New York vs Bed Bugs » Toronto

Toronto Bed Bug Workshop, March 15-16

Renee Corea — Wed, 26 Jan 2011 20:43:23 +0000

The workshop is called Getting Rid of Bed Bugs / Keeping Them Out! – Sustainable Elimination through Integrated Pest Management. Details and registration here. This is the agenda (PDF).

Organized by Sam Bryks, speakers include Allison Taisey, Changlu Wang, Clive Boase, and local experts in housing, pest management and law.

Also check out this primer on bed bug management (PDF) on the IPM Consultancy (Sam Bryks’) site.

The workshop sounds very useful. Especially promising is something that is sometimes missing from this type of program, the participation of tenant advocates and housing law experts. Speakers here include Harry Fine, a former adjudicator with the Ontario Rental Tribunal, and Kenneth Hale, Director of Advocacy and Legal Services, Advocacy Centre for Tenants, Ontario.

I look forward to hearing about it.

Previous interview with Sam Bryks here.

Ontario provincial government to fund bed bug education and assistance programs

Renee Corea — Mon, 10 Jan 2011 06:49:33 +0000

The Star is reporting that the Province of Ontario will fund educational and assistance programs for the province with 5 million dollars. Local public health units will be able to apply for funds and the province will fund a public education campaign.

The article mentions the work of Member of the Provincial Parliament Mike Colle (Eglinton-Lawrence). MPP Colle has been working with various stakeholders on the bed bug issues for several months. He called a bed bug summit in September — read the recommendations here: Recommendations and Strategies: Arising from the Bed Bug Summit at Queen’s Park, held on September 29, 2010. [The policy and recommendations literature is growing every day, isn't it? You can see more here.]

Congratulations, Ontario.

You may recall that in the 2009 report from the Toronto Medical Officer of Health [PDF here], there was a clear statement about the long-term unsustainable burden on Toronto Public Health resources:

TPH work in addressing the bed bug problem in Toronto is presently funded through reallocation of resources from other mandated programs. This is not sustainable in the long term.

[...]

The TPH Bed Bug Unit in 2009 has been supported by three Public Health Inspectors and two Public Health Nurses who have been re-assigned to this work from the Health Hazard and the Vulnerable Adults programs. These resources will continue to support the Bed Bug Project in 2010 and the estimated cost of continuing this project is $500,000 gross and $125,000 net which will be absorbed within TPH 2010 Operating Budget.

Toronto is one of the most experienced cities in North America in this great bed bug fight. There is so much to learn from the Canadians (Vancouver and Toronto). They have described the problem and issues with extraordinary understanding and compassion, and in the creation and support of social enterprise bed bug services, they have innovated solutions that work. Previously here we have wishfully looked at Toronto Public Health’s bed bug website, talked to one of the architects of the city’s bed bug response plan, and reviewed the bed bug contract specifications made public by the Ontario Non-Profit Housing Association and much more. See all previous Toronto posts here.

Bed bug treatment specs in TCH’s July 2009 RFP

Renee Corea — Wed, 03 Feb 2010 03:09:29 +0000

If you want to see an example of bed bug treatment specs within the context of a full RFP, see Toronto Community Housing’s Integrated Pest Management Services Request for Proposal from July 2009.

Pest treatment specifications for bed bugs are in appendix B-4.

Please note that the PDF has a wayward dot—you may need to rename the file (add a .pdf extension) in order to open it.

See also previously: Bed bug treatment specs from ONPHA. (The ONPHA specs are substantially the same but the warranty is specific to bed bugs and other details have been elaborated upon. Highly recommend that you check them out.)

Bed bug treatment specs from ONPHA

Renee Corea — Tue, 26 Jan 2010 17:59:51 +0000

The Ontario Non-Profit Housing Association has posted bed bug management specifications which were developed in collaboration with hsi solutions. This is a great communication and education tool for their residents and property managers — but there’s also generosity at play here for the rest of us who can now read this example of clearly thought-out bed bug treatment contract specifications.

The items are:

Bed Bug Pest Management Services;
Expected Service Levels and Treatment; and
Minimum Warranty (PDF).

