UP CLOSE: Prisons hit by a pandemic

UP CLOSE:
Prisons hit by a pandemic

In Connecticut, the COVID-19 crisis has brought the prison healthcare system under even further scrutiny.

Published on April 22, 2020

In January 2017, Patrick Camera complained to the medical staff of Osborn Correctional Institution about ongoing sinus and nasal pain.

During the months that followed, Camera repeatedly visited the medical unit, sometimes multiple times a day, to get Tylenol or Motrin for his bleeding nose. But after a June chest x-ray that did not reveal abnormalities, the staff began turning Camera away. By August, his nosebleeds had twice required a team of people in hazardous material suits to clean up after him.

Only when Camera was taken to a hospital in an ambulance in November 2017, did the doctors discover that Camera had a tumor in his nasopharynx that had grown to the size of a baseball and invaded his eye socket and brain.

In September 2018, almost two years after Camera first notified the medical staff about his health conditions, he filed a lawsuit against his doctors and then-commissioner of the Connecticut Department of Corrections Scott Semple. In the lawsuit, Camera alleged that his doctors suspected he was not telling the truth about his symptoms but was attempting to gain access to pills instead. 

In 2019, less than a year after the lawsuit was filed, Camera died of advanced-stage cancer

Camera’s case is one of many harrowing accusations of medical malfeasance across correctional facilities that have been levelled against the Connecticut Department of Corrections in recent years. 

Until 2018, prison healthcare was managed by Correctional Managed Health Care, a division of the University of Connecticut that was charged with providing care to about 13,400 inmates across Connecticut’s 14 correctional facilities. However, after numerous lawsuits, the CDOC flagged 25 inmate medical cases that had ended tragically — including Camera’s. This resulted in the CDOC terminating its annual $100 million contract with CMHC and taking over its own prison healthcare in 2018.

Still, the CDOC has continued to face claims of inadequate healthcare in the two years since its takeover. Last year, a pregnant 19-year-old at York Correctional Institute filed a lawsuit after her request to see a doctor was denied and she gave birth in the toilet of her cell. In January of this year, an inmate died at Osborn Correctional Institution after hitting his head, and two correctional nurses are on leave pending the result of an internal investigation into his death. The CDOC did not respond to multiple requests for comment for this article.

This year, correctional facilities have been hit by the biggest health crisis in living memory: the COVID-19 pandemic. As of April 21, the CDOC reported that they had seen 303 cases of inmate infection in the state and 222 cases in correctional staff. Earlier this month, the state saw the first inmate death from COVID-19 infection — a man in his 60s with underlying conditions, who died after being hospitalized at the University of Connecticut Health Center. And it is not only inmates who are shouldering the impact of the pandemic — healthcare workers and correctional staff are also struggling due to short staffing and a lack of protective equipment, several such workers said in interviews with the News.  

According to Alicia Schmidt Camacho, chair of Ethnicity, Race & Migration, it is not the pandemic that lies at the heart of concerns about health and safety inside prisons. Instead, the pandemic is laying bare the preexisting problems of mass incarceration that both inmates and correctional workers have been facing for years.

A BREEDING GROUND FOR THE VIRUS

The very nature of correctional facilities makes it almost impossible to follow the mantra of the COVID-19 pandemic: social distancing. The Center for Disease Control and Prevention splashes in bold print on its website that the best way to prevent illness is to avoid exposure to the virus. But in a system that relies on shuttering people within close quarters, evading contact with the virus seems unlikely. 

“Prisons and jails are the single most dangerous place to be during a pandemic,” Brett Davidson, founder and co-director of the Connecticut Bail Fund, told the News. “The spaces are filthy, there is no possibility for social distancing, virtually no access to healthcare and widespread dehumanization and abuse. None of these problems are new, but they are all intensified in a moment like this.” 

According to a lawsuit filed by the American Civil Liberties Union of Connecticut, the close proximity of prisoners create the ideal circumstances for a virus to fester. Common areas such as dayrooms, bathrooms and showers are breeding grounds for COVID-19. Even if a facility goes on lockdown, contact is inevitable — between prisoners and staff, or between prisoners themselves, as a simple cell change or trip to the shower provides opportunities for transmission. 

According to Sean Howard, a correctional officer at the Cheshire Correctional Institution, inmates were still leaving their cells and congregating with each other — playing sports such as basketball and handball outside or playing cards with each other indoors. In addition, Howard said inter-facility transfers were still occurring — last week, an inmate transferred into Cheshire with a fever of 102 degrees.

“Prisons and jails are the single most dangerous place to be during a pandemic.”

