On April 11, 2020 the Premier of Quebec, François Legault, confirmed 31 residents of the long-term care facility Maison Herron located in a Montreal suburb had died of complications related to infections with the COVID-19 virus. Montreal was already the epicenter of the Canadian pandemic, yet the circumstances of these deaths – care workers had effectively abandoned the facility for fear of contracting the virus due to unsafe working conditions – shed light on the dire situation in both public and private care homes known by their French acronym CHSLD (centres d’hébergement de soins de longue durée). By July 2020, nearly 70 percent of the COVID-19-related deaths in Quebec (most of which were in the Montreal metropolitan area) occurred in such facilities, and they routinely lost up to 40 percent of residents to the virus (Carman, 2020).

Concurrently, disadvantaged urban boroughs such Montreal-Nord or Mercier–Hochelaga-Maisonneuve emerged as community hotspots. Although yet to be empirically proven, early assessments by public health experts link both the spread of the virus between Montreal care homes and within the community to the high concentration of low-income health care workers, who live in these dense boroughs and work in multiple homes (Santé Montréal, 2020). Care work requires prolonged physical contact with patients, thereby creating the conditions for workers to contract COVID-19, carry it to other care homes, and infect their own families. However, unions and scholars more explicitly blame the historically poor working conditions in Quebec's CHSLD system, which predate the pandemic, as the main cause for uncontrolled transmission: low wages and short-term contracts force workers to seek out jobs at several understaffed facilities – often mediated by temporary staffing agencies who take a percentage of the wage. Care work thus is ‘one of the most precarious jobs in Quebec’, according to Quebecois labor scholar François Aubry (Monpetit, 2020).

In this chapter I outline how the spread of COVID-19 in Montreal care homes not only made the poor working conditions within CHSLDs public, but also reveals important, yet previously invisible, information about the complex and precarious geographies low-income health care workers servicing multiple care homes encounter daily. These involve long and irregular commutes likely occurring across the entire metropolitan area (for international examples, see Xavier, Chapter Seven; Rocco et al, Volume 1; Sternberg, Volume 1).