From the warranty:

Warranty for Unit Treatment

The warranty for unit treatment, planned or demand, shall be three (3) months from the service date. The warranty is also dependent on specific factors that may compromise the service effectiveness, such as adjacent infestations and other factors such as extremely heavy infestation, or conditions requiring further services. Unless such factors are identified by the Pest Control Service Provider (PCSP) to the Housing Provider before or at the time of treatment, the warranty shall be in force for the period noted.

From the expected service levels:

Adjacent Unit Inspections

Units immediately adjacent to the treated unit on the same floor shall be inspected at the same time as the treatment of the unit is undertaken. This will require preparation and advance notice to the tenant by the Housing Provider.

I think there are IPM contract recommendations out there but I have not seen one specific to bed bugs, so I hope this is helpful for those of you who are considering your own RFQs or negotiating contracts.

ONPHA also has a bed bug list-serv for their member property managers. Very cool.

Toronto schools bed bug policy

Renee Corea — Sat, 05 Dec 2009 21:29:04 +0000

The Toronto District School Board has published a bed bug procedure as a standard for all schools, outdoor education, child care and administrative facilities.

The policy provides for mandatory notification of “signs of bed bugs in any teaching area or work site” to the principal or site manager, whereupon:

(b) If signs of bed bugs are confirmed, the principal or site manager shall promptly notify:

(i) Head caretaker/family team leader

(ii) Manager, Occupational Health and Safety

(iii) Superintendent of education

(iv) Toronto Public Health

(v) Organizations leasing space in the school

Source: Toronto District School Board Operational Procedure PR599 (PDF)

Treatment would then trigger additional notifications to parents, staff and organizations that lease space on the site.

Additional documents:

Form 599A: Signs of Bed Bugs Reported (Notification Letter)

Form 599B: Students Sent Home from Outdoor Education Site (Notification Letter)

Form 599C: Signs of Bed Bugs; Continued/Resumed Use of Facility (Notification Letter)

Toronto Public Health Bed Bug Fact Sheet

The New York City schools bed bug kit (PDF) for comparison.

Thinking through procedures and notification policies as bed bugs prove themselves to be extremely challenging in schools is absolutely necessary. Schools are in a very difficult position because the root of the problem is elsewhere, in the homes of children and staff who are affected. However, schools are also uniquely positioned to disseminate good bed bug information and, well beyond that, to actually educate their communities, especially those who do not have access to professional pest control services, about mitigation strategies.

I wonder for how long actual eradication will continue to be beyond our reach.

2nd ONPHA video in planned series: bed bug treatment preparation

Renee Corea — Mon, 23 Nov 2009 06:59:43 +0000

The second Ontario Non-Profit Housing Association (ONPHA) video is up:

See previously: Ontario Non-Profit Housing Association bed bug awareness video.

ONPHA also has a bed bug resources page.

I was surprised to find that it links to a section on Landlord and Tenant Board cases, some of which are more interesting than they should be, like this one (PDF) concerning a tenant claim against a landlord:

I find on a balance of probabilities that the female Tenant brought the bedbugs into the unit by bringing a bedbug infested headboard into the unit. This headboard was discarded by the resident of unit 807, which was treated for bedbugs on January 18, 2008. The Tenant salvaged the headboard from the garbage collection area. The Tenant did not dispute that she brought the headboard into the unit, but contended that it was not the source of the bedbugs because she cleaned the headboard and used it on the balcony of the unit. I find the Tenants’ theory of causation wanting.

Nonetheless:

Although the Tenants brought the bedbugs into the unit, the Landlord is still responsible for treating the unit as part of its maintenance obligations and to prevent other units from infestation. In this regard, the Tenants alleged that Ms. H informed the Landlord’s agents, the superintendent and assistant superintendent, of the bedbug problem on March 18, 2008, and that they told her to deal with the problem herself.

Bed Bugs Are Back: Are We Ready? available from WoodGreen

Renee Corea — Wed, 11 Nov 2009 21:11:22 +0000

Bed Bugs Are Back: Are We Ready? (PDF) — the new Toronto report from WoodGreen Community Services, Habitat Services and Public Interest is now available for download at the website of WoodGreen Community Services.

~~[To be updated.]~~ Sorry, I’m still reading this extraordinarily ambitious work. It is simply a must read and you should spend some quality time with this report yourself. We’ll examine it in full in another post.

