U.S. prisons are crowded, dirty and opaque. COVID-19 is running rampant.

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• Judy Woodruff:

  COVID-19 is sweeping through the country's jails and prisons. They have proven to be a breeding ground for contagion, with tight quarters that don't allow room for social distancing, for shortages of cleaning supplies and lack of protective gear like masks.

  Some prison systems and jails have been releasing inmates early to free up space. But people we spoke to inside say it is too little, too late.

  Tonight, we are launching a new series of reports on criminal justice reform. We are calling it Searching For Justice.

  In a moment, William Brangham will talk with the former medical director of New York's prisons.

  But, first, Yamiche Alcindor brings us some voices from prisoners and their families.

• Yamiche Alcindor:

  There have been dozens cases of COVID-19 inside the District of Columbia jail.

• Cykeithia Staley:

  He tells me that people catch it like it's water.

• Yamiche Alcindor:

  The situation became so dire that, in April, a federal judge ordered an emergency overhaul of the jail's health measures.

  Cykeithia Staley's partner, William Cox, is being held in the D.C. jail on a weapons possession charge.

• Cykeithia Staley:

  People who have corona, instead of them, like, sending people home or sending them to a doctor, all they doing is quarantine them in the cell for a long period of time.

  And that's not safe, because the cells are dirty. People have died from it in the same unit, on the same floors that he's on. He feel like that it's easy for him to get it.

• Yamiche Alcindor:

  Right now, more than two million Americans are sitting behind bars as the coronavirus outbreak deepens. Many prison systems have ended in-person visits for loved ones.

  Inmates say there's little they can do to avoid catching the virus.

  Brian Asey is serving a life sentence for kidnapping and rape at San Quentin State Prison. He now directs a media outlet there run by inmates.

• Brian Asey:

  It's not really built for six-feet distance, because it's too packed. When they let us out to eat dinner, we still have to stand in a line to get our food, and there's still — there's no way we can keep the six feet.

  If you have symptoms or anything, it's like they punish you, because they put you in the hole to quarantine you away from everybody. So, if a person is sick, they're going to try and get away from them, because nobody wants to go the hole.

  If something happens, there's nothing that they can do because it's too crowded in here.

• Yamiche Alcindor:

  California's prison system says they are making use of vacant space to keep inmates six feet apart.

• Computer Voice:

  You may start the conversation now.

• Yamiche Alcindor:

  One inmate, who preferred not to use his full name, described the conditions inside the Missouri prison where he's serving time for murder.

• Jack:

  Well, we have masks. They just gave us something that they can call a mask. But the staff are not required to wear masks at this time.

  We keep trying to reason with them, where we need the staff to wear it, because they're the only ones that can bring it in here. We don't get cleaning chemicals for our cells. If you can afford Ajax, the only thing you can clean your cell with is Ajax.

  My main concern is the ventilation system, because of — they don't have no air blowing out. If I cough in my cell, and if there's germs in it, it can go to the next cell or whatever. We're all hooked up together. If one person get it, we all got it.

• Yamiche Alcindor:

  Cammie Maturin runs a nonprofit that works with incarcerated people in Louisiana, including her fiance, Sirvoris Sutton, who is serving a life sentence for second-degree murder.

• Cammie Maturin:

  He has been there for — this is his 29th year. I believe that he had called the coronavirus back in March, because he had all the symptoms. He had the sinus, the cough, the congestion. He had fever.

• Yamiche Alcindor:

  She worries prisons authorities are resigned to COVID deaths.

• Cammie Maturin:

  When you hear that they have accepted 2,500 body bags, and you get a will and testament from your loved one, that is — that knocks the wind out of you, because I did receive a will via e-mail. So did a couple of other people.

• Yamiche Alcindor:

  Meanwhile, inmates and their family members can do little but wait and hope the virus doesn't find them behind bars.

  For the "PBS NewsHour," I'm Yamiche Alcindor.

