“My husband won’t let me leave the house,” a victim of domestic violence, tells a representative for the National Domestic Violence Hotline over the phone. “He’s had flu-like symptoms and blames keeping me here on not wanting to infect others or bringing something like COVID-19 home. But I feel like it’s just an attempt to isolate me.“

Her abuser has threatened to throw her out onto the street if she starts coughing. She fears that if she leaves the house, her husband will lock her out.

For people who are experiencing domestic violence, mandatory lockdowns to curb the spread of COVID-19 (the disease caused by the new coronavirus) have trapped them in their homes with their abusers, isolated from the people and the resources that could help them.

In the United States, where 5,218 people have been infected with the coronavirus, the National Domestic Violence Hotline reports that a growing number of callers say that their abusers are using COVID-19 as a means of further isolating them from their friends and family. “Perpetrators are threatening to throw their victims out on the street so they get sick,” Katie Ray-Jones, the CEO of the National Domestic Violence Hotline tells TIME. “We’ve heard of some withholding financial resources or medical assistance.”

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From Europe to Asia, millions of people have been placed under lockdown, as the coronavirus infects more than 183,000 people. But Anita Bhatia, the Deputy Executive Director of the United Nations Women tells TIME that “the very technique we are using to protect people from the virus can perversely impact victims of domestic violence.” She added that “while we absolutely support the need to follow these measures of social distancing and isolation, we also recognize that it provides an opportunity for abusers to unleash more violence.”

One out of three women in the world experience physical or sexual violence in their lifetime, according to the World Health Organization, making it “the most widespread but among the least reported human rights abuses.” While men experience domestic violence, women make up the majority of victims, with LGBTQ individuals also facing elevated rates of domestic violence. But during times of crisis—such as natural disasters, wars, and epidemics—the risk of gender-based-violence escalates. In China, the number of domestic violence cases reported to the local police tripled in February compared to the previous year, according to Axios. Activists say this is a result of enforced lockdown.

“We know that domestic violence is rooted in power and control,” says Ray-Jones. “Right now, we are all feeling a lack of control over our lives and an individual who cannot manage that will take it out on their victim.” She says that while the number of abuse cases may not rise during the coronavirus crisis, people who were already in an abusive situation will likely find themselves facing more extreme violence, and can no longer escape by going to work or seeing friends.

The current crisis also makes it more difficult for victims to seek help. As medical facilities around the world scramble to respond to the coronavirus, health systems are becoming overloaded, making it more difficult for victims to get access to medical care or therapists. “In the best of circumstances, women already have a hard time being heard,” Bhatia says.

For many women, even the fear of contracting the coronavirus is stopping them from seeking out medical care after experiencing physical abuse.

“I spoke to a female caller in California that is self-quarantining for protection from COVID-19 due to having asthma,” an advocate at the National Domestic Violence Hotline wrote in the organization’s log book. “Her partner strangled her tonight. While talking to her, it sounded like she has some really serious injuries. She is scared to go to the ER due to fear around catching COVID-19.”

Many victims also feel that they can no longer seek refuge at their parents’ home, for fear that they could expose their elderly parents to the virus. For some, travel restrictions may limit their ability to stay with loved ones. Women’s shelters may also be overcrowded during this time or may close their doors if the risk of infection is deemed too high.

The coronavirus crisis, which is expected to push the world economy into a recession, may also ultimately make it more difficult for victims to leave abusive relationships. Ray-Jones says leaving an abusive partner often involves secretly saving money, which will be more difficult if victims begin to lose their jobs.

Many social services for victims of domestic violence will also suffer budget cuts under a recession. “We are expecting our philanthropic efforts to be really impacted,” Ray-Jones says. “It’ll be hard to fundraise.”

Domestic violence advocates say that victims who are not yet in quarantine status should seek help now. Meanwhile, domestic violence organizations like the National Domestic Violence Hotline are developing new strategies to support victims under lockdown. Ray-Jones says digital contact with victims will be very important during this time but that it will be difficult for victims to call while at home with their abusers. The hotline does offers services via online chat or texting, making it easier for victims to seek out help while at home.

Bhatia from United Nations Women has also called for governments to provide packages for paid sick leave and unpaid care work, in order to allow women facing domestic violence to maintain financial independence from their abusers. She added that in order for this public health response to be gender-sensitive, women will have to have decision-making power.

Even with women at the table though, legally mandated lockdowns and quarantines present unprecedented challenges that domestic violence advocates have never faced. As Ray-Jones says “we are in uncharted territories in terms of what survivors are going to experience.”

If you or someone you know is experiencing domestic violence, contact the National Domestic Violence Hotline via text or call at 1-800-799-7233.

Please send any tips, leads, and stories to virus@time.com.

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