—Brett Davidson, founder and co-director of the Connecticut Bail Fund

Prisons across the United States also suffer from overcrowding, as the U.S. has more incarcerated people than any other country in the world, both in absolute numbers and per capita. According to data collected by the American Civil Liberties union, while the country has less than five percent of the world’s population, its prisoners account for a quarter for the global prison population. These numbers indicate that it is difficult, if not impossible, for prisoners to keep six feet of distance from one another — especially where facilities like the Willard-Cybulski Correctional Institution house up to 100 individuals in one dormitory-style room. 

Steve Wales, a correctional officer at Corrigan-Radgowski Correctional Center in Montville, said that while the CDOC had restricted activity, inmates were still “mingling all day” as they lived together in one dorm. Corrigan-Radgowski spread out their inmates from 105 to a room to 60 after the COVID-19 outbreak and implemented guidelines for social distancing, but Wales said that the prison had turned into a hotspot for the disease regardless. 

Another key advisory by the CDC is to continuously wash one’s hands — another great challenge in correctional facilities, according to Matt Post ’22, president of the Yale Undergraduate Prison Project. In order to gain access to soap and other personal hygiene supplies, inmates must purchase them from the prison commissary unless they have less than $5.00 in their account, according to the Friends and Family Handbook for Offenders and Inmates released by the CDOC. A memo sent to the prison population about the commissary on April 6 stated that all soaps were sold at cost. 

“By design, these prisons were not set up to promote public health,” Post told the News. “When you put people in cages, in close quarters next to each other, the end result is people dying unjustly.” 

Hand sanitizer is usually considered contraband in prisons, as its alcohol base can be removed from the gel. Yet even if alcohol-free sanitizers were made readily available, the CDC recommends an alcohol content of at least 60 percent to effectively combat COVID-19. According to the ACLU-CT’s lawsuit, cleaning equipment is also often frequently in short supply or diluted, and the strong cleaning agents — such as bleach — needed for high-touch surfaces like doorknobs and light switches are often unavailable. 

OVERWORKED AND UNDERSTAFFED 

Unions across the state who represent healthcare workers and other correctional staff have been warning the CDOC about understaffing for years. According to a document provided by the CDOC to the legislature’s nonpartisan office of fiscal analysis last March, the department had 309 nurses on staff for 12,320 inmates, and one medical provider — a doctor or physician’s assistant — for every 579 inmates. 

“We’ve been alerting the state for a couple years now that the healthcare staff in prisons is too short,” Pedro Zayas, spokesperson for Connecticut healthcare workers’ union SEIU Healthcare 1199NE, told the News. “You can see that if you look at the overtime numbers even before the crisis began. There’s just not enough frontline staff for each shift.” 

One nurse at Northern Correctional Institution, which currently houses all Connecticut inmates who have tested positive for COVID-19, painted a bleak picture of work conditions. Ellen Durko, who is part of SEIU Healthcare 1199NE, told the News that there were only two nurses on staff every shift to care for the COVID-19 positive inmates at Northern. Northern Correctional Institution could not be reached for comment.

As Northern is part of a cluster of four correctional facilities in the area, Durko said that staff were stretched so thinly that two of the facilities were left “high and dry” without a nurse on night shifts when healthcare personnel were diverted to COVID-19 patients. If there were an emergency in one of those facilities in the middle of the night, Durko explained, there would be nobody on-site to provide immediate care. All nurses are required to work double shifts, she said — 16 hours without relief for meals or breaks. 

“I’m utterly exhausted,” Durko said in an interview with the News. “I was mandated 16 hours twice within the span of four days. Sometimes I feel like I’m going to pass out when we’re doing the assessments.” 

Durko said that she typically engages in an assessment of 60 to 70 inmates on one shift with one other nurse. Her equipment consists of one vital signs machine and one pressure cuff. She wears a disposable gown intended for single use throughout the week, and the strap on her mask is already broken from overuse.

In response to the pandemic, press releases by the CDOC and its commissioner Rollin Cook state that the department has discontinued all social visitation, suspended inmate community work crews and increased cleaning efforts and availability of soaps at facilities. Lawyers are encouraged to make legal calls in place of visits, and nonessential inter-facility transfers have been limited. Staff have also waived the $3 co-pay usually required for medical attention.

“I’m utterly exhausted. I was mandated 16 hours twice within the span of four days. Sometimes I feel like I’m going to pass out when we’re doing the assessments.”

