The Charlotte-area United Family Services domestic violence shelter has evacuated its residents to “a safe place” in order to battle a recent infestation of bedbugs, said Libby McLaughlin, vice president of development and communication. The staff anticipates reopening the shelter in two to three weeks.

But the move has added to the difficulties the women face, which include other time constraints. Shelter rules dictate that, upon arrival, residents have 30 days to find a job and another place to stay.

The bites and rashes from the bedbugs have made it hard for some women to find a job. And the medicine given to fight the itching, such as steroids or Benadryl, has triggered the addictions of some women with substance abuse problems.

“People are saying to go back home,” said one anonymous shelter resident. “I don’t have that option, because I’m not going back home.”

One would hope that the normal rules of the shelter would be adapted during such a crisis.

While removed from much more dangerous situations in their homes, these women have still been suffering from a lesser kind of “domestic crisis.” It’s a lot to expect for women who may be losing a lot of sleep and suffering from stress, visible bed bug bites, and itching (which can be quite uncomfortable) to find new jobs and a new home within thirty days.

We’ve previously reported on another Charlotte shelter, the Salvation Army women’s shelter, which houses homeless women, and which has been battling bed bugs off and on for nearly a year. The Salvation Army has apparently spent $50,000 in the last few weeks on renovations aimed at eliminating their bed bug problems.

Meanwhile, the United Family Services shelter has invested in new flooring, mattresses and bedding. It has also purchased a new dryer and new metal frame beds. (It is not mentioned in the article, but I hope they are getting good, aggressive pest control treatment as well.)

Local public health officials stress bed bugs are not a health problem,

“This is not a public health pest,” said Lynn Lathan, environmental health supervisor for the Mecklenburg County Health Department. “They’re annoying, but not transmitting disease.”

However, I personally think that a condition which can cause serious skin irritation, visible welts all over your face and body, other allergic reactions, anxiety and loss of sleep is a health concern.

Nevertheless, the women at United Family Services have worse threats to worry about:

For women in the United Family Services shelter, there’s a choice: Face the bugs in the shelter, or face abuse at home.

“I have a choice of going back to my husband and getting punched in the eye or getting eaten by bugs,” said one anonymous shelter resident.

We can only hope things are better for these women soon.

• Bed bug news round-up: South Jersey apartment complex; Charlotte, North Carolina Salvation Army shelter
• Charlotte, NC Salvation Army Women’s Shelter has bed bugs again
• bed bug news for 2007-11-13
• Bed bugs usually plague a city for a few weeks before being eradicated. Really, Waterbury Health Department?

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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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Calvin Merritt’s problems at Hillrise Apartments are pretty simple.

“Mostly bugs, roaches and all that…”

The “all that” is bed bugs. Dead ones were easy to find under Calvin’s mattress, and piles of them behind the bed. When exterminators come in to spray here, their work’s easy to see, pesticide stains run down Calvin’s walls. Calvin pays 313 dollars a month for this one bedroom…what little furniture he had was mostly pitched, because it was infested.

Calvin Merritt, Resident: “I done lost everything got here, my couch, my other chairs, all the stuff I had was new, I had to get rid of all of that.”

At the other end of the hall, Jeanette Jessie doesn’t have any bedbugs, but she worries about them just the same.

Jeanette Jessie, Resident: “They just spread them from one end of the building to the other, this is crazy, get this place cleaned up, spray it at one time and get rid of this mess.”

It sounds a bit like the Phyllis Wheatley YWCA in Washington DC, Halcyon House in Denver, and Warren Towers in East Moline, Illinois. Elderly people, disabled people, and anyone in low-income housing is being dealt a raw deal when it comes to getting rid of bed bugs. Let’s face it, bed bugs are expensive to treat. They’re also a rather sudden problem no one was expecting and no one has budgeted for.

Bed bugs are difficult to treat, too. Traditional treatments require multiple pest control visits at short intervals. Residents must prepare for treatment, which can be a lengthy process and costly too (especially for those on a fixed income).

However, make no mistake: non-aggressive treatment (treating only some of the infested units, treating at too-long intervals, or not coming as many times as needed), waiting for tenants who might be unaware they have bed bugs to report them, and not providing assistance with preparation costs and physical labor–all of these reactions from landlords and housing managers mean that bed bugs will be around longer, spread into more units, and cost much more to get rid of.

It just does not make sense on any practical level to not be aggressive, thorough, and quick to treat bed bugs in a building you are responsible for. It is simply a display of ignorance about the nature of this beast.

We can’t entirely blame landlords for this ignorance; none of us were expecting bed bugs. But we need to educate the public about the signs of bed bugs, and we need to educate professionals in all walks of life (from those who provide housing, to hospitality services, to health care, education, and on and on) about the need for a bed bug protocol which includes both proactive searching for signs of bed bugs, and swift reactions to any bed bug signs or sightings.

Too many people seem to be hoping they’ll just go away. Good luck with that. In the meantime:

Channel 12 reports,

Officials from the Cincinnati Health Department tell us they’ll soon be taking a closer look at conditions in the apartments.

I love the Cincinnati Health Department. But you knew that.

• Cincinnati Establishes Bed Bug Furniture Pick-Up Procedures and Hotline
• Cincinnati fights bed bugs, declares some success
• Cincinnati: “best weapon against bed bugs is … education”
• Cincinnati government discovers bed bugs are not easily treated, news at 11

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First, this item from NJ.com about an infested building South Jersey (Jamestown Square in Blackwood, NJ) makes me wonder: what if there was a newspaper item for every single infested building in New York?!? The New York Times would have to use a 4-point font. That’s the second bed bug infestation reported on NJ.com today.

Then there’s the Salvation Army Women’s Shelter in Charlotte, North Carolina, as reported by News 14. (Click the link at top right to watch the video.) The shelter houses 300 women and they’re busy “cleaning” and coating wooden bunk beds in polyurethene to seal cracks. They are instituting new rules about washing clothes frequently and not bringing in lots of stuff. But let’s hope they get a good PCO treating every two weeks until they are completely gone, because no amount of cleaning or sealing alone will do the trick.

• Charlotte, NC Salvation Army Women’s Shelter has bed bugs again
• Bed bugs in another women’s shelter in Charlotte, North Carolina
• Salt Lake City Firehouse closed due to bed bugs
• FAQ: dry cleaners and bed bugs

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