The intellectually challenged woman who had been part of our lives for the past two years exists in a complicated, yet porous social safety net. Living semi-independently, she has access to a support worker about four hours a week who helps with everything from shopping to doctor appointments to hygiene to money management to just talking with her on the phone when she’s lonely.

But this is a bed bug website, so you know where I am headed, right?

Yes, she got bed bugs.

Mohan noted how devastating bed bugs were to this woman:

It’s hard to give quality care for someone who has the mental development of a six-year-old in just four hours a week. When her apartment was overrun with bedbugs, all her belongings were thrown out without proper explanation to her. She had to start all over again, including relocating.

This bed bug case may have been mismanaged. In most instances, throwing everything out is not a good idea. It is not necessary, costs the resident a lot of money and heartache, and doesn’t actually solve the problem. It also can help spread the bed bugs to surrounding neighbors. Most PCOs we know don’t tell people to throw everything away, but instead treat mattresses and furniture, direct people to encase their mattress, and give instructions on how to wash and dry clothing, so most or all belongings can be saved.

To throw away a disabled person’s things without even explaining it to her is simply horrible.

Besides the need for thoughtful and proper bed bug treatment, this heartbreaking story also reminds us of the need for better emergency social services for people with bed bugs.

It is not just people with intellectual challenges, as this woman, who might need extra help with preparing for bed bug treatment. The elderly and physically challenged also need help with prep (decluttering, obtaining and fitting mattress encasements, washing and storing belongings, etc.).

Four hours a week of assistance might be reasonable for normal circumstances, but this woman needed a lot more help during her bed bug infestation. With proper assistance, this infestation would not probably have been so devastating.

• Vancouver public education forum on bed bugs is a start, but probably not enough
• bedbugs at Stanford University dorms (again)
• Dumpster-diving tenant evicted after Winnipeg apartment seriously infested with bed bugs
• Freehold, NJ Social Service agency asks county for money to treat bed bugs

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Well, that’s amazing, right? Thank Goodness.

Interestingly, there’s more to this article.

Kelly’s living with bed bugs. Her husband is staying in the Gateway Shelter to get away from them, but Kelly is staying in their bedbugged apartment, because she is afraid she’ll lose her home otherwise.

[Husband Randy] Isenberg is staying at Gateway Shelter because their building is infested with bedbugs. He’s got the bite marks on his arms to prove it.

The Toronto Community Housing Corp. building where they live in the Eglinton Ave. and Allen Rd. area was part of a television exposé on the shabby state of public housing in Toronto. His wife remains in the building.

“She doesn’t want to move out because she’ll lose her unit,” he said.

Though she doesn’t sleep at night, Isenberg doesn’t believe fatigue played a part, he said. But existing health issues with her leg have not been helped by the stress.

I suppose if anything will put bed bugs in perspective, it’s escaping death by only seconds.

Despite what she says, I would not be surprised if fatigue did play a part. She is not sleeping because of the bed bugs. Many of us have been there, and know what a toll lack of sleep can mean to our health, productivity, and mental and emotional wellbeing.

I am so glad that Theresa Kelly’s story of tripping and falling onto the subway tracks has a happy ending. I just hope she doesn’t have to go home to bed bugs — and without her husband — for much longer.

• Toronto Community Housing does good; Orlando, Florida tenants and Billings, Montana shelter guest demonstrate why more bed bug education is needed
• After a fire, bed bugs “rain down from ceilings” into other apartments
• bed bug news for 2007-11-11: Lexington, KY and Toronto, ON
• Covington, Kentucky IRS building infested with bed bugs

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The story focuses on Lisa Courtney’s bed bug battle:

Courtney tossed out her bed, mattress and linens. CityHousing, Hamilton’s social housing agency, had her Cumberland Avenue apartment treated and life returned to normal.

But now, the bedbugs are back. Courtney’s anxiety has shot up with reports of three neighbours with the same problem.

“I’m psychotic now, because people down the hall have them, too,” she said.

Landlords need to learn that you can’t simply treat the unit of the person who complains about bed bug bites. You have to have all adjacent units (above, below, and on all sides) carefully inspected and treated if necessary.

Apartment managers would be advised to read this article from Techletter.com about dealing with bed bugs in the properties under their care.

