Canadian Continence Foundation Position Paper Toilet Access during the COVID-19 Pandemic

Bodily fluid and matter elimination is a normal and necessary function to all living creatures, as natural and essential as breathing. Cultural norms dictate that we void in private and in appropriate facilities both at home and when out in public.

At the start of this current pandemic most if not all public toilets across many provinces were closed and placed off limits to the public, and many establishments started denying access to their toilets for public use.

Even during “normal” times these same people live with an enormous fear of having a public accident. This fear will often drive them limit their trips outside the home and isolate themselves, only allowing themselves to visit others who know of their condition or having others visit them. For these people, socializing in public places has always been difficult and now, with imposed lockdowns, the isolation has increased manifold. It is a well recognised that self-isolation as a consequence of incontinence is a major cause of depression and anxiety . Imagine how much worse it is now with most provinces mandating no mixing of people indoors. The combination of social distancing measures and no toilet access poses even stronger limitations on those living with incontinence, causing greater isolation and depression.

The homeless are also greatly impacted by the toilet closures, particularly in those municipalities where access to public toilets is denied, and it is these washrooms this population use, having very few other options. Unfortunately, many municipalities regard public washrooms as an attraction, even an opportunity, for illegal drug and other “undesirable” uses. This view should not be used to close toilets and deny vulnerable people the dignity of access to public toilets.

We are also concerned with the stories we are hearing from the trucking industry. Truckers delivering essential goods during the Covid-19 pandemic have faced a worrisome struggle to find open washrooms. According to a CBC report , many chain restaurants and local businesses that remain open have restricted public access to their facilities, which means truckers working long shifts may end up not using a restroom all day. Not having bathroom access could lead to stretching the bladder muscle (overdistention) resulting in decreased bladder sensation, long-term health effects like kidney disease and kidney stones. Industry has reported an increasing demand for incontinence products, which likely reflects an increase in incontinence episodes, which could result in deterioration of quality of life and increased risk of skin lesions secondary to incontinence.

The Canadian Continence Foundation has received multiple calls from individuals and news-outlets decrying the toilet closures and wanting information on what can be done. We believe access to toilets is a human right and as such call upon all levels of government and private establishments to unlock their toilets and give the public access.

While we do understand the concern that giving public access to toilets may spread COVID-19, it is our belief that the current measures put in place in retail outlets and restaurants; i.e. hand sanitizer, disinfectant wipes, and cleaning procedures, as well as soap and hot water in washrooms, would appropriately mitigate these risks, and avoid the undeniable harms caused by preventing toilet access to those living with incontinence.