The researchers conducted an amazing number of interviews with people in Toronto and the world over. Bed bug world people, stakeholders in Toronto, landlords, social and health services workers, sufferers, everyone. Imagine an intelligent interviewer asking the important questions and getting at the essence of the bed bug problem.

I think excerpts don’t do this report justice and I wish you will read this yourself. From a bed bug sufferer profile, page 35:

Most importantly, I became so isolated. To be honest, until you go through it, you have no idea just how horrifying it really is. It is just natural for you to become paranoid; you lose sleep, you end up dreaming and thinking about bed bugs—they just consume every fibre of your being. I had to isolate myself from my family and friends; I did not want anyone coming over. I was too afraid that they would bring bed bugs home. This was very difficult for me because you need someone to talk to because it is awful … very awful. There were many days that I did not see an end in sight.

I do want to share one more thing for now. Some resourceful researcher at Public Interest got the full walking bed bugs story straight from Permakil’s Erich Hardebeck! Remember this? Page 11:

While bed bugs are known to travel unit to unit, they are also known to walk from building to building in severe and exceptional cases. Eric Hardebeck of Permakil, an American pest control company, reported bed bugs crawling through an alley in broad daylight, climbing up the sides of a building and crawling along telephone wires to enter into an apartment building adjacent to the alley. Bed bugs were found running out into the street, and some had been run over by cars. The bed bugs had survived in mattresses discarded in the alley and by feeding on homeless people who were using the mattresses. The infestation had reached such high levels that the bugs were mobile outside during the day.70

Mercy. That may be the bed bug story to end all bed bug stories.

Reports from Toronto, including new Toronto Bed Bug Project updates

Renee Corea — Tue, 10 Nov 2009 03:18:39 +0000

There’s news from Toronto today, the presentation of a new report titled “Bed Bugs Are Back: Are We Ready?” commissioned by the city of Toronto and the Ontario Ministry of Health and Long Term Care according to this news report. Here’s another story with a video segment.

So, I can’t find it! Do send a link if you know where this report is available. We’ll discuss it when we can read it, yes?

Nonetheless, don’t go away, because it turns out that the Toronto Medical Officer of Health has issued a follow-up report on the Toronto Bed Bug Project to be presented at the November 16 Board of Health Meeting.

There are three components and you can download them and read them with me. For now some brief highlights:

Toronto Public Health’s Response to Bed Bugs – Staff Report, from the conclusion:

Over the last two years, it has become clear that the bed bugs in Toronto are a complex and costly problem, requiring labour intensive interventions for effective management.

Toronto Public Health is not adequately resourced to undertake this task and the realignment of staff to work on this issue is not sustainable in the long term.

Bed Bugs in Toronto – Developing an Effective Response (October 2009) (PDF), a report from the Toronto Bed Bug Project Steering Committee, from the executive summary:

The High Cost of Doing Nothing: The longer left alone and untreated, the more the bed bugs will multiply and migrate. When colonies reach a certain size, some of the bed bugs begin to break away and migrate, moving further into adjacent units or traveling on belongings into new spaces, creating multiple infestations.

Letter from Toronto Community Housing entitled “Pest Management Program” (PDF), on the effect of sealing apartments:

Sealing of unit cracks and crevices has been found to be a very successful method of reducing the spread of bed bugs to neighbouring units. From 2007-2009, staff have sealed approximately 6,394 units portfolio-wide through the Unit Refurbishment Program. As well, approximately 10% of Toronto Community Housing units are sealed per year during turnover of units. Where units have been correctly sealed, staff have noticed an up to 60% decrease in infestation rates.

In addition, you can read the detailed agenda for the board of health meeting (PDF), on the financial impact:

The TPH Bed Bug Unit in 2009 has been supported by three Public Health Inspectors and two Public Health Nurses who have been re-assigned to this work from the Health Hazard and the Vulnerable Adults programs. These resources will continue to support the Bed Bug Project in 2010 and the estimated cost of continuing this project is $500,000 gross and $125,000 net which will be absorbed within TPH 2010 Operating Budget. TPH will continue to work with TESS and SSHA in the delivery of this program in 2010.

