Shelters in Place
Organizations that provide services for Knoxville’s homeless population are making adjustments as they prepare for COVID-19.
Knoxville’s homeless population might have many transient members, but they’re not usually world travelers. They don’t vacation in Europe or fly to Japan on business. And they don’t typically socialize with people who do.
Service providers have altered sleeping arrangements at shelters, asked volunteers to stay home and changed meal service as they brace for a potential COVID-19 outbreak.
But the homeless population is particularly vulnerable to the novel coronavirus that is sweeping the world and has reached Knox County. If COVID-19 gains a foothold among their number, the results could be devastating.
“We’re extremely concerned about the risks they face,” said Michael Dunthorn, the city’s homeless program coordinator. “They were already in a difficult situation.”
Organizations that serve the homeless population are taking steps, in consultation with the Knox County Health Department and following guidelines from the Centers for Disease Control and Prevention, to protect the people who rely on them for life’s essentials.
Shelters are rearranging beds to create more distance between residents. Like many restaurants, organizations that feed the homeless are switching from dine-in meals to carryout. Volunteers are being asked to stay home.
A Population at Risk
The homeless population is fluid, but many characteristics remain fairly constant. Some of those attributes are cause for concern among providers.
Homeless men tend to be older, for example, with a high concentration being over 50. According to the Knoxville Homeless Information Management System (HIMS), there were 425 homeless seniors in Knoxville during the last quarter of 2019. Three in 10 Tennesseans who have tested positive for the novel coronavirus as of Wednesday afternoon are 50 or older. Seniors are particularly at risk for death from COVID-19.
People who are homeless also are highly likely to already have health problems. According to HIMS, about four in 10 reported having a physical disability or chronic medical condition in 2018. That’s in addition to those whose systems have been ravaged by drug and/or alcohol addiction.
“They’re already medically compromised,” said Bruce Spangler, president and CEO of Volunteer Ministry Center.
The fact that homeless individuals typically don’t travel by air and have limited interactions with those most likely to be infected offers some measure of protection, he said, at least for now. Spangler acknowledges, however, that any barrier that relative insularity erects against the novel coronavirus will vanish soon.
“Once there’s community transmission, that’s out the door,” he said.
The primary need for people experiencing homelessness is a roof over their heads. Knoxville has 373 total beds in its homeless shelters, though many who are homeless live on the streets — in cars, in camps and in makeshift structures.
Social distancing, one of the key measures the Health Department and the CDC recommend to prevent the spread of the coronavirus, is difficult in shelters, where cots fill open rooms and limiting gatherings to 10 or fewer people is often impossible.
At Knox Area Rescue Ministries (KARM), which houses more than 300 people a night at its main location at 418 N. Broadway and at Serenity, a women’s shelter, beds have been rearranged to maximize the distance between them, according to president and CEO Burt Rosen. Classes have been canceled and staff is not holding face-to-face meetings.
“Our goal is to be part of the community solution,” Rosen said in an interview on Wednesday.
At The Foyer, the recently opened low-barrier shelter across from KARM managed by VMC, rearranging sleeping arrangements is also one of the preventive measures. “We’re doing the checkerboard approach for social distancing, so we’ve spread out the bunks,” Spangler said.
Maintaining good hygiene, particularly washing hands, can be a challenge for people who are homeless. Rosen said KARM has added stations for hand washing and sanitizing. The Foyer has restrooms that people who are not residents but spend time in the city-provided “safe place” beneath the adjacent Interstate 40 overpass can use.
VMC has temporarily closed its Bush Family Refuge, which helps keep individuals and families out of homelessness, but Spangler said his organization would continue to provide all essential services.
Providing meals is another primary task for the homeless service agencies, but the volunteers who normally help are being asked to stay home.
“One of the first things we did was shut down our volunteer program, so volunteers who might have traveled won’t come into contact with the population,” KARM’s Rosen said.
Spangler said VMC, which serves lunch daily, has asked groups that provide meals to bring them to the center, but staff would take it from there.
Churches and other faith-based organizations have their own programs and are making adjustments as well.
Lost Sheep Ministry will be distributing meals from a food truck on Wednesday evenings instead of offering sit-down service under the I-40/Broadway overpass.
Church Street United Methodist Church will continue to offer lunch to the homeless population each Thursday, even though other on-site activities at the church, including services, have been suspended.
“Instead of doing a sit-down meal, we are doing carry-out bags,” said Associate Pastor Palmer Cantler, who is in charge of the program.
Cantler said people will be allowed to enter two at a time to pick up their meals in an effort to keep them from congregating in an enclosed space. The church also has a health team made up of lay members, including doctors and an infectious disease specialist.
“We’re trying to figure out the best way to respond and still be the hands and feet of Christ,” Cantler said.
Rosen, Spangler and other leaders of social services agencies for the homeless had a teleconference meeting with Health Department officials Wednesday morning to go over plans to adjust to the dangers posed by COVID-19.
VMC is awaiting delivery of a forehead thermometer so staff has a safer way to take the temperature of someone exhibiting symptoms of illness. The agency also has case managers who already work with people needing services, including healthcare.
KARM has formed a COVID-19 rapid response team and already has an eight-bed ward that it manages along with Covenant Health. That space can be used as a “fever center” to check residents exhibiting symptoms.
Rosen said plans are being developed to create three shelters in one — an area for the general population, one for quarantine and one for observation.
“When someone is diagnosed with this virus, the Centers for Disease Control and Prevention (CDC) advises them to quarantine at home,” he wrote in a message sent to supporters and posted on Facebook. “Well, KARM IS HOME to more than 300 men, women and children each night. Our main campus and Serenity are the only home they have.”
Dunthorn, the city’s homeless program coordinator, said the organizations that work with the homeless are scrambling to meet their needs, but their options are limited. “Unfortunately, a pandemic doesn’t make all the resources we need miraculously appear,” he said.
Dunthorn said those who want to help shouldn’t freelance but instead should donate to the established providers, who are in the best position to help. “We’ll work together,” he said, “and do our best.”