California
California jails, prisons on alert for coronavirus. Fear it will ‘spread like wildfire’
Hundreds of people confined to a single space every day. People — many with existing health problems — come and go, bringing untold illness and viruses inside. Scores of inmates and staff sharing chow halls and recreation yards, cell blocks and bathrooms.
Jails and prisons are petri dishes.
As coronavirus spreads across the country, health experts say it’s a matter of time before COVID-19 finds its way into county jails and prisons, where containing the spread of disease can be difficult.
“If it’s inevitable that it’s going to hit the country, it’s even more inevitable it’s going to hit the jails and prisons,” said Michele Deitch, a jails and prisons expert who teaches at the University of Texas at Austin’s School of Law and Lyndon B. Johnson School of Public Affairs. “And it’s going to spread like wildfire.”
No incarcerated people or correctional staff are known to have been diagnosed with COVID-19 in the U.S., as of Friday afternoon. Still, some jails and prisons have announced changes in the wake of the outbreak. Others won’t say.
The Merced County Sheriff’s Office announced last week that it would halt visitation at the Main Jail downtown and the John Latoracca Correctional Facility — the same week as the nation’s first community transmission of unknown origin was reported in a patient in Sacramento.
“This is a precautionary measure as we continue to learn more about coronavirus,” Merced County officials wrote, noting they had not confirmed any cases of the virus in the county. They lifted the visitation restriction on Tuesday but said they would block any visitor showing signs of illness.
Nearby, a Fresno County Sheriff’s Office spokesman on Thursday said the agency had no plans to halt visitation and was “constantly educating inmates, staff and visitors about the importance of good hygiene.” The county earlier this year quarantined hundreds of inmates amid a mumps outbreak.
Sacramento County said it has not changed anything about its daily operations, intake screening, jail visitation or communicable disease practices because they were already “sufficient.” Placer County, where a cruise ship passenger died this week, said it would not answer basic questions without a formal request under California’s Public Records Act.
Meanwhile, California prison officials convened a panel of infectious disease control experts, custody and operations staffers and department planners to help modify its seasonal influenza playbook in response to the potential spread of COVID-19.
There are roughly 115,000 state inmates held in three-dozen prisons across the state. Another 70,000 people are held in California’s county jails at any given moment — facilities that are located in 56 counties across the state.
And citing last week’s community spread in Northern California, Sen. Kamala Harris in a letter Thursday demanded more information about what steps the Federal Bureau of Prisons was taking to protect its 175,000 people in custody.
“The risk of community spread poses a critical and unique threat to vulnerable populations, including those in our prisons and jails,” she wrote. “Our incarcerated population faces severe threats to their health and safety every day, and BOP must prioritize and work diligently to improve prison conditions nationwide.”
Corrections health personnel need only look to what happened last month in China for reason to be concerned. More than 200 cases of the new coronavirus were confirmed at a women’s prison in Hubei province, according to the South China Morning Post. Hundreds more were sickened at facilities after a prison guard started coughing earlier that month.
Several prison officials were fired because, Chinese officials said, they “poorly implemented their responsibilities.”
Constant churn through jails
People are constantly booking into jail and prison facilities, being ushered to court hearings, and then being released to their communities. Correctional officers walk the halls, guard inmates and come and go from jails all day. Medical staff constantly evaluate their patients. Food service workers and linens cleaners and teachers and religious leaders are in and out all day.
Each contact point is a potential coronavirus entry-point — and a point of concern, Deitch said.
Jails have a greater risk, Deitch said, because of the constant churn of new inmates and people being released from custody. Many people being booked have existing health conditions that could leave them especially susceptible to illness. And others who are being arrested and might not show symptoms but could still transmit the new coronavirus to others.
Most jails are already at or near capacity. That means isolating someone who might be showing signs of an illness or quarantining those who may have been exposed can be all-but-impossible, especially in older, dilapidated facilities.
“It raises so many operational issues and we are woefully unprepared for it,” Deitch said.
Washing hands, sanitizing communal spaces and so-called social distancing are among the main ways experts say people can help limit the spread of the virus.
They’re also difficult to do when cleaning chemicals and even functional sinks are hard to come by in a cell and every minute of the day is spent in close quarters with other people.
“A lot of the public health measures one would take ordinarily, you can’t do there,” Deitch said.
