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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Ironically, when these men have made the choice to leave homelessness behind, they’re made to live in housing that makes the street look attractive.  (This is a problem elsewhere too.)

There have been rat droppings on the old, musty carpet and frequent mouse sightings near holes in the pocked, plaster walls. For months, exterminators have fought an infestation of bedbugs, which left at least one client with bite marks so bad he was treated at a hospital. Watermarks stain the aging ceiling, and some window frames are so old and ill-fitting that duct tape was used to stop drafts. In bathrooms, many of the urinals, toilets, and sinks are out of order.

Officials at the Cardinal Medeiros Transitional Program say they have complained about the conditions for years, but they contend that the YMCA Greater Boston, their landlord in the century-old building on Huntington Avenue, has ignored them while investing in top-of-the-line equipment for its gym. They accuse the Y of neglecting the 63 formerly homeless men who live there after an effort to terminate the program’s lease failed four years ago.

Now, program officials are threatening to withhold state lease payments to cover the cost of renovations, which they estimate could cost hundreds of thousands of dollars.

Click here to read the rest of this Boston Globe story.

• Portland’s public housing and bed bugs
• A tale of another city: Monticello, NY low-income tenants 1, slumlord 0
• Homeless people wandering streets, refusing to stay in infested homeless shelter
• Brown student wants to provide free bed bug treatment to those who can’t pay

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Bed bugs may be responsible for a number of vagrants roaming the streets of Port-of-Spain because sleeping at their Riverside location has become unbearable.

According to some homeless people, the bed bugs “are biting wind” and it is now more comfortable, but not particularly safer to rest under the stars.

Health officials are expected to visit the Riverside Carpark homeless facility next week to deal with the bugs, although officials there say the bugs are not a serious issue.

But certainly there are many problems with vagrants all over Port-of-Spain. One died on Chacon Street, Port-of-Spain, last week. Strewn garbage and human filth are everywhere.

There are always officials to say bed bugs are no big deal in a given location. I’d guess they’d become an issue pretty quickly if the officials had to sleep there.

The story goes on to detail the plight of the homeless in Port-of-Spain and other cities in Trinidad and Tobago.

Lest anyone think that bed bugs are only to be found in homeless shelters (as many still do), the article also contains a section on bed bugs at the end, advising people that:

Complete elimination of the bed bug infestation may be difficult without the service of a knowledgeable Pest Control Service.

This story by Darcel Choy is from Trinidad and Tobago’s Newsday.

• YMCA housing for men in need is called deplorable (yes, bed bugs are part of this)
• Bed Bug Outbreaks on the Rise in SoCal (Fox News)
• More on bed bugs at the Montana Rescue Mission in Billings
• Freehold, NJ Social Service agency asks county for money to treat bed bugs

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“… when bedbugs spread to her apartment, and when the Toronto Community Housing Corporation could not respond to her complaints…, she booked a fumigator on her own and paid… to take care of the problem. She has now been reimbursed by TCHC.” This public housing agency in Toronto seems to be taking bed bugs seriously.

Bed Bugs Force Orlando Family To Throw Out Furniture - Central Florida News 13

Tenants in Orlando “throw out mattresses and wash all of their clothes, but the bugs are still there.” This video reminds us that tenants, landlords, and journalists need to be better educated about bed bugs. Tossing furniture out is not the way to get rid of bed bugs.

And, finally, the first ever Bedbugger.com “Aim Higher” award goes to this shelter resident, who declares living in a shelter with bed bugs “beats sleeping outdoors:”

Billings Gazette (letter to the editor): Staying in Mission beats sleeping outdoors

“As a resident of the Montana Rescue Mission, I have experience with bedbugs. They aren’t fun, but no worse than a few mosquito bites at a barbecue. Anyone who says they prefer to sleep on the streets isn’t credible.”

Absolutely, sleeping on the streets is almost always worse than bed bugs. But I disagree that they are no worse than mosquitoes. For many of us, much worse. Bed bug bite reactions vary from not noticeable to extremely uncomfortable. Some are so allergic they end up in the hospital, while others on the “itchy” end of the spectrum lose sleep and experience discomfort.

In any case, I believe strongly that people living in shelters should be entitled to accommodation that’s a darn sight better than sleeping rough. Isn’t that the point?