—Ellen Durko, nurse at Northern Correctional Institution

Yet, according to Durko, correctional staff had been left with their “mouths wide open” as the pandemic unfolded and the CDOC remained inert. She said that as the state closed down schools, bars and restaurants in March, prison functions — such as non-essential transfers and work assignments — continued. As the CDOC lacked a “concrete plan,” Durko said, and nobody from the Central Office at the DOC had updated nurses, staff at Northern were told to construct the COVID-19 unit just hours before sick individuals were set to arrive.

In interviews with the News, correctional officers told the same story of a system unprepared for a crisis. Wales, who is the corresponding secretary for the union AFSCME Local 1565 as well as a correctional officer, said that staff at Corrigan had only received N-95 masks last week. According to Wales, this was despite warnings from union members as early as December that the department lacked PPE equipment.

Howard, who is also president of the union AFSCME Local 387, told the News that correctional officers desperately needed personal protective equipment as they came into close contact with inmates daily to perform pat-downs and searches. 

“I worry every day, because not only do I worry for myself, I worry for my fellow co-workers and our families that we’re going home to after we do this job for 8–16 hours,” Howard said. “It’s a dangerous time, and it’s even more dangerous during this COVID time when [the CDOC] isn’t giving us the proper equipment to do our job.” 

Howard said that, like healthcare staff, correctional officers are mandated overtime and becoming increasingly short-staffed as they continue to come down with the virus. 

“TORTURE IS NOT A PUBLIC HEALTH SOLUTION” 

The CDOC announced that all inmates who have tested positive for COVID-19 after April 8 will be transferred to an isolation unit at the Northern Correctional Institution in Somers, Connecticut. Upon testing negative for the virus, the individual would be returned to their original facility. 

Northern is Connecticut’s “supermax” Level 5 security prison. The facility has a capacity of 500 — generally isolation units — and is designed to hold male convicts serving long-term sentences for highly violent crimes. It also housed inmates on death row before Connecticut abolished capital punishment in the state in 2012. 

As of April 17, the CDOC said that 170 COVID-19 positive inmates had been transferred to Northern. If an individual’s situation worsens, the CDOC said, they would be transferred to a hospital.

“Solitary confinement is bad enough on its own, but when you start to have massive numbers of people without adequate planning at a facility that is known for inhumane treatment — you’re going to see incredibly devastating conditions,” Joseph Gaylin, a steering member for the social justice organization Stop Solitary CT, told the News in an interview. “The other problem is that, since they know they’re going to face something akin to solitary confinement, transferring COVID-positive inmates to Northern CI disincentivizes people from self-reporting their symptoms.”

Stop Solitary CT has long been advocating for the closure of Northern and the abolition of solitary confinement. In an open letter to Connecticut Gov. Ned Lamont, the group claimed that “torture is not a public health solution,” and in fact, solitary confinement constituted a public health crisis of its own because of its psychological toll. Studies of prisoners placed in isolation have reported depression, intrusive thoughts or symptoms of psychopathology such as hallucinations and perceptual distortions. 

The Allard K. Lowenstein International Human Rights Clinic at Yale Law School penned a letter last year to the United Nations Special Rapporteur on Torture, urging the rapporteur to declare that the DOC’s use of prolonged isolation, especially at Northern, constitutes torture under international law.  

In their report, the Lowenstein Clinic collated multiple testimonies of individuals incarcerated at Northern.  The clinic found that the isolation cells at Northern were unsanitary beyond what could be expected in a lower security prison, documenting the use of in-cell restraints and negligence that have led to individuals trapped in cells covered in their own bodily fluids. According to Durko, the CDOC is not letting the COVID-19 positive inmates in Northern shower for the duration of their quarantine. 

“The way that Northern is built is designed to break you down … to make you feel worthless, unwanted and scattered in that building like unwanted remains,” wrote Kezlyn Mendez, an inmate at Northern, in his testimony to the clinic.  “It’s a dump for humans — you can do whatever you want with them. That’s where they dispose what they consider to be trash for the state.” 

However, Durko told the News that she believed the staff at Northern were generally compassionate and cared about the health of their inmates. Durko cited a CERT team — a correctional emergency response team — of officers who had volunteered to work on the frontlines of the crisis, who she said “bent over backwards to do everything they could to make the inmates comfortable.” Durko explained that these officers checked on sick inmates throughout the day and fulfilled requests for materials such as paper and books. She said that this was part of efforts to show inmates that they were supported in overcoming COVID-19. 

“FREE THEM ALL” 

According to Camacho, the nature of a punitive facility means that, in some cases, healthcare staff can have a conflict of interest when providing patient care — especially when doctors are reporting to the prison itself. In addition, she said, for-profit prisons have a motive to restrict and reduce costs. 

