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‘When this virus gets behind bars, it runs like wildfire,’ experts warn

George Texeira thinks he might not make it. Fifty years old and serving a 25-year sentence at Sing Sing prison in New York for a burglary, he feels vulnerable to the coronavirus raging through the facility.

For his crime, “he doesn’t feel like he’s innocent, but doesn’t feel like he should have been given 25 years for it,” said Lawrence Bartley, the director of the News Inside, a print publication from The Marshall Project distributed in prisons across the country. Bartley, who has been talking to prisoners worried about contracting COVID-19, says that Texeira feels that “now he won’t even make it to see civilization because COVID-19 has turned his sentence into a death sentence possibly.”

Fifty-one inmates at Sing Sing have tested positive for the virus and four have died, according to the most recent numbers provided by the Department of Corrections and Community Supervisions. But experts and prison watchers think that infections in most prisons around the country are likely underreported, and that the virus’ deadly spread has helped shed light on the pre-existing flaws within the prison system.

Prisons are incubators for the virus. Social distancing, frequent hand-washing and use of masks are preventative measures that are accessible to much of American society, but they’re rare luxuries for the incarcerated. Basic supplies like soap and paper towels are not readily available at many prisons, and hand sanitizer is not sold at prison commissaries. New York state prisons made masks mandatory for correctional staff, but reports from inmates reveal that several staff members don’t follow these rules, not wearing masks on many occasions. Also, the New York system initially only allowed prisoners to wear makeshift handkerchiefs as masks. It wasn’t until May that prisoners were allowed to wear cloth masks that had been donated to the prisons.

“When this virus gets behind bars, it runs like wildfire through these facilities,” said Dr. Homer Venters, the former chief medical officer for the New York City jail system.

READ MORE: The essential coronavirus FAQ

Venters pointed out that the infrastructure and way that prisons are run contribute to the spread of the virus: close living quarters, overcrowding, intake pens, squalor.

Prisons “are a part of the community,” Venters said. “In my experience with H1N1 [flu] at Rikers, we like to pretend these places are not a part of the community, but the virus does not start here, it gets here through staff and visitors coming in every day and leaving every evening.”

An outbreak at a prison can also rapidly affect the surrounding community. Especially in rural areas where many detention facilities are located, a high number of cases from a prison can overrun hospitals, experts point out.

Around 1,282 staff in the New York state prison system have tested positive for the virus, according to New York state numbers as of June 8. The New York city jail system, which includes two jails in the Bronx and eight jails on Rikers Island, the biggest jail system in the state, had a cumulative 1,407 staff confirmed positive with COVID-19 as of June 4.

The best way to get an accurate sense of how pervasive the virus is in the prison system would be wide-scale testing, but testing at facilities across the country is the “Wild West,” said Venters, who explained that some places have zero testing, others test a handful who are showing symptoms and others do extensive testing and not just among the sick. The New York prisons system is an example of the last category, with an aggressive testing policy.

But testing is just one piece of many measures that could help contain COVID-19 in such facilities.

Another essential way of finding prisoners with COVID-19 symptoms is the “sick call” — the process of an inmate reporting any illness and getting facetime with a health care worker. But people close to the prison systems say that system was broken long before the start of the pandemic.

“Many jails and prisons really have barriers to people just saying, ‘I need help. I have a medical complaint,’” Venters said. “People fill sick call slips that aren’t responded to. They do that multiple times over and over. They’re writing down really critical COVID symptoms and nobody’s paying attention to them.”

Reports from prison-watchers have also noted the ways some facilities have been neglecting CDC guidelines on symptoms by only checking for fevers while ignoring inmates’ complaints of sore throats, shortness of breath and other symptoms consistent with coronavirus. Advocates say that prison officials are also paring down CDC guidelines of who is considered high-risk, creating the appearance of a much smaller number of at-risk people than the reality. A large portion of prison populations have chronic health problems, so loosening the criteria for high-risk guidelines leaves highly susceptible people without proper protection or surveillance, also driving up potential COVID-19 mortality numbers.

The New York City jail system has a unit devoted to communicable disease isolation, where 88 cells are designed to separate sick inmates, said Dr. Ross MacDonald, the current chief medical officer of Correctional Health Services at New York City Health and Hospitals, which provides health care for jails including Rikers. But that facility hit its capacity in just over a week, prompting them to open a decommissioned area to help separate people with symptoms from the rest of the prison population.

Many advocates and health experts think the most effective solution to stop the rampant spread of the virus in detention facilities is releasing prisoners.

“Releasing as many people as possible is the best public health response,” MacDonald said.

“We know which of our patients are most at risk,” MacDonald said, adding that if they were released “it would allow for social distancing, and total cases can be reduced so we could space out in time and have the resources necessary to address this effectively.”

A lawsuit representing inmates at a prison in Ohio tried to get around 800 elderly or medically vulnerable transferred out, citing the impossibility of social distancing. According to filings in the case, at least 20 percent of the prison’s nearly 2000 inmates had COVID-19 as of the week of June 5. Despite the suit stating that keeping the prisoners there is “deliberate indifference to a life-threatening disease” and “cruel and unusual punishment,” the Supreme Court on the night of June 4 temporarily blocked their transfer.

According to MacDonald and the others, the prisoners who should be immediately considered for release include older prisoners and those who are at high risk due to pre-existing health conditions. Another group are parole violators whose reasons for being incarcerated are based on technicalities and do not present a danger to society, as well as people who are locked up for minor infractions or simply because they can’t afford to pay their bond.

“People are languishing in these jails for these minor slap on the wrist crimes where coronavirus can fester and people can catch it,” Bartley of News Inside said. “So when you have someone with a very minor offense go to jail, could turn into a death sentence even before the person is convicted at a fair trial.”

To Venters and others, the virus has acted like a magnifying glass on systemic issues within the prison system. He points out the way this crisis demonstrates the lack of evidence-based health care for prisoners, and involvement from health agencies like the CDC, state and local departments of health, and the Department of Health and Human Services.

“Millions are spent every year on traumatic brain injury findings and preventing it in youth sports. But they don’t spend a single dollar on that clinical problem behind bars, even if it’s more common behind bars,” Venters said.

Bartley feels this moment has more broadly shed light on the peril of mass incarceration.

“Our country incarcerates more people than any other country in the world and now we’re feeling the unintended effects of mass incarceration. People are living on top of each other,” he said.