HEALTH

'They have no place else to go': In coronavirus pandemic, Nashville's homeless need shelter

On Thursday, Metro Nashville will open three temporary locations for Nashville's vulnerable homeless community to help un-crowd shelters and provide more room for social distancing and isolation.

Jessica Bliss
Nashville Tennessean

Outside the black gates at Room In The Inn, more than 100 members of Nashville's homeless community stand waiting for their lunch ticket numbers to be called.

The process is organized and orderly — turn in your number, get a squirt of hand sanitizer, pick up your aluminum tray of mac 'n' cheese and baked apples, then disperse — but it is not how the homeless are normally treated here.

In different times, they would be welcomed inside, gather together for a meal in the courtyard, socialize and find the support services they need to help rebuild their lives.

The coronavirus has changed that. The number of people allowed inside Room In the Inn is limited to 10 at a time now. And those who need food are given meals from under a tent in the street and then sent immediately on their way to promote social distancing.

The biggest difference is, while everyone else is being told to isolate themselves in their homes, this population has no home to go to. Shelters are where they find solace.

"We have had to take away their safe space," said Rachel Hester, executive director of Room In The Inn.

A Room in the Inn staff member offers a homeless guest a free lunch outside their facility Wednesday, March 25, 2020 in Nashville, Tenn. During the Coronavirus outbreak the Room in the Inn is limiting the number of guests or clients into their facilities.

Men and women struggling with homelessness are particularly vulnerable to illness. Often, their health is already compromised by preexisting conditions, the effects of addiction or the stress, filth and scarcity that comes from living on the streets.

The coronavirus escalates those concerns, forcing leaders who care for Nashville's homeless to take creative action and issue urgent pleas for the city and the state to help.

The most recent “point in time” count identified 1,401 homeless sleeping in shelters and another 585 on the streets. But that doesn’t include people staying in motels, hospitals, jails, in their cars — or those simply not spotted by volunteers who scoured the streets last May. Advocates say the number of homeless in Nashville is many times that.

In the face of the pandemic, the most pressing need has been finding a way to distance the thousands facing homelessness from each other while continuing to meet their critical needs. On Thursday, the city will open three temporary shelters to help address the confluence of crises that could come if homelessness and disease collide.

"If we are telling the whole world to stand six feet apart, we have to first un-crowd the Mission," Hester said. "If we don't, you are going to lose all of us. We are going to be the face of the pandemic in Nashville, Tennessee."

'They have no place else to go'

While Room In The Inn has scaled back activities in its day-center — which typically provides 200 to 400 people a place to shower, do laundry and check mail — its guest house remains open. Residents there are the highest-risk, including those who are medically fragile, in recovery and aging.

Nashville Rescue Mission also continues to provide food and shelter to those in need. Though it has suspended all volunteer activities, it is still serving 1,600 communal meals a day and providing beds for more than 800 men, women and children to sleep at night.

The risk is high, and they are doing what they can to be diligent and smart by opening the chapels on both the men's and women's campuses to allow guests to spread farther apart. But, prompted by responsibility, leaders feel they can't turn people away.

"They have no place else to go," said the Rev. Glenn Cranfield, president and CEO of Nashville Rescue Mission. "We have to be the ones who say, 'You matter. You have dignity. You have worth. You have value. And we’re here to plead for you.'"

For more than a week, executives from the Mission, Room In The Inn, Oasis Center, Neighborhood Health and more, have been holding daily conference calls with representatives from Metro government and the city to find solutions.

Ruth Ellis with the Neighborhood Health clinic talks with Ronald Harvey outside their office on Eighth Avenue on Wednesday, March 25, 2020 in Nashville. The clinic is making preliminary assessments of patients outside for COVID-19 symptoms before allowing patients into its facility during the coronavirus outbreak.

They are a tight-knit group, conditioned by decades of standing together on the front line for people experiencing homelessness, hunger and neglect. Now, they are facing one of the city’s most conspicuous health crises — bringing gravity to their missions.

"For years we've said: If it’s a homeless issue, we've got it," Hester said. "But we don’t have this one. This is a public health issue, not a homeless issue. We will take every every single bed in the health care system if we don’t get people out of here, because they can’t quarantine at home. They will be in hospitals instead."

Temporary shelters for the homeless open Thursday

Almost a week ago, the group of advocates recommended that temporary shelters be opened for the homeless community. On Thursday, three shelters will begin operation.

One will be for healthy individuals who need food and a place to shower, to do laundry and to self-isolate.

Room in the Inn staff member Taylor Wilder provides hand sanitizer to a homeless guest outside their facility before delivering free lunches to clients Wednesday, March 25, 2020, in Nashville. During the coronavirus outbreak, Room in the Inn is limiting the number of guests or clients into its facilities.