“Things like dispensation of medication, access to quality care, checkups, exercise, education, mental health services — all of that gets reduced,” Camacho said. “And as this is a population that’s captive and largely invisible to the larger society, there’s very little accountability around that. So decisions are made, like keeping calorie counts very, very low and restricting access to medicines.” 

A lack of sufficient prison healthcare, combined with the aging prison population in Connecticut, means that many prisoners are among the most vulnerable to COVID-19. The virus is known to most heavily affect older individuals and those who are immunocompromised. 

A coalition of organizations — including the Lowenstein Clinic, Stop Solitary CT and the Connecticut Bail Fund — penned an open letter on March 16 calling on Connecticut Gov. Ned Lamont to release at-risk prisoners throughout the state. 

The letter specified suggestions for pretrial release and post-conviction release. The former concerns individuals who cannot post bail and are imprisoned before they are sentenced; the latter is directed towards individuals who are serving a sentence but are particularly vulnerable to COVID-19 due to their age or health status. 

“There are certain buckets of people where we believe the governor can pretty quickly get people out,” Gaylin said. “There are over 2000 people that have less than a year left on their sentence, and 1600 people in prison for technical violations. There’s over 5000 people who are parole-eligible, and 3000 people that are unsentenced.” 

One group has been lobbying politicians across Connecticut with the broadest call: to free all incarcerated individuals in the state. The Connecticut Bail Fund is demanding full decarceration and a moratorium on the incarceration of any new individuals. 

“In a rapid response manner, we established a prison support hotline, we dramatically grew our commissary fund, and, for the first time in four years, we depleted our bail fund, getting as many people out as possible,” Davidson, co-director and founder of the Bail Fund, told the News. “We are trying to put resources in the hands of families so they can better advocate for their loved ones — both in the courts and on the streets — while also protecting the integrity of our message, which is the total illegitimacy of the system and the need to free all incarcerated people globally.”

The Bail Fund has also spearheaded several protests outside correctional facilities across the state and outside Lamont’s mansion. In order to adhere to social distancing guidelines, organizers have turned out in their cars in “honkathons” in place of traditional protests. In the past two weeks, the Bail Fund has posted videos on Facebook of organizers chanting and leaving their cars outside correctional institutions to wave flags emblazoned with the words “Free Them All.” 

A SLOW RESPONSE 

The ACLU-CT has claimed that over 100 government agencies have mechanisms they can use to legally release prisoners.  Police officers, at their discretion, can choose to serve individuals accused of misdemeanors with written complaints or summons instead of arresting them on the spot. The 13 state’s attorneys and the chief state’s attorney have the power to alter pretrial detention recommendations, modify existing sentences or adjust their own sentencing recommendations. The Board of Pardons and Paroles has independent authority to grant paroles and commutations to people who are incarcerated. For specific offences, such as individuals convicted of certain motor vehicle and drug offences, the DOC could recommend release from facility to homes under electronic monitoring.

Most activists have focused on the CDOC and Gov. Ned Lamont, as the two could use emergency powers to immediately release large swathes of people. 

Following protests outside Lamont’s mansion on April 6 by the activists and families who had members incarcerated, the governor eventually agreed to a meeting to discuss releases. Lamont offered a meeting for April 9, which he rescheduled for days later and eventually cancelled, according to a press release from the Katal Center for Health, Equity, and Justice. Lamont did not respond to a request for comment on this story.

In a press briefing on April 7 with Lamont and CDOC Commissioner Cook, Cook said that the prison population count had dropped by 727 people since March 1 — the largest one-month reduction in Connecticut history. 

Lamont said the releases were largely focused on “low-violence, lowest-risk” individuals while making certain that they had safe places to return to upon release. Cook said he would not release anyone from a correctional facility who did not have a home to return to, but that the CDOC was collaborating with the judicial branch to analyze the pretrial population to determine their eligibility for compassionate and medical parole. 

Both Cook and Lamont have said that they consider criminal justice reform to be a key priority of their tenures. Lamont supported a bill allowing the erasure of criminal records for misdemeanor offenses and has signed laws increasing transparency around police use-of-force instances and data collected on the criminal justice system. 

“Prior to any staff or offender COVID-19 cases, my direction was clear: review all eligible and suitable low-risk offenders for release without circumventing routine protocols that support public safety as swiftly as possible, and add a layer of review that will prioritize offenders considered high-risk per the CDC guidelines,” Cook said at the press briefing. 

However, an analysis by Hearst Connecticut Media indicates that the drop in prison population since March 1 is overwhelmingly the result of fewer new intakes into jails, not large-scale releases of existing prisoners. 

Prisons across the country have planned to release thousands of inmates in accordance with a memo from Attorney General William Barr to increase