Since bed bugs can be hard to detect, especially in the early stages of infestation, landlords may also consider that treating all adjacent units where bed bugs have not been found may be a good idea. The City of Boston’s Housing Division actually requires this when the Inspectional Services Department finds bed bugs in an apartment:

Our Standard bed bug notice of violation also requires that owners inspect all units in the dwelling, and they must treat all horizontally and vertically adjacent units to the infested unit(s).

Boston landlords treat adjacent units even if they turn up no visible signs of bed bugs.

You don’t know how often Bedbuggers tell us (often in the forums) both of the following: (a) I have had 4+ bed bug treatments and the problem persists, and (b) none of my neighbors have bed bugs. When pressed, people invariably say neighbors were “asked.” Since as many as 50% of people don’t react to bites, asking doesn’t do much. Many times, inspection also turns up nothing. And then a few months later, lo and behold, bed bugs are back.

You also don’t know how often I hear (often in discreet emails) about professionals eventually discovering the badly-infested unit, with so many bed bugs they’re falling from the walls in broad daylight — invariably a bed bug infestation later discovered in a building where some other poor soul thought they were the only ones infested. Sometimes neighbors don’t know they have bed bugs because they can’t see them.

Other times bed bugs are clearly visible, but residents don’t know what they are, or fear repercussions for bringing the problem to light, or are impaired in some way such that they cannot recognize the problem or act on it, or (in rare cases) they know and just don’t care (shudder).

The good news is Hamilton is taking bed bugs seriously:

Stan Yung, a Hamilton public health manager, says the city is already intervening. It has been tracking cases since 2005 and now has a new public education campaign.

(I look forward to hearing how they are tracking infestations.)

• FAQ: Do I have to tell my landlord / co-op board / condo association / residents of attached house next door?
• Bed bugs in North Jersey
• Bed bugs in Ventura County (Thousand Oaks, California)
• Amanda at Apartmenttherapy.com, part 5

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A Toronto man has filed a civil suit against the Howard Johnson Hotel on Ellice Avenue alleging he caught a case of the bed bugs while rooming at the establishment.

Steven Lipson claims after a one-night stay at the hotel in January 2007 he developed welts and itchiness. Lipson alleges a dermatologist confirmed he was bitten by bed bugs. He is suing the Howard Johnson for damages claiming he suffered pain, embarrassment, and permanent scarring.

There isn’t much to chew on there, but we don’t often hear about Canadian bed bug lawsuits, so it does feel quite newsworthy.

• FAQ: Where can I read about bed bug lawsuits? Can you help me find a lawyer?
• new Ohio Hilton bed bug lawsuit
• Virginia Beach hotel sued over alleged bed bug attack
• bed bug lawsuit against the Mandarin Oriental Hotel, Kensington, London

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Student Aaryn Secker finally moved out after battling bed bugs in Solin Hall for months:

Secker notified Howard Zinman, Services Coordinator for Solin Hall, after discovering tiny red bites all over her body in September. Residence Services was initially responsive to her concerns, replacing her mattress and couch, paying for dry cleaning, and spraying her room with chemicals to kill the bugs.

But despite the intensive cleaning, Secker said that the bedbugs returned.

“They kept coming back. McGill [Residence Services] replaced my bed about twice. By the end of it they ended up taking out my bed and my fridge,” she said.

When the problem persisted, Secker moved out for good and sought rent compensation from the Student Housing Office for the entire academic year.

McGill’s refusal to reimburse Secker for rent or to terminate her lease has caused Secker to threaten bringing her case to the Régie du Logement, Quebec’s housing office.

Zinman refused to comment on Secker’s case, citing confidentiality reasons. He said the process of treating bedbug infestations has not changed since last year’s incidents in MORE Houses and New Residence, where bedbugs were found in several rooms.

It is not easy to treat for bed bugs, let alone in student housing. But replacing a bed twice does not seem like the most well-considered protocol, since beds can be treated, and moving infested furniture is tricky.

Perhaps McGill and their pest control operator should talk to Stanford and their pest control operator (who we believe is Crane Pest, San Francisco). Stanford has had its share of bed bugs, but the reports of their responses so far have been the best we have heard of on college campuses. And let’s face it, there will be bed bugs on college campuses, you can’t stop that from happening, though you can try to implement policies to help prevent it. And you can educate students and staff about the problem.

What matters most, though, is the response when bed bugs are discovered.

