Guest blog by Marilou Gagnon RN,PhD (Victoria, BC) published with consent. A shorter version of this text was shared in a twitter thread,

The first case of COVID-19 was confirmed nearly 4 months ago and since then, all eyes have been turned to this unfolding public health emergency. However, let us not forget that Canada was already in the midst of an unprecedented public health emergency before COVID-19 – one that has taken the lives of more than 15,000 Canadians in less than 4 years and stalled our national life expectancy. The overdose crisis is not going away because of COVID-19.

In fact, it is getting worse.

Many cities across the country have been reporting spikes in overdoses and overdose deaths amid the COVID-19 pandemic. This is true for Vancouver and Toronto. It is also true for other cities including Victoria, Guelph, Windsor, Red Deer and Calgary.

Three factors have been contributing to this rise in overdoses and overdose deaths: reduction and closure of essential supervised consumption services, self-isolating requirements forcing people to use alone, and disruption of supply chains combined with the lack of access to a safe drug supply. Two of the most important measures governments can take now to address this dual public health emergency is to implement safe supply programs and scale up access to harm reduction services including supervised consumption services.

This brings me to the situation in Calgary.

IIn 2019, Calgary recorded the highest number of overdose deaths in the province. Despite this, there is currently only one supervised consumption site in operation in the city. Due to COVID-19, this site has been operating at reduced capacity, which has resulted in a drop in visits from 6,600 a month between December and February to 5,850 in March and 4,440 in April. At the same time, the site has been recording an increase in overdoses. Between December to February, staff responded to an average of 57 overdoses per month. In March, they responded to 83 overdoses and 87 overdoses in April.

A similar spike in overdoses has been reported at the city’s largest homeless shelter, the Drop-In Centre. On a regular night, before COVID-19, the Drop-In would see as many as 650 people per night. At reduced capacity, it now welcomes about 300 people per night. Despite this, staff were called to respond to 47 overdoses in the month of March alone, a 327% increase from the month of February. This has contributed to high levels of moral distress and trauma among the staff who are not only managing multiple overdoses in a shelter setting but also doing so without the supports of an in-house supervised consumption service (and team).

Rapid implementation of a mobile site could address gaps in supervised consumption services in the city and, in turn, reduce the risk of overdoses, and overdose deaths.

There is a mobile site available in Calgary – but Alberta has taken it off the table.

Leslie Hill, HIV Community Link executive director, inside the new mobile safe drug consumption site, in Calgary on Thursday.  CHRISTINA RYAN / STAR CALGARY https://www.thestar.com/calgary/2019/05/02/new-mobile-supervised-drug-co… — Leslie Hill, HIV Community Link executive director, inside the new mobile safe drug consumption site, in Calgary on Thursday. CHRISTINA RYAN / STAR CALGARY https://www.thestar.com/calgary/2019/05/02/new-mobile-supervised-drug-consumption-site-announced-for-forest-lawn.html

Unfortunately, in June 2019, the provincial government placed a moratorium on any new funding for supervised consumption services in Alberta. Prior to this announcement, a mobile supervised consumption site and pictures of the brand new and fully equipped van circulated in the media. It appeared to be ready to hit the road and save lives but it remains unused to this day – despite the challenges brought on by COVID-19 and spiking overdoses. This begs the question, why is a perfectly functional mobile site not being used and why is not being deployed to support frontline workers in the middle of a dual public health emergency? What could possibly be a valid reason to withhold this essential, life-saving, service right now? Knowing that frontline services are working at reduced capacity, why not implement a rapid solution to address gaps in services and reduce the strain on a health care system that is already overextended?

Supervised consumption sites are preventative rather than reactive. They prevent overdoses and prevent overdose-related deaths or complications. They are also equipped to safely manage overdoses and other medical emergencies during the COVID-19 pandemic that do not require transfers to hospital. For these reasons, they reduce health care utilization and costs. They can also take pressure off overworked staff by preventing overdoses and helping more effectively manage them when they do occur. In turn, this reduces the risk of COVID-19 spreading to staff and clients – and to the broader community.

In the context of a dual public health emergency, governments should be doing everything in their power to prevent overdoses, and reduce the risk of exposure to COVID-19. This means deploying all the resources at their disposal – including a mobile supervised consumption site.

Dr. Marilou Gagnon, RN, PhD, is an Associate Professor in Nursing at the University Victoria and a Scientist at the Canadian Institute for Substance Use Research. She is also the President of the Harm Reduction Nurses Association.