“Incarceration affects health. In fact, more than half of the population in prisons and jails are at high risk for COVID-19 because many have chronic conditions. This pandemic has further highlighted the need for better public health measures within the prison and jail systems of our country,” said Homer Venters, a physician, epidemiologist and professor who focuses on public health in correctional facilities.
Shortly after the pandemic took hold, Venters began traveling across the country to investigate the impact of COVID-19 in our prisons, jails and immigration detention centers. Since April, he has visited approximately 12 facilities, from Illinois to Virginia to Tennessee to California. Venters is evaluating whether facilities are adequately detecting and responding to coronavirus cases, if they are implementing steps to slow the spread, and if they are protecting people who are at an increased risk of developing serious complications should they contract the disease.
In understanding the effects of the ongoing pandemic, Venters found that screening systems within correctional facilities are deeply flawed. His work has led him to advocate for the release of prisoners who face heightened risk of death and illness from COVID-19.
In 2020, approximately 2.3 million individuals were incarcerated in this country, according to the Prison Policy Initiative. Even during non-pandemic times, the system is already overwhelmed. Therefore, a pandemic has disproportionately impacted a prison and jail system already inundated with ongoing challenges.
Venters explained that because there is no relevant and reliable data to understand the epidemic curve for COVID-19 inside correctional institutions, there is no understanding of what is actually happening.
“We need to approach incarceration and health from a human rights perspective,” he said. “The voice of those who are impacted is also missing and we need to include them in the ongoing discussions about public health in the prison system.”
Earlier this year, a federal judge appointed Venters to inspect the pandemic response at the federal prison in Lompoc, Calif., after a COVID-19 outbreak of more than 1,000 infected prisoners prompted a class-action lawsuit. Based on his findings, Venters provided recommendations to mitigate the spread of COVID-19 throughout prison and jail systems. However, pandemic or no pandemic, his mission is to increase awareness of the deficiencies in basic public health practices within our prison and jail systems.
“We need to increase advocacy around these issues and I am committed to doing my part in that process,” he said.
Among Oregon’s state prisons as of press time, there were 1,315 confirmed cases of COVID-19 among prisoners and 16 deaths. There were 327 positive cases among staff.
REPORT: Prisoners decry conditions among Oregon state prisons as COVID-19 spreads
The Centers for Disease Control and Prevention released guidelines for correctional and detention facilities in response to the pandemic. While the comprehensive guidelines are broad — including enhanced cleaning and hygiene practices, strategies to limit transmission from visitors, verbal screening and temperature check protocols, and health care evaluations for those suspected of having COVID-19 — the challenge will be in the implementation.
Drawing from extensive research, organizations such as the Prison Policy Initiative are working hard to expose harm due to mass criminalization. Their work allows activists to develop thoughtful campaigns to address the negative impacts of incarceration.
According to Wanda Bertram, the Prison Policy Initiative’s communications strategist, there is no meaningful way to stop the spread of COVID-19 among prisoners unless thousands are released to reduce the impact of living in close quarters. The organization’s health experts indicate people in prison disproportionately suffer from chronic diseases such as diabetes, high blood pressure and HIV. Additionally, there may be conditions related to substance use and mental health. No doubt, these conditions are worsened in the midst of a pandemic.
“Before the pandemic, there were lots of barriers for prisoners to obtain adequate medical care. To elaborate, when prisoners need care for complex medical conditions, they have to petition a judge to allow them to be examined by a specialist. There is a lengthy lapse in time during the process, and as a result, the prisoners’ health is further worsened,” stated Bertram. Such barriers to care need to be addressed in order for us to improve health care in prisons.
Another barrier to care is that prisoners incur copay fees during their medical visits. For many of them, family and friends send financial support to cover those costs. However for some, that poses an increased financial burden. The positive change that has occurred during the pandemic is that the copay has been waived for those who are suspected of having COVID-19 exposure, said Bertram.
According to a piece published by the Prison Policy Initiative with data from the department of corrections in each state, only half the states require correctional staff to wear face masks. Furthermore, fewer than one-third of all states require incarcerated people to wear face masks.
Bertram stated that in order to mitigate the spread of the virus, correctional facilities should create policies that require and provide masks to all employees and prisoners. In Oregon; however, those policies have not always been successful. As The Oregonian reported on Oct. 27, some prisoners and staff continue to shun masks despite mandates and COVID-19 outbreaks. Prisoners in Oregon have been infected at 10 times the rate of all Oregonians.
Juan Chavez, an attorney and project director for the Civil Rights Project at the Oregon Justice Resource Center, said most prisons and jails have a constitutional mandate to provide some medical care. However, he added, the quality of care is not high, and people end up with negative health consequences. Another issue with the current system, Chavez noted, is that it doesn’t allow for preventive health care. In fact, most people go to prison for a period of two to five years and when they are released, their health is in a worse condition.
“Not enough people are considering public health in prisons as they should. The health issues of the incarcerated should not be ignored,” Chavez said. In his daily work, he takes field calls from people in underrepresented communities who seek legal assistance. “The cases we work on are difficult ones. That is the reason we work on them,” he humbly noted.
From his time at the center, he has learned incarceration is a driver of poor public health outcomes. “Some of the prisons are like a petri dish for viruses,” Chavez said.
Our country’s epidemiologists have already provided specific guidelines that we should abide by, but according to Chavez, implementation of the rules is subpar.
The Civil Rights Project he leads was created to examine and track civil rights issues related to the criminal justice system in Oregon. Through programming and advocacy, the project’s goal is to gain equal and fair treatment for those who are incarcerated.
Jennifer Black, the communications manager at the Oregon Department of Corrections, indicated the biggest challenges facing state prisons in terms of health care include poor infrastructure, staffing shortage and retention, increase in the population of elderly prisoners, limited bed spaces and a lack of electronic health records. Currently, all health care records are maintained in chart format. The department is actively involved in acquiring an electronic health records system through the Oregon Department of Administrative Services.
With that said, all prisoners have access to basic health care services from registered nurses, nurse practitioners and medical doctors. The services included are sick calls, emergency needs, infirmary care, dental, optical, laboratory and radiography services, maternity services, behavioral health services and prescribed medications. Black added that all prisoners receive regular physical exams, especially if they are in the facility for longer than six months.
The department launched a COVID-19 tracking tool to track the number of positive cases and deaths at all the correctional facilities in the state. The tracking tool is meant to be used as a communication tool with their stakeholders and the general public.
Even with all the advocacy surrounding issues of public health in correctional facilities, there seems to be a more dire need for it now. As Chavez noted, prisons are there to make people disappear. The incarcerated have long been neglected and sometimes forgotten by society at large. More needs to be done in terms of preventing poor health outcomes and providing high quality care to those in prisons and jails.
As a public health activist, I believe that if we pay attention to the health of the incarcerated right now, we can prevent an even bigger crisis from occurring in the future.