• Comment dites-vous le bed bugs en français?
• Ryerson University: a study in unenthusiastic bed bug control practices
• Bed bugs at the University of Vermont
• bed bugs at University of Bridgeport

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Concern about the recent city-wide rise in bed bug infestations has led to the creation of a bed bug forum, coming to Etobicoke this Wednesday, April 2 at LAMP CHC.”You have a couple of generations who are not used to living with bed bugs,” Reg Ayre, manager with the Healthy Environment Program at Toronto Public Health, told The Guardian. “Before the Second World War bed bugs were fairly common and people knew how to live with them and how to deal with them. Now you’ve got the situation where folks are having to learn to deal with them all over again.”The forum will feature speakers from Toronto Public Health, South Etobicoke Legal Clinic and Sam Bryks, Manager, Environmental Health at Housing Services Inc.

According to the article,

The forum runs from 6:30 p.m. to 8:30 p.m. at LAMP CHC, 185 Fifth Street, Community Room. Light refreshments provided.

• Reg Ayre of Toronto Public Health: bed bugs a “health concern,” not a “health hazard”
• After a fire, bed bugs “rain down from ceilings” into other apartments
• bed bug news for 2007-11-16
• Toronto Councillor Paula Fletcher has some progressive ideas about bed bugs

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Bill McLeod’s body is covered with bites. It’s bedbugs — and they’re crawling all over his apartment building.His home — in a B.C. Housing complex in Surrey — has been sprayed nine times to deal with a stubborn bedbug infestation. But the pests aren’t going anywhere.”I can’t sleep like this,” McLeod told CTV News. “I’m up until three in the morning. I have to leave all my lights on.

The article later claims,

B.C. Housing says it’s spent tens of thousands of dollars on pest control companies, and has a rigorous and comprehensive plan to eradicate the pests.And it’s a major problem for people in low-income housing who may have other barriers such as mental illness that make it harder for them to deal with the problems.

Mr. McLeod’s home has been treated for bed bugs nine times. Something must be going wrong then, eh? Nobody should be forced to live with this problem. Especially not folks who are older, disabled, or with other health concerns. If residents need help with prep or otherwise need support during treatment, then either social services, or BC Housing, will need to provide this assistance.

• Bowling Green Towers: residents organize to demand proper bed bug treatment in low-income building
• Bed bugs invade Chicago’s Presidential Towers, and another Vancouver Island detox
• Bowling Green Towers: another infestation in elderly and disabled housing
• Portland’s public housing and bed bugs

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2 a.m.!

That’s just the beginning.

“There was a fire in the building in November, on the fourth floor. One man was killed. Nobody knew him; we’re still suffering from the stress of that … the bugs were totally blown out of that unit.”

Blown out?

“People were coming to me in tears, in total frustration, from bugs on the fifth floor, and more on the third floor; they were falling from the ceiling.” Bedbugs fleeing fire.

As if the horror of a fire in the building and a neighbor losing his life were not enough. Imagine bed bugs raining down from your ceiling.

Fiorito’s assessment of the public housing situation in Toronto vis a vis bed bugs?

Funny, TCHC [Toronto Community Housing Corporation] staff told me last year there might be three or four of their buildings with bedbug problems. I now believe there might be three or four without bedbug problems.

Toronto now has a Bed Bug Action Committee, so change is hopefully on its way. As I said before, I have no doubt Fiorito’s excellent series of articles on bed bugs in Toronto has a lot to do with that. Rock on, Joe!

• bed bug news for 2007-11-11: Lexington, KY and Toronto, ON
• Reg Ayre of Toronto Public Health: bed bugs a “health concern,” not a “health hazard”
• Toronto Community Housing does good; Orlando, Florida tenants and Billings, Montana shelter guest demonstrate why more bed bug education is needed
• Bed bugs not so nice either

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It’s worth noting that Wikipedia claims Seaton House is the largest homeless shelter in Toronto, housing at times as many as 700 men.

I found more information on this initiative in this PDF at the City of Toronto website. (”Bug and Scrub” is item #2.) They even have a great name, though if they are only dealing with bed bugs–and this is not clear from the description–they might have gone with “Bed Bug and Scrub” to make this clearer.

It sounds like the program provides full-service assistance with bed bugs (from detection, to cleaning and prep for treatment, pesticide application, and follow-ups):

Bug and Scrub is an all in one service that incorporates responsible and reliable measures to deal with the bed bug issue. Following an Integrated Pest Management protocol, full treatment is provided including assessment, prep work, spraying of the bed bugs, removal of belongings and follow up. The business has already proven successful and has provided many low-income, vulnerable individuals with this unique service.