Jails are used to responding to small outbreaks — like tuberculosis or mumps — that require minimum levels of quarantine and isolation, said Dr. Homer Venters, former chief medical officer of New York City jails. Now a national expert and consultant on jail health care and jail conditions, Venters said he is especially concerned about what a large-scale outbreak could mean for daily jail and prison operations.
“We also have to anticipate that staff will get sick,” Venters said in an interview this week. “If this virus is in the community, it’s going to be in the jails.”
An effective response will require robust record-keeping to identify especially vulnerable inmates, like those who are older and have chronic medical conditions, Venters said. Keeping track of that requires enhanced screening and communication between correctional staff, county agencies and other health experts — a tall order in California’s vast and fragmented correctional systems.
“Because we have so many county jails, they should not be developing the response systems on their own, nor should the state prison system,” Venters said this week. “It should be in concert with the health authorities.”
Sonoma County, where there has been at least one confirmed case of the COVID-19, has added a litany of screening questions about coughing or fever to its jail intake process after consulting with health officials. Anyone with a prolonged cough or high fever is immediately flagged for a follow-up evaluation.
“If they do, then we take them for medical clearance to the hospital,” Sgt. Juan Valencia said Friday. “A lot falls on patrol when they’re contacting people and arresting people.”
And Alameda County, which has about 2,600 inmates in its Santa Rita Jail, has been dealing with a seasonal influenza outbreak for about three weeks, said Sgt. Ray Kelly, a sheriff’s office spokesman. The jail stockpiled extra supplies and quarantined sick inmates who had close contact with them. Kelly said the number of cold and flu cases has declined as COVID-19 concerns intensified in the Bay Area.
The sheriff’s office has asked police departments to use extra discretion when deciding who to bring to jail.
“Where they can cite people who have cold or flu symptoms, we’re asking them to do so,” Kelly said.
Prisons organize
Though prisons have relatively more stable populations than jails, they are also prone to outbreaks of infectious disease, said Steve Fama, an attorney with the Berkeley-based Prison Law Office. Since the group sued the state over conditions in prisons decades ago, Fama’s primary work has been overseeing health care in them.
“One might say that as vastly different as the environments are, an analogue might well be a cruise ship,” Fama said. “The difference here, of course, is you have people coming and going — the staff.”
California Correctional Health Care Services, the group providing health care in California’s prisons, has generally done well responding to past outbreaks, including mumps and norovirus, Fama said. Now, the state’s prisons are using their seasonal influenza protocol as a template and adjusting as more is learned about how exactly the new coronavirus is spread and where it has been detected.
“There’s a lot of uncertainty and that ain’t’ limited to the prison system,” Fama said Thursday. “As society in general, it’s still being determined what should be done and when.”
In a lengthy statement, CDCR spokeswoman Dana Simas said an expansive workgroup with health care and custody staff were preparing for a scenario where the virus spreads into the prisons.
“There are currently no suspected or confirmed cases of COVID-19 within CDCR institutions,” Simas said Thursday. “However, we are proactively refining our established infection control practices to prevent the spread of any communicable diseases.”
Prisons could go on “modified programming,” a slightly less restrictive status than a full prison lockdown. If the illness were to enter a prison, officials could order inmates to stay in their cells, prevent them from going to common dining areas, and limit movements to only essential appointments.
Simas also said CDCR was displaying fact sheets and posters to keep incarcerated people and staff informed. Officials were providing disinfectant and cleaning supplies across facilities. And all inmates entering the prison system, and those who return from county jails where they have ongoing court cases, will also receive a “comprehensive health screening and assessment.”
There were no plans as of Thursday afternoon to close visitation in the state’s prisons.
“If there is a significant impact on staffing at CDCR institutions visitation may be postponed,” Simas said, “but the department is doing all it can to avoid this scenario.”
By Friday morning, more than 100,000 people globally had been infected with the new coronavirus, according to a map maintained by Johns Hopkins University. At least 3,400 people have died, including one person this week in Placer County and 13 in Washington.
In response to the surge in cases and deaths in the Pacific Northwest, the Washington State Department of Corrections increased its health screening measures, said Janelle Guthrie, a department spokeswoman.
Officials haven’t restricted visitation yet. But they are encouraging people with any sort of illness to use video visitation instead.
“This,” Guthrie said, “is an evolving situation.”
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