• William Brangham:

  To help us better understand how and why this virus is hitting prisons and jails so hard, I'm joined now by Dr. Homer Venters. He is the former chief medical officer of the New York City jail system, and author of "Life and Death in Rikers Island."

  Dr. Venters, thank you very much for being here.

  We heard a lot of concerns in that tape piece by Yamiche Alcindor about conditions inside the prison. We have heard that there's a lot of outbreaks in there.

  This may seem very obvious to you, but can you just tell us a little bit more about why jails and prisons are such great vehicles for spreading the virus?

• Homer Venters:

  Certainly. And thank you for having me, and focusing on this important topic.

  Jails and prisons and ICE detention centers, they're really created, physically, in a manner that promotes the spread of communicable disease. And COVID-19, we know, is very easily spread from people, one person to another.

  And so the close contact that people are in when they're detained, when they're in housing areas, other parts of these facilities really promotes the spread between both the people who are detained and staff.

  But two other very important aspects are that, the way they're run, these facilities, the way there's a high tolerance for squalor, for filth, where the idea of infection control is really antithetical to what you see inside these places, with trash and garbage and lack of attention to keeping the places clean, the operational standards in these places really promote the spread of this disease.

  And then, finally, because we have kept all of our evidence-based health structures and organizations outside of these walls for decades, places like the CDC, state departments of health, CMS, and the Joint Commission, things that help us have evidence-based practices in the community, those groups are generally AWOL when it comes to health practices and transparency behind bars.

  And so we find that implementing evidence-based practices in an emergency like this is very hard to do, when we haven't tried to do that before the emergency started.

• William Brangham:

  Knowing who is sick and who is not inside the prison walls is obviously enormously important. That comes back to testing.

  What can you tell us about the landscape of testing? Is it being done? Is it being done enough in jails and prisons around the country?

• Homer Venters:

  No, it is certainly not being done enough.

  There are places that continue to have scores of people reporting that they are short of breath, or even people that have objective fevers that are not being tested. So there is not enough testing.

  But your point is a really critical one, which is that these places already have broken systems for people who are sick to access any kind of health service, something that's called sick call in most of these places, where somebody writes down on a piece of paper, my stomach hurts, my head hurts, I can't breathe.

  Many places that I have investigated, those complaints of real medical problems go completely unanswered. So, that's the landscape. That's the baseline.

  And then you put in COVID-19, where, all of a sudden, scores of people in these places have new health problems, and there are broken systems at play. Certainly the lack of testing, though, is an important part of this, because when you see, for instance, cases among staff going up, up, up, up, up, but you see no testing or no positive cases among detained people, you have to wonder what's going on.

  It's probably not that nobody who is detained actually has the virus.

• William Brangham:

  We have certainly seen certain jails and prison facilities releasing prisoners to try to free up more space. We saw Donald Trump's former campaign manager Paul Manafort released because he's an older person.

  How important is releasing prisoners to free up space as far as preventing the spread inside these facilities?

• Homer Venters:

  It's a critical tool, and it's one that's being used effectively in many areas, but not enough.

  It's a critical tool because it allows us to get some of the most vulnerable people out of detention settings, people we know are at high risk for actually dying if they contract COVID-19.

  It's a critical tool, as you mentioned, because it helps us manage the outbreak inside for everybody who is still there, so we can spread people out, keep people in appropriate housing areas at a safer distance from each other.

  But it's also a critical tool because it helps us prevent local hospital systems from becoming overwhelmed. When the virus runs like wildfire through these facilities, just in the space of a day or two, it can overwhelm a local hospital.

  And particularly for rural counties, where we have fewer and fewer hospitals because of hospital closures, but we have lots and lots of county jails, state and federal prisons, and ICE detention centers, when this virus takes hold in crowded facilities, it can completely overwhelm the sole hospital that might be serving one or two counties in the space of a day or two.

• William Brangham:

  All right, Dr. Homer Venters, thank you very much for your time.

• Homer Venters:

  Thank you so much.