Staff at Seaton House support clients during their training and employment phase. Anyone residing in the City of Toronto can receive the Bug and Scrub service. Fees operate on a sliding scale and can range from $250 -$800 based on the type of work required.

For more information please contact Richard Grotsch at 416-392-5572.

Remember, contrary to some misconceptions, IPM doesn’t mean no pesticides are used. It means fighting bed bugs on multiple fronts, trying to remove them as much as you can, and then treating to kill what’s left.

I have to say, the Bug and Scrub concept excites me: these men are getting training in what is unfortunately a growth field, they’re getting support as they make an educational/career transition, and Toronto residents are hopefully getting good, reasonably-priced pest control service.

• Toronto Public Health now has a Bed Bug Action Committee. Action, people.
• Bed bugs: what’s really working?
• bed bugs in Toronto; Vancouver; Billings, MT,
• Abbey the Bed Bug Dog: news report

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Toronto has had a serious bed bug problem for some time, just like New York, London, San Francisco, Vancouver–I could go on and on, but you get the idea.

The Toronto Star also has a journalist called Joe Fiorito who wrote extensively and repeatedly about how serious a problem bed bugs were, for everyone who gets them, but especially for the poor, the elderly, the disabled. You can see links to just some of Fiorito’s articles on my del.icio.us page. I mention Fiorito because I do not doubt for a moment the effects that good (or bad) journalism can have on public perceptions of the bed bug problem. In Fiorito’s case, the journalism was very good.

Then in November 12, 2007, Toronto City Councillor Paula Fletcher asked the Board of Health (of which she is a member) to take action on bed bugs. This is a PDF of her letter.

Fletcher wrote,

Traditionally Public Health officials consider and have categorized bed bugs as a nuisance because they do not carry and spread communicable diseases. However, ailments stemming from a bed bug infestation can range from secondary infections due to scratching to anxiety, embarrassment, and loss of sleep.

Moreover, residents who experience infestations are faced with considerable financial costs associated with fumigations as well as replacing furniture deemed to be unsalvageable.

Here is a politician who understands the bed bug problem. Clearly, she’s been listening to her constituents.

In the letter, Fletcher specifically asked the Board of Health to

• Review and report on the current procedures for bed bug inspection and control, including changing categorization of bed bugs as a public health ‘hazard’ and the harmonizing pest control under Municipal Licensing which currently deals with pest control relating to mice, cockroaches and termites
• Investigate and report back on a Bed-Bug Furniture Pick-up program
• Investigate and report back on North American best practices, including by-laws relating to sale and disposal of used furniture and mattresses
• [To provide an] Expansion of public education initiatives on measures, particularly to tenants, occupants of multi-residential units and users of shelters
• Report on the City’s regulatory authority to require action from property Owners, Operators of Hotels and Other Multi-unit dwellings including
  o Requirements for control and prevention, including pest control management plans included as part of landlord licensing requirements
  o Requirements for responding to complaints
  o Procedures for reporting to City officials
  o Treatment and control of bedbugs in hotel rooms
  o Guidelines for pest control companies
  o Responsibilities of tenants and homeowners

Fletcher noted that even though property owners are responsible for bed bug eradication, there is a need due to the “resilient and migratory nature” of bed bugs, for government agencies to re-examine their practices regarding the pest.

In response, Dr. David McKeown, the Toronto Medical Officer, unveiled a proposal for dealing with bed bugs last month. He asked the Board of Health to take action, outlined in this PDF.

McKeown’s report opened with a brief introductory paragraph, followed by this statement:

Bed bug infestations occur in all neighbourhoods and communities in the City and most households deal with the problem without assistance from the Municipality. This is not the case with the most vulnerable populations in our community. In recent months, Toronto Public Health has devoted significant resources to deal with severe infestations impacting on the health of the elderly, those living with physical and mental health issues and people living in poverty. This report is intended to focus primarily on strategies to ensure that vulnerable people get the assistance they need to lead independent, pest free lives.

The Medical Officer of Health’s made a series of proposals to the Board of Health (outlined in the same PDF) to deal with bed bugs.

