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Cassandra Poggi gets anxious in small spaces. She feels trapped when she’s told where she can or cannot go.

It transports her back to a half-bathroom in San Francisco, where three years ago she watched her own blood splash the floor with red as her boyfriend beat her so severely she thought she might not make it out of that small room alive.

D.C. Safe — a nonprofit that coordinates emergency victim services in response to requests from 17 federal and local agencies, including court clerks, police and hospitals — said its call load has doubled in the past two weeks.

“We’re overwhelmed,” Executive Director Natalia Otero said. “We literally don’t have enough response-line phones to go around.”

Since March 8, the group has handled more than 1,500 calls, according to internal logs, that run the gamut from fielding calls from emergency rooms to ordering pizza for an abuse survivor who fled her home without grabbing her wallet.

“Once people start spending more and more time together and you start having multiple incidents of violence at home, our call volume is just going to continue to increase,” Otero said. “We’re all-hands-on-deck right now, and it still doesn’t feel like enough.”

The National Domestic Violence Hotline has held steady at nearly 2,000 calls a day. Officials said a jump could mean violence is increasing, or a drop could mean victims don’t feel safe enough at home to call for help.

D.C. police did not respond to requests for comment about domestic violence cases in the city.

On Tuesday, two dozen U.S. senators from nearly 20 states — including Sen. Mark R. Warner (D-Va.) — sent a letter to the Department of Health and Human Services asking the Trump administration to allow agencies that support domestic violence victims and their children to be flexible and accessible throughout the pandemic.

“An unintended but foreseeable consequence of these drastic measures will be increased stress at home, which in turn creates a greater risk for domestic violence,” the senators wrote.

An HHS spokesperson on Thursday said the agency had “received a number of letters from Congress on covid-19” and “is working to respond.”

Domestic violence advocacy groups have encouraged staff to work from home to minimize the risk of spreading covid-19, the disease caused by the coronavirus. That means moving calls for help online and leaning on telehealth services to provide counseling and support.

But some services cannot be rendered from a distance. The virus has forced groups to rethink how they provide essential services — and what programs can be temporarily sacrificed to slow its spread.

Domestic violence advocacy groups have closed volunteer programs. They have shut down support groups and suspended supervised visitation with noncustodial parents to limit the number of people in and out of their facilities. They have shuttered administrative offices and canceled walk-in appointments.

Families already in shelters when the health crisis began have largely been advised to stay put as cities and states crack down on “nonessential” movement and services. Some worry that if the public health crisis persists, the number of beds available for families in need could be limited.

Several shelters said they were nearing capacity this week — and had only just begun to see the impact of the virus.

The House of Ruth in the District is quickly nearing capacity, Executive Director Sandra Jackson said, and the pandemic has made those already in the shelter feel destabilized and panicky.

“It’s one thing to meet the needs of the families we already have in our place, but what about those folks in the situation right now trying to make a decision about whether they should stay or whether they should go? And we just don’t know what the other side of this looks like right now,” Jackson said.

Unlike homeless shelters, many domestic violence shelters are equipped to provide single-family units to parents who seek refuge with their children. Shelters say they have enforced rigorous cleaning schedules, while staff members have offered residents information on how to prevent the spread of the coronavirus.

Some organizations, like the District Alliance for Safe Housing in D.C., are setting aside vacant rooms for residents who need to quarantine. But that decreases capacity, Executive Director Koube Ngaaje said.

“If anything, this pandemic has made our services much more critical,” Ngaaje said. “With the pandemic going on, with people being mostly indoors and at home, it limits the opportunities survivors have to leave or call for help. There is a heightened sense of vulnerability and danger.”

Many victims of domestic violence decide not to leave.

Some, advocates said, have refused to seek medical treatment for fear of contracting the virus at a hospital or clinic. Others refuse to seek help from friends or relatives for fear they could expose people they love.

“Maybe their child has special needs or medical needs and they don’t want to be in a group setting, so they’re choosing not to go to a shelter because the risk of their child being infected by the virus is higher than their risk of physical violence, so they’ll manage the risk of staying home through this,” said Maureen Curtis, vice president of criminal justice and court programs for Safe Horizon, a victims’ assistance association in New York.

It’s a fear abusers have begun to exploit, advocates said.

One woman who called the National Domestic Violence Hotline last week said her husband was making her scrub her hands until they were raw, cracked and bleeding.

Another woman whose job requires her to work on-site said her partner told her she wasn’t allowed to leave the house for fear she might be exposed to the virus and bring it home.

A woman in California called after she was choked by her partner, then was afraid to go to an emergency room because of preexisting conditions that made her vulnerable to the coronavirus. The advocate speaking with her on the phone reported she could hear in the woman’s voice how badly she had been injured. She offered alternatives: Would she allow medical service providers to check on her injuries if they could come to her? Could she seek refuge with friends or family?

“I worry that people won’t have the ability to access help — that they’re being monitored so closely that it doesn’t seem there is a lot of hope for them,” said Ray-Jones, with the domestic violence hotline.

For many victims, work and school are safe havens, a place to escape turmoil at home. Canceled classes mean that more than 50 million students are spending their days at home rather than school.

“People are losing these pockets of rest, places where they can regroup and recharge,” Ray-Jones said. “We’re very worried about that.”

The pattern is an old one: Domestic violence tends to skyrocket in the aftermath of natural disasters, financial downturns and even major sporting events.

In China, where the coronavirus first spread, organizations that work to protect women from intimate-partner violence reported a jump in cases. Many attributed the spike to the virus and the country’s strictly enforced lockdown.

Maryland and the District, along with 12 other states, have laws that allow police to remove guns from the homes of people deemed dangerous, including suspected abusers.

The Maryland Network Against Domestic Violence last week altered its guidance around assessing violent situations to account for covid-19, advising law enforcement to stand at least six feet away when speaking to victims and to consider when making plans to follow up that many victims “are confined at home with their abuser.”

“When you’re being bombarded with messages like ‘stay safe at home,’ that can be really hard to hear when home is not a safe place,” said Kelly Starr, managing director of public affairs for the Washington State Coalition Against Domestic Violence.

In cites like the District, accommodations meant to help small businesses stay afloat may also contribute to an increase in alcohol consumption, which increases the likelihood of violence. Many bars have been allowed to fill takeout orders. Liquor stores in the Washington region and states around the country have been deemed “essential businesses.”

Advocates warn that the risk to domestic violence victims could outlast the virus itself.

Financial stress from lost jobs and an increasing likelihood of a worldwide recession can make it more difficult for people to leave abusive relationships and add strain to already volatile situations.

The National Network to End Domestic Violence, which lobbies for legislation to protect abuse victims, said cities and states pausing evictions, providing economic relief and streamlining processes for claiming unemployment benefits will help abuse survivors. The group has asked Congress and state lawmakers to provide funding for domestic violence relief, including hotel nights for survivors who have to isolate or quarantine but can’t at home or in a shelter.

“What we’re seeing is the needs are similar as we see after a natural disaster,” said Deborah Vagins, president of the national network. “But this is much more challenging because covid is affecting the entire country at once.”

The National Domestic Violence Hotline is available 24 hours a day in more than 200 languages at 1-800-799-SAFE, or text LOVEIS to 22522. The D.C. Crisis Helpline is available at 202-561-7000. Maryland’s Domestic Violence hotline is available at 800-MD-HELPS. Virginia’s Domestic Violence hotline is available at 800-838-4753. If you are in immediate danger, call 911.