The second will be for those who show symptoms of illness: a fever, cough or shortness of breath. People there will be tested for the virus and stay in the shelter as they await results.

The third housing facility will be a place of quarantine for those who have tested positive for COVID-19 but whose symptoms aren't severe enough to be hospitalized.

Each facility can house several hundred people, said Dr. Alex Jahangir, chair of the Metropolitan Board of Health of Nashville and Davidson County.

Partners from Second Harvest Food Bank, Dollar General and the American Red Cross will provide food, cots, blankets, pillows and other necessities for those taking shelter.

Two shelters will be at the Nashville Fairgrounds, he said. Safe transportation to these locations is still being finalized.

Staff at Room in the Inn prepare to deliver lunches to  the homeless outside their facility Wednesday, March 25, 2020 in Nashville, Tenn. During the Coronavirus outbreak the Room in the Inn is limiting the number of guests or clients into their facilities.

"Our homeless residents are a vulnerable group," Jahangir said. "Prior to this outbreak, it was challenging for them. It's even more challenging now.

"In an epidemic in which we are all talking about social distancing and self isolating, it's very hard for our un-housed individuals to do that. These are residents of our city, and we've got to take care of them."

They are 'incredibly resilient'

Meanwhile, local nonprofits continue to help those within their neighborhoods as they acclimate to the temporary new normal in homeless outreach and service.

On Wednesday, Neighborhood Health set up a tent outside its entrance on Eighth Avenue — just around the corner from Room In The Inn and the Rescue Mission.

The downtown clinic, which services many of Nashville's homeless, administered preliminary screening tests for COVID-19 symptoms to patients outside the building before allowing them in the facility.

Signs affixed to the wall and tables made it clear the clinic was not testing for coronavirus. Instead, it was administering normal care, tending to wounds and illness.

A handful of people sat outside waiting for service. As one returned a borrowed cell phone, Ruth Ellis, her face covered by a mask and plastic shield and her hands covered by blue gloves, wiped the surface intensely with a disinfecting cloth.

"People who are homeless are disproportionately likely to be medically complex," said Neighborhood Health CEO Brian Haile. "If we don't take drastic action immediately then we are setting ourselves up to fill hospitals and ICUs.

"When we talk about needing shelter, to be clear, it is in the self interest of every individual that lives in Nashville, Tennessee."

Ruth Ellis with the Neighborhood Health clinic talks with a homeless man outside their office on Eighth Ave. Wednesday, March 25, 2020 in Nashville, Tenn. The clinic is making preliminary assessments of patients outside for COVID-19 symptoms before allowing patients in their facility during the Coronavirus outbreak.

Many homeless are "incredibly resilient," Haile added, and a lot of things they are doing to protect themselves are already happening naturally, such as staying in tents.

Those who normally rely on other shelters at night are also learning about such options. As the virus has prompted capacity restrictions, Room In The Inn has distributed shelter.

"For the first time in our 30 years we handed out tents," Hester said. "I think everybody deserves the dignity of being indoors. But we’re having to be nimble to make sure they have an option to protect themselves."

This is not a need isolated to Nashville.

Statewide, the governor's office has established a task force called the Tennessee Homeless Service Sector, to deal with the needs of the homeless population across other cities and counties. That group — led by Major Ethan Frizzell of the Salvation Army — is also developing action plans to meet the needs of the people on the ground.

As new actions come to light, Nashville's homeless advocates continue to work with their small staffs to conquer a big issue.

Room in the Inn staff members Sarah Williams and Annette Cullison help to deliver free lunches to homeless guests outside their facility Wednesday, March 25, 2020 in Nashville, Tenn. During the Coronavirus outbreak the Room in the Inn is limiting the number of guests or clients into their facilities.

At Room In The Inn on Wednesday, employees who passed out bottles of water and warm meals greeted many of those who came through the line by name. They offered smiles and kind words.

They are still trying to understand how to do their work in this time of pandemic — but they know even as they change how they operate, their services remain essential.

"This is not the hospitable thing to do," said Quiana Jimerson, senior manager of day services, said as she greeted homeless guests waiting for food. "But it is the right thing."

Reach Jessica Bliss at 615-259-8253 and jbliss@tennessean.com or on Twitter @jlbliss and please support local journalism.

Help for those without homes

If you are in Nashville and in need of shelter or medical assistance, these resources can help.

To talk to a physician, regardless of the kind of support you need, reach Neighborhood Health at: 615-227-3000 and www.neighborhoodhealthtn.org/

For shelter, contact:

Room In The Inn: 615-251-9791 and www.roomintheinn.org/contact

Nashville Rescue Mission: 615-255-2475 and nashvillerescuemission.org/services/get-help-now/

Oasis Center (emergency shelter for teens): oasiscenter.org/about/emergency-shelter

Nashville Launch Pad (for youth members of LGBTQ community): www.shelternashvillelaunchpad.com/