When two women living in an Ottawa homeless shelter tested positive for COVID-19 last spring causing an outbreak, Dr. Jeff Turnbull couldn’t understand how they had become infected.

But then he learned that, although they slept at the shelter each night, the homeless women worked as personal support workers during the day in long-term care homes.

“It turns out that they live in a shelter, but they work outside of the shelter. They just can’t earn enough money to afford Ottawa’s rental circumstances,” Turnbull, the medical director of Inner City Health, told Ontario’s Long Term Care Commission last month.