‘Public Health Disaster’ Rolls On in U.S. Prisons

In November I wrote something about the slow-motion disaster unfolding as incarcerated people and staff in the nation’s prisons and jails come down with COVID-19. The next phase of the tragedy could involve state vaccination policies that fail to account for how prisons have been affected and their role in community transmission.

Before we get to the vaccination question, just doing a Google news search on COVID and prisons brings up plenty of terrible headlines from the past week. From the Oregonian: “Inmates detail horrid conditions amid COVID spike in Oregon prisons.” At the Coffee Creek Correctional Institution in Wilsonville, Ore., of the 219 coronavirus cases since the beginning of the pandemic, 164 have been diagnosed in the past three weeks. With the state correctional facilities recording 3,392 cases of COVID-19 and 42 deaths to date, the Oregonian reported on Feb. 2 that a judge ordered all inmates in the Oregon prison system to be prioritized for COVID-19 vaccinations.

A story from the San Jose Mercury News says that “California prison system officials created a “public health disaster” at San Quentin and Corcoran prisons last year by transferring inmates from other prisons through a poorly-planned and rushed process while COVID-19 rates were spiking across the state, according to a damning report by a state oversight agency.”

The report by the Office of the Inspector General found that transfers to San Quentin from the California Institution for Men in Chino made in the spring and summer of 2020 “were deeply flawed and risked the health and lives of thousands of incarcerated persons and staff.”

In New Jersey, the top prison official at Fort Dix federal prison — where more than half the inmate population has tested positive for COVID-19 and one inmate has died from the virus — is no longer overseeing the facility, NJ Advance Media reported. David Ortiz, the prison’s former warden, has been temporarily reassigned to the Bureau of Prisons’ (BOP) northeast regional office, which is an administrative office in Philadelphia, a BOP spokesman said.

The COVID Prison Project (CPP) was established to increase transparency about coronavirus in incarceration settings as well as to track national and state policies and procedures, and it provides weekly updates on statistics from around the country.

As of Feb. 2, 2021, there have been 367,722 COVID-19 cases among people incarcerated in prisons, and 2,255 deaths of incarcerated individuals in prisons due to COVID-19. There have been 86,105 COVID-19 cases among staff working in prisons and 142 deaths.

According to the CPP statistics, the rate of COVID in the general population is 76.61 per 1,000 individuals. In the prison population, the rate is 261.27 per 1,000 individuals. On average, the rate of COVID infections in prison populations is over 3.4 times the rate of COVID infections in the general population. Hawaii and Michigan continue to have prison infection rates that are over 10 times that of the state general population, the CPP report states.

Despite the continued surge of COVID cases in the general population in the last two months, in 47 of the 50 US states, the rate of COVID infections among those imprisoned still exceeds the rate of COVID infections among the general population.

In the last week, case rates have continued to increase drastically in prisons in multiple states. Last week, 25,806 individuals in Texas’ prison population of 151,126 had tested positive. Case rates in prisons have also increased drastically in Arizona and West Virginia. The highest case rate in the state prison systems remains in Michigan with 24,049 of its incarcerated population (651.54 per 1,000) having tested positive for COVID. Over half of the state’s prison population has tested positive for COVID in Alaska, Arkansas, Kansas, Michigan, and South Dakota.

The CPP notes that states have varying testing strategies within prisons and for their general population, suggesting that these rates likely reflect a falsely low disease incidence with some states’ rates being more accurate than others.

The CPP’s Morgan Maner also wrote about their analysis of state interim vaccination plans relating to prisons. CPP analyzed each of these plans to identify in which phase incarcerated people are targeted for COVID-19 vaccination. Fourteen States/Territories have, so far, included incarcerated populations as part of their Phase 1 vaccine distribution; of these 14, two have specifically prioritized incarcerated populations that are medically vulnerable to COVID-19 — those over the age of 65 or who have two or more chronic conditions.

Twenty states include incarcerated populations as part of their Phase 2 vaccine distribution. Tennessee and Missouri designate incarcerated populations for vaccination in phase 3; in Missouri, incarcerated people are identified as targets for Phase 3 while correctional staff are targeted for Phase 1. “We have categorized Montana as Phase 1 but must note that they organized their prioritization categories as tiers, making their plan more difficult to discern,” CPP noted. “In addition, in both Michigan and Rhode Island, they distinguish between medically vulnerable incarcerated people and the rest of the population. They have included only the medically vulnerable incarcerated people in Phase 1. Fourteen states did not explicitly identify how they would prioritize incarcerated populations in the distribution of vaccines.”

Distrust about taking the vaccine among the prison population is another issue that will have to be addressed. Speaking last November, CPP’s co-founder, Lauren Brinkley-Rubinstein, Ph.D., assistant professor of social medicine at the University of North Carolina-Chapel Hill, said that how vaccines would be distributed in prisons and jails is an issue that would need to be addressed from an ethical framework and with the input of incarcerated people. In many cases, that doesn’t appear to be happening, and the public health disaster rolls on.