The Toronto Bed Bug Project is surveying residents about bed bugs

Renee Corea — Tue, 10 Nov 2009 02:23:21 +0000

Check out the online survey:

Anyone can get bed bugs! Bed bugs can cause anxiety, allergic reactions, and financial hardship.

The Toronto Bed Bug Project is working to develop strategies to manage bed bug infestations.

Did you buy any over-the-counter products to deal with bed bugs?

This is so encouraging.

“A continuous and sustained effort”: Q&A with Dr. Stephen W. Hwang

Renee Corea — Wed, 16 Sep 2009 18:38:39 +0000

Dr. Stephen W. Hwang is a research scientist at the Centre for Research on Inner City Health, the Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, and Associate Professor of Medicine and Director of the Division of General Internal Medicine, University of Toronto. He is lead author of the influential 2005 Toronto bed bug infestations study. Dr. Hwang graciously answered our questions about the recent anemia case report in the Canadian Medical Association Journal which has deepened our understanding of the health effects of bed bugs on vulnerable populations.

New York vs Bed Bugs: Can you tell us about the severity of the patient’s condition and why it was caused by bed bugs? This was a life-threatening condition?

Dr. Stephen W. Hwang: The patient had severe anemia (a very low level of red blood cells) because he had an extensive bed bug infestation in his apartment that had gone untreated for months. This man was losing a substantial amount of blood on a daily basis to the thousands of bed bugs living in his bed and mattress, to the point that he became iron deficient. His blood levels reached a very low level that could be described as potentially life-threatening, although fortunately he did not suffer any permanent damage to his health. As we describe in our report, we are quite certain that the bed bugs were the cause of his anemia because an extensive series of medical investigations did not reveal any other source of blood loss or an alternative explanation for his anemia. In addition, his anemia went away and did not return after his apartment was treated for bed bugs.

New York vs Bed Bugs: The patient’s bed bug infestation has been abated but not eradicated. Presumably he is still at risk should the infestation grow to previous levels. Have you any indications of the prevalence of persistent bed bug infestations in the vulnerable populations which are the subject of your research interests? And what are the implications for the care of individuals who are at higher risk for chronic bed bug infestations? What would you recommend to health care providers?

Dr. Stephen W. Hwang: We have not done a follow-up study to find out if bed bug infestations are more common than before among vulnerable populations such as people living in homeless shelters or residents in low-income housing. In my experience as a physician caring for patients who are homeless, I would say that the problem of bed bugs has become even more prevalent over the last 5 years. Although many people complain about bed bug infestations, and rightly so, I think that the main point of our case study is that we should be keeping our eyes open for those individuals who have bed bugs in their home and are not complaining about it, for whatever reason. I suspect that people who have severe mental illness, addictions, or cognitive impairment (such as dementia) are at highest risk of developing overwhelming bed bug infestations. Health care providers need to familiarize themselves with the symptoms of bed bug bites and infestations, and be prepared to give advice on how to deal with this problem.

New York vs Bed Bugs: Aside from severe allergic reactions, there is little evidence in the medical literature for any of the potential health risks that have been suggested for bed bug infestations. It’s an open question, however, whether there is awareness and capacity to detect effects. In the years since your Toronto survey of bed bug infestations, what has been the interest in and perception of bed bugs in the medical and social services communities?

Dr. Stephen W. Hwang: Over the last 5 years, I think bed bugs have changed from being a new and unfamiliar problem to one that many health care and social service providers are very accustomed to seeing. Since this is a problem that shows no sign of going away, we need to prepare ourselves for a continuous and sustained effort to improve the control of bed bugs, rather than expecting to “defeat” or eliminate them. The risk is that we can’t afford to become either complacent or hopeless in this ongoing struggle. I also believe that we need to devote more resources to ensure that people who don’t have the capacity or resources to deal with bed bug infestations in their home can get the assistance that they need.

Publications:

Pritchard, M.J. & Hwang, S.W., 2009. Severe anemia from bedbugs. CMAJ, 181(5), 287-288. doi:10.1503/cmaj.090482

Hwang SW, Svoboda TJ, De Jong IJ, Kabasele KJ, Gogosis E. Bed bug infestations in an urban environment. 2005. Emerging Infectious Diseases 11(4), 533-538. http://www.cdc.gov/ncidod/EID/vol11no04/04-1126.htm