After photos of homeless people sleeping in painted rectangles in the Cashman Complex parking lot drew criticism from around the world and as COVID-19 threatens Nevada's most vulnerable populations, Southern Nevada officials will open a temporary Isolation and Quarantine Complex (ISO-Q).

The City of Las Vegas and Clark County announced in a joint press conference Monday, that the shelter, designed for members of Las Vegas' homeless population exposed to the coronavirus, will open at 6 p.m. The new facility consists of tents in the Cashman Complex parking lot outfitted with heating, Wi-Fi and other amenities and is able to house up to 500 people.

"As you know, we wanted to get this complex open sooner after beginning construction on March 31, but the pandemic has slowed everything," Las Vegas Councilman Cedric Crear said in the press conference. "And as you will soon see, a lot has gone into ensuring that the ISO-Q is fully functional and a safe place for patients and staff."

The temporary facility includes restrooms, food, medical care and security. It will also have three sections for homeless individuals to isolate. One area will be for those with confirmed test results, another for those who are showing symptoms and are waiting on test results and the third for people exposed to the virus but have no symptoms.

Clark County oversaw construction for the facility, and the City of Las Vegas will be directing operations and security for the facility, which will only be open to those staffing it and members of the homeless population who have a referral from a medical provider. 

Crear said that the city and county chose to place the tents in the parking lot of the Cashman Complex because they are, "reserving the building for a possible hospital alternative care site and to avoid cross-contamination." 

United Healthcare and WBF Management LLC are providing complimentary meals to patients and staff and contractors are taking care of trash and medical waste disposal as well as laundry, security, clinical observations, case management and protective equipment. The city and county are covering the costs for the facility.

In addition to the ISO-Q shelter, the Salvation Army has 32 beds for people who are 65 and older who have underlying medical conditions, Crossroads of Southern Nevada has 39 beds for isolation and Well Care has another 114 beds for isolation.

Clark County officials said that there had been a "slight uptick" in cases of vulnerable populations who need placement in a press conference on Wednesday. Still, the more significant concern lies with protecting homeless people staying in shelters, which can pose challenges to enforcing social distancing.

Kevin Schiller, a Clark County assistant manager, said that the county is exploring the availability of motels as well as other locations as options to house individuals. 

"We are still accessing motels, and that's part of the beds you're hearing about both on the Well Care side and the Crossroads side," he said during Wednesday's press conference.

Shelter space for the homeless in Las Vegas also increased after operations for Catholic Charities of Southern Nevada's shelter resumed on April 1, following the facility's temporary closure on March 26 because a shelter client confirmed positive for the virus. 

The organization implemented distancing measures that limited the capacity of the shelter to 250 beds and is giving preference to those who are disabled, physically challenged or elderly. 

As part of spread prevention efforts, Catholic Charities is also screening patients before they enter the shelter and directing people with symptoms to Cashman Field and other sites for medical evaluation or isolation.

Jace Radke, a Las Vegas city spokesman, estimated that while Catholic Charities was closed, roughly 400 people were staying at the Courtyard Homeless Resource Center. This city-funded facility can sleep up to 450 people per night in its open-air courtyard.

One concern for many is the lack of space at the Courtyard. The shelter's 0.6 acres make it difficult to follow the Centers for Disease Control and Prevention recommendations for emergency shelters to place beds and sleeping mats at least 6 feet apart, and city officials do not have plans to reduce occupancy.  

Since Catholic Charities reopened, Radke said that the number of people staying at the Courtyard has decreased and that so far, the Courtyard has not had to turn away anyone looking for shelter. 

Similar to Southern Nevada, Northern Nevada has taken a regional approach to address the issues the crisis presents to homeless populations. Washoe County and city staff, in collaboration with organizations working with the homeless community, have created isolation spaces for those who are showing symptoms or tested positive for COVID-19. They also installed port-a-potties around the area and are working on putting up hand sanitizing stations. 

In Reno, city officials opened the Downtown Reno Events Center for Volunteers of America, and the VOA staff relocated three of their shelters to the Downtown Reno Events Center to better maintain social distancing protocols. 

The VOA is also providing emergency housing for over 600 clients, including families, seniors and the working poor. The family shelter is still operating, and the men's shelter is now serving men with underlying health conditions and veterans. Their mental health program, ReStart, is also operating and providing outreach and case management services.

According to Linda Grace, the regional development officer for the VOA in Northern Nevada, the VOA is anticipating a $750,000 budget shortfall, which could grow depending on how long the health crisis lasts. She said the deficit stems from overtime costs, demand for food supplies by shut-in seniors and families as well as a need for protective equipment beyond what the organization budgeted for this year.

"The COVID-19 outbreak magnifies the complexity and financial costs of delivering services. VOA is an essential business, our staff cannot work from home. They need to report to work every day and care for those who are vulnerable, isolated and afraid," Grace said.

In a press conference on Wednesday, Kevin Dick, the Washoe County district health officer, did not provide specific numbers on how many members of the homeless population have COVID-19 but said that the county has both confirmed and suspected cases in the homeless community.

Dick added that those with confirmed and suspected cases are being housed and are receiving support services. 

Monica Cochran, the manager of Reno's housing and neighborhood development program, and a part of Northern Nevada's regional effort to address problems the pandemic poses for housing insecure individuals noted that the situation surrounding the pandemic changes quickly and is most worried about when the virus will be hitting the community the hardest.

"Everyone keeps talking about when the peak happens," Cochran said. "I'm just concerned that we try to all do our best and, and flatten the curve. It's an unknown. So we just have to do our best."