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Sounding the Alarm

The public health crisis in our jails and prisons amid the coronavirus pandemic.

Photo by Matthew Ansley on Unsplash
Source: Photo by Matthew Ansley on Unsplash

In Chicago, the Cook County Jail reported their first two COVID-19 cases on March 23rd and most recently they reported a triple digit jump of positive cases to 289 inmates and 203 staffers.

At Rikers Island, one of the nation’s largest correctional institutions has experienced a surge of COVID-19 cases now reaching 334 inmates and 441 staffers. According to the Legal Aid Society, they have seen an infection rate that is eight times higher than in the community at large.

Federal prisons across the nation are also experiencing outbreaks in record numbers as the contagion spreads like wildfire.

This is a public health crisis that could impact the lives of 2.2 million incarcerated men and women across the nation and the thousands of staffers working in correctional institutions.

Correctional institutions turn to lockdowns as a method of social distancing to reduce spread.

Inmates often live in close quarters where physical distancing is next to impossible and its serving as the perfect petri dish for the virus to thrive.

During a time when most Americans are stressed about the restrictions on physical distancing, inmates are lockdown to their 6’ x 8’ cell for most of their days. For those in barrack style housing units, it means sharing the space with 50 to 100 inmates sleeping in bunk beds that are just a few feet apart. Inmates have to share spaces for showering and toileting; and many have limited access to soap and disinfectants that are effective in controlling the spread.

Furthering the stress and panic of dealing with the pandemic, correctional institutions are suspending visitations. Due to lockdowns, inmates now have very limited opportunities to check on their families, as they have to compete with others to make phone calls.

While these measures are necessary during the pandemic to slow the spread, correctional institutions should consider the release of vulnerable inmates. Notably, 12 percent of inmates in our nation are aging adults who are more vulnerable to dying because of chronic medical conditions.

Early reactions to the pandemic across the nation are mixed.

In response to the crisis, the Bureau of Prisons (BOP) has released vulnerable inmates to home confinement. So far the BOP has released 1,198 inmates and have been asked to continue aggressively reviewing the eligibility of cases from the hardest hit areas.

New York just began releasing a select number of non-violent offenders, elderly individuals, and inmates that are close to their release date. Similarly, California plans to release over 3,500 nonviolent offenders. Law enforcement agencies are also working to reduce the number of arrests by issuing citations and releasing people immediately when possible.

Some jurisdictions argue that keeping ‘criminals’ behind bars will reduce crime and that releasing inmates is not necessary to mitigate the spread. However, history has shown that large scale releases can be done safely and have been common in the US and in other countries.

Additionally, some release initiatives, as seen in Texas, are adding restrictions for prisoners, such as the need to pay a bail fee, that mitigate these interventions and place the opportunity for release out of reach for thousands of marginalized individuals that cannot afford to pay a fee.

The sluggish response is continuing to put the lives of inmates and correctional staff in great danger.

Reducing the number of inmates can save lives and reduce the burden on correctional institutions and healthcare workers.

Continuing to keep an excessively large number of inmates in correctional institutions can only increase the risk of contagion in systems that are already stretched thin because of overcrowding and staffing shortages.

Complicating the situation further, many institutions are finding themselves severely shorthanded because staffers are getting infected at alarming rates. They also have limited access to basic Personal Protective Equipment (PPEs) and in some cases barred from wearing them. Correction officer unions across the country [New York; D.C., Oregon] have asked the courts to intervene as they deal with the threat of the virus in often cramped and unsanitary conditions with little protection from the infection.

In New York, the top doctor in charge of correctional institutions has alerted officials to take swift action as the number of COVID-19 cases skyrocket. This will increase the demand for beds and ventilators needed at local hospitals.

Correctional institutions have a responsibility of protecting the lives of inmates and their staff amid public health crisis.

Jurisdictions across the nation must take action now to save the lives of vulnerable inmates that remain in their custody and the staff responsible for their care. Responses should employ effective public health strategies and account for co-morbid health needs.

The prevalence of inmates experiencing mental health problems is as high as 64 percent in jail populations. Releasing inmates with psychiatric histories should include plans to maintain supports in the community that is sensitive to their mental health needs and mitigate the risk of suicide.

Government and public health officials across all levels should work together to develop a dynamic response to this rapidly growing problem. As seen in a few states, this may include the release of elderly inmates, pregnant women, inmates with chronic medical conditions, individuals nearing their release date and non-violent offenders. Release programs should ensure that inmates released have shelter and the social and behavioral health support needed in the community.

Public defenders, district attorneys, and law enforcement agencies should work together to overcome challenges associated with delayed or suspended court procedings.

We cannot sit in ignorance as thousands of lives are threatened. The sluggish response across the nation sheds light on the structural racism and classism of our criminal justice system that often devalues the health and lives of inmates.

We can prevent this virus from doing further harm by urging government officials at the local, state, and federal level to respond quickly to this rapidly growing public health crisis that threatens the lives of inmates and staffers living in our communities.

By Melvin Pagán-González, Psy.D. on behalf of the Atlanta Behavioral Health Advocates