Muckle said.

The Booth Centre has a special care unit that is staffed around the clock, where clients can be isolated in their rooms. Each is equipped with just a cot and a beside table.

"The staff wear protective gear if they go in and the clients wear protective gear if they go out," Muckle said.

Ottawa Inner City Health has also stockpiled six weeks' supply of such gear, including masks, gloves and gowns.

Beaudoin said that already, people with respiratory symptoms are being isolated there, although everyone so far has been released after a couple of days, once their symptoms subsided and tests showed they didn't have H1N1.

Michael Maidment, area director for public relations and development for the Salvation Army, said the unit does not have any ventilator machines, so anyone who requires that kind of help to breathe will be sent to the hospital.