Hawaii officials dealing with the rapid spread of COVID-19 at the Oahu Community Correctional Center find out what many of their opponents on the mainland already know: once the virus has entered a prison, it is almost impossible to to contain it without immediate action to clear up tests and disperse the inhabitants.
Dense neighborhoods, limited access to sanitary facilities and a large population of elderly residents with chronic diseases make prisons particularly vulnerable to the spread of highly contagious diseases. Researchers at the Johns Hopkins Bloomberg School of Public Health reported last month that COVID-19 case rates were 5.5 times higher and escalated much faster in prisons than in the general U.S. population.
As in Hawaii and other states, one of the remedies to limit infections is the release of certain categories of prisoners to make more room for physical distance. The California Department of Corrections and Rehabilitation, which oversees 35 adult prisons, has released about 10,000 inmates since mid-March and could release up to 8,000 more by the end of August.
As of Thursday, there were 96,881 people in California prisons, with 1,036 active cases of COVID-19. In all, there have been 9,135 confirmed cases and 53 deaths among residents, according to CDCR. In addition, there were 2,235 confirmed cases and nine deaths among employees.
Other measures taken by the California prison system include activating a centralized command of health care staff and staff, providing masks and hand sanitizers to all staff and inmates, suspending intake from county jails, reducing the number of people living in common areas at the same time using time, setting up transfers of persons from dorms to individual cells and tents to serve as alternative housing and isolation / quarantine option.
Dr. Stefano M. Bertozzi, a professor of health policy and management at the University of California, Berkeley, School of Public Health, was a member of a team of medical advisors who run the state’s oldest prison, San Quentin, in the middle of June when only 14 COVID-19 cases were reported. As of Thursday, there were 2,233 confirmed cases, and now Folsom is teetering after a similar explosion of infections.
Bertozzi, who is associated with Amend, a group working to improve the health of its residents, said he had no information about the situation in Hawaii, but that “it is very important to look at the different levels of risk depending on the facility. ” Speaking through a California Zoom video call, he said that prisons at much higher risk for the rapid spread of COVID-19 have collective housing in bedrooms or cell blocks with bars where residents spend hours together to breathe the same air – “a perfect set up for one of these super-spreading events ”- versus facilities where the population is spread out in cells with doors, walls and adequate ventilation.
In the case of the San Quentin outbreak, according to Bertozzi, there were only 100 individual cells to house the 620 residents from a five-level cell block that had to be quarantined.
‘They did not act fast enough to get them into hotels or bedrooms or any other facility where they could have, like a cruise ship. They tried to be creative, but it did not happen; they did not catch them in time and it ended up infecting the vast majority of the people in the cellblocks, ‘he said.
Bertozzi mentioned three essential actions to limit the outbreaks of prisons in their early stages: “cohorting” of residents and staff; widespread testing with rapid turnover; and release of prisoners, especially those at high risk for serious health complications.
“You want to divide that prison into a bundle of small prisons, even if it’s in the same prison,” he said. ‘You want pieces of prison to deal only with themselves and not to interact over cohorts. That you want prisoners who are in a certain part of the prison to stay with those prisoners and not cross over, and you want the staff who interact with those people to work only with those people. And if you have someone who needs to cross over, they take extreme precautions. They are tested very often, ideally every day they cross, and they use stricter PPE (personal protective equipment)….
“And you also have to really work on social distance and wearing mask for everyone in prison, but especially for the staff, because that’s the route of introduction in prison.”
Turnaround testing is a problem across the country, but it is essential to prevent transmission, Bertozzi added. “You really need to get the test labs to place these tests at the top of priority list, because there is no place that is at a higher risk for a rapid spread than a prison set-up. Where else do you have dorms with 200 men? “
And finally, “let people … that’s really important.”
The good news for California, Bertozzi noted, is that the number of active cases in custody has fallen since early July, though that may change as the Folsom outbreak gets steam.
