Information For Harm Reduction & Other Community Agencies

 

Harm reduction in the context of the COVID-19 outbreak

Harm reduction workers play critical roles in preventing the spread of COVID-19 across vulnerable population, such as people who use drugs (PWUD). PWUD are more likely to engage in risky behaviours such as congregating (no social distancing) and sharing drug equipment (snorts and injectable), compared to people who do not use drugs and these could expose them to COVID-19. Drug use has been linked with reduced lungs function and poor immune response.

Frequently Asked Questions

The high prevalence of chronic medical conditions among people who use drugs suggests that they may be at higher risk of getting infected with COVID-19. Recreational drug use is linked with reduced pulmonary function and immune suppression, both of which are risk factors for COVID-19. Because COVID-19 attacks the lungs, people who smoke or vape drugs are likely to experience severe respiratory symptoms if they become infected. With evidence showing that the odds of COVID-19 infection becoming severe is 14 times higher among people who had a history of smoking compared to those who don’t smoke, more attention should be focused on people within this population. Some examples of severe respiratory complications from drug use include;

  • Tobacco and nicotine dependence from the use of cigarettes and vaping devices have been associated with negative health outcomes such as cancer, bronchitis and emphysema.
  • Marijuana smoke has been shown to cause chronic bronchitis, a respiratory condition that could be worsened by COVID-19
  • Smoking crack cocaine has been associated with lung damage and severe respiratory problems. Thus, with the imminent reduced lungs function from COVID-19, people who use drugs would likely experience negative health outcomes.
  • Methamphetamine has been shown to reduce lung function by constricting blood vessels. A COVID-19 diagnosis could further lead to poor outcomes.
  • There is evidence that opioid misuse can negatively impact the body’s immune system. As a result, people who use drugs may be at a higher risk of getting infected with COVID-19 virus.
  • When responding to overdose, wear non-latex gloves to provide chest compression and dispose of them immediately after use.
  • Adapting spaces within your facility in order to increase social distancing between clients.
  • Establishing measures to prevent overcrowding such as limiting the number of visitors at the facility and reducing the duration of stay.
  • Ensuring that the environment is kept clean and frequently disinfected to protect the health of the workers and clients at the facility. For more details, please refer to Health Canada cleaning recommendations.
  • Educating clients about respiratory etiquettes to prevent spread of COVID-19
  • Creating spaces within the facility that can be used to accommodate clients who show symptoms of respiratory illness.
  • Monitoring the Windsor-Essex County Health Unit website for current information related to COVID-19.
  • Identifying and maintaining essential services such as client services, payroll and communication
  • Creating internal policies and emergency operations plan specifically for dealing with people who use drugs.
  • Anticipating potential medication and equipment shortages and creating contingency plans to deal with supply chain disruptions.
  • Identifying and stockpiling essential supplies that are required for service delivery
  • Anticipating potential staff shortages and creating mitigation plans such as cross-training employees on critical job functions, creating flexible attendances and sick-leave policies

If, in the course of your work, you encounter a client with a suspected case of COVID-19, it is recommended that you immediately report this to your Supervisor/Manager. The following are safety measures that you may consider implementing;

  • Educate clients about safer drug use
    • Provide clients with drug use education to prevent sharing of drug supplies and equipment.
    • Focus education on the need for social distancing in order to by advising clients to reduce physical contact with other people who use drugs wherever possible
    • Clients should be advised to prepare their drugs themselves
  • Ensure health monitoring and surveillance activities for people who use drugs
    • Identify and isolate individuals who show signs of a respiratory infection and refer them to the testing centre
    • Closely monitor symptoms and immediately refer serious cases to the hospital
  • Maintain hygiene
    • Provide COVID-19 prevention supplies such as soap, sanitizers, trash baskets and face-masks for clients at the facility.
    • Maintaining a clean space is critical in curbing the spread of COVID-19 your facility. Workers are advised to regularly disinfect and clean surfaces
    • Educate clients about proper hand hygiene methods and encourage them to immediately report symptoms
  • Stock up on supplies
    • Stock up on essential supplies such as personal protective equipment, First Aid supplies, needles, syringes and naloxone.
  • Recommend buddy up system for people who use drugs
    • It is advisable for clients who are on quarantine to find buddies who can bring them food, harm reduction supplies, medicines and drugs that they require.
    • Ensure clients maintain 2 meters from their buddy in order to minimize the risk of transmitting infected respiratory droplets from person to person.
  • What is the proper technique for disinfecting surfaces?
    • Surfaces should first be cleaned with soap and water, and then disinfected with approved agents. Allow the agent sit for 10 minutes before wiping. For more details, please refer to Health Canada cleaning recommendations.