• bed bugs in Toronto; Vancouver; Billings, MT,
• Toronto tenants camping in parking lot rather than sleep in bed bug-infested unit
• Bed bugs in another women’s shelter in Charlotte, North Carolina
• More on bed bugs at the Montana Rescue Mission in Billings

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This article carries more details on the bed bug war going on in the Montana Rescue Mission men’s shelter than the one blogged last week. It is a harrowing reminder of how hard it is to get rid of bed bugs under certain circumstances.

More than a year ago, the mission spent $5,500 replacing all 27 wooden bunk beds in the men’s shelter dormitory with steel bunks that give the bugs no openings to hole up in or to build nests. All the wooden beds at the mission’s Women’s and Family Shelter on First Avenue North were replaced at the same time, [shelter manager Tracy] Hansen said

Ecolab Pest Elimination Services has been coming at least once a month to do treatments at the shelter, and shelter workers also use a nontoxic powder to treat areas in which bedbugs are found. All the mattresses were replaced at one point, and sheets are now washed daily.

Blankets are also washed regularly, Hansen said, and soon they will be dried in a large commercial dryer, which will kill any bedbugs.

After initially making good progress against the bedbugs, the shelter saw another outbreak over the summer. As Drake explained, “We have so many people bringing in so many things on their persons.”

Hansen said the problem this summer and fall has been concentrated in the chapel, which handles overflow sleepers. Although the dormitory sleeps 54 people and 20 more men involved in change-of-life programs sleep in several common rooms, as many as 40 men a night will stretch out on mats on the floor of the chapel. People are asked not to bring in bags or their own blankets, but they still end up bringing in bedbugs in their clothes.

Over the summer, mission workers ripped out the baseboard all around the chapel, where they found several nests in decaying wood and plaster. Those areas were treated, but there are still occasional finds, Hansen said. Over the summer, he might find 10 to 15 live bugs a day. On Thursday, he said, he found two.
.

Replacing wooden beds with metal probably helps, though bed bugs can also infest metal beds; they can even harbor in the groove of a screw-head. And replacing bed frames does nothing, if mattresses are not properly encased (whether replaced or not). I would like to know if the mattresses are encased, which will help keep them from becoming reinfested.

Regular treatments are good, but most PCOs who know bed bugs seem to recommend treating more than once a month. Washing/drying sheets daily and washing or even just drying blankets (which should also be done daily under such circumstances) is a good idea.

The sad fact is that it is probably hard to do more than control bed bugs in a shelter situation. Even if guests do not bring in bags, as long as people are coming in wearing clothing, the potential for reinfestation is there.

One statement in the article really jumped out at me:

Barbara Schneeman, the communications and advocacy manager at the Yellowstone City-County Health Department, said the department hasn’t heard of any problems with bedbugs anywhere else in Billings. In a given year, she said, there might be one or two calls about bedbugs.

If a homeless shelter has bed bugs, a person brought them in, or they were brought in with a shipment. The former is more likely.
The person can have been an employee, visitor, or homeless guest.

If people are exposed to bed bugs in the shelter, they will also carry those bed bugs elsewhere.
Those people can be employees, visitors, or homeless guests.

Where those people go next, they may leave bed bugs: stores, cafes, government offices, laundromats, buses, trains, cars, schools, hospitals, PCO’s offices, employees’ and visitors’ and guests’ and their friends’ apartments and houses.

If a homeless shelter in Billings has bed bugs, there are problems with bed bugs in other places in Billings.
It’s a matter of time before people realize it.

I hope everyone in Billings with bed bugs will call the Yellowstone City-County Health Department and let them know. Public health officials will not recognize bed bugs as a problem unless you call them and tell them they are a problem. If they shrug it off, do not take it personally. If everyone calls, officials will have to take this seriously. Other health departments are beginning to.

• Salt Lake City Firehouse closed due to bed bugs
• bed bugs in Toronto; Vancouver; Billings, MT,
• Toronto Community Housing does good; Orlando, Florida tenants and Billings, Montana shelter guest demonstrate why more bed bug education is needed
• Charlotte, NC Salvation Army Women’s Shelter has bed bugs again

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• bed bug news for 2007-11-11: Lexington, KY and Toronto, ON
• bed bug news for 2007-11-16
• Bed bugs in homeless shelters, casinos, hotels, apartments: Waynesboro, Atlantic City, Greenpoint, Toronto
• bed bug news for 2007-11-14

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