The Board of Health then met on 2/26, and (as outlined in this PDF):

1. requested the Medical Officer of Health to establish an action committee comprised of city divisions, housing providers, health care organizations, social services, community groups, representatives of landlords and tenants, and other appropriate stakeholders to develop a comprehensive action plan to reduce bed bug infestations in the City of
Toronto with particular emphasis on vulnerable populations;

2. requested the Medical Officer of Health to report on the progress of the action committee within six months;

3. requested the government of Ontario to incorporate the issue of bed bug infestations in their poverty reduction strategy; and

4. referred all communications/submissions, and the following motions to the new Action Committee described in Recommendation 1:

Motion by Valerie Sterling:
“That Recommendation 1 be amended by adding the words “and in addition, consider broader public education and social marketing strategy to address the stigma associated with having bed bugs.”

Motion by Councillor Fletcher:
“That the Medical Officer of Health and TorontoPublic Health be requested to educate the medical community in identification of bed bug bites.”

This CBC article which was written in advance of the meeting notes that Toronto’s public health department surveyed PCOs about the increase in bed bug cases. This is the easiest way to get a realistic picture of the number of cases in a city, though of course those who self-treat will be left out.

Toronto Public Health surveyed 12 pest control companies in December 2007 and received six responses. All six reported an increase in numbers of inquires and calls related to bedbugs from 2006 to 2007. The majority of calls were in apartment buildings.

This was an informal check with just 12 companies. Remember the study done in Toronto in 2003? That year, every PCO reported every case of bed bugs in the city (well, theoretically, anyway). Most cases then were in single family homes. That might sound strange to some, since bed bugs are now a much bigger problem in apartment buildings, but it’s fully plausible.

Anyway, the Toronto officials know that if you want to know who has bed bugs in your city, you don’t simply rely on tracking official housing violations (as the New York government is trying to do) or official complaints to the Toronto Public Health Department. You ask the PCOs. Obviously, in this case this is just an informal inqury, not an official study (like the one in 2003). But the principle is the same.

A Toronto Sun article last December noted that the Toronto Public Health Department had gotten 160 calls about bed bugs in the first nine months of 2006. But Reg Ayre, the city’s Healthy Environments manager, said back then that anecdotal evidence from PCOs showed much higher incidence of bed bugs. One PCO claimed to be treating 1200 cases a year, another claimed to treat 400-600 a month (more on that below). You can read more about this here. (Sadly, I cannot link to the original article, since the Toronto Sun is holding out on us, so you’ll have to make do with the report I did on it in December.)

There were other documents associated with the Board of Health meeting, including several fact sheets and this: a PDF of a Toronto Community Housing proposal for dealing with bed bugs in public housing. (The key components, not surprisingly, are educating staff about bed bugs, educating tenants about bed bugs, getting both to cooperate, and using only qualified pest control contractors).

Bed bugs are clearly a problem that is far more serious than current Toronto Public Health data. The officials in Toronto are smart to recognize this. Here in New York, city officials seem happy to cite the number of bed bug cases in NYCHA public housing, or the NYCHPD housing violations for bed bugs, though it is obvious to us that these are just the tip of the iceberg.

The action we’re seeing in Toronto seems to stem in part from

• a vocal and forward-thinking city councillor taking up the cause of bed bugs,
• a persistent and talented journalist taking up the cause of bed bugs,
• a Board of Health willing to re-consider the definition of a “health hazard,”
• a Medical Officer of Health looking deeper into available bed bug statistics, and prioritizing the issue.

Doubtless, there are many more factors I can’t yet see. In any case, I am grateful for all those working to solve this problem in Toronto, and anywhere else.

I can’t overestimate how significant it is that Fletcher and the Board of Health were willing to consider bed bugs as having a significant effect on health. On February 26, other issues the Board of Health was dealing with included the provision of dental care to people on low incomes, and a plan for dealing with an inflenza pandemic. Deadly possibilities like an infleunza pandemic must be planned for, but we also need to deal with bed bugs, even if the health effects are not deadly.

I hope that cities which have not yet taken action will use the work being done elsewhere as a starting point. McKeown’s report, for example, cited what was being done to deal with bed bugs in Vancouver, and Hamilton (Ontario). Problems may vary from place to place, but the bed bug enemy is the same, and cities would do well to use the best practices beginning to be developed elsewhere as a starting point.

I look forward to hearing more from Toronto.

Many thanks to hopelessnomo for helping me think about this issue and for providing the location of the Board of Health’s document stash.

• bed bug news for 2007-11-16
• Toronto Councillor Paula Fletcher has some progressive ideas about bed bugs
• Toronto Public Health now has a Bed Bug Action Committee. Action, people.
• New York vs. Bed Bugs: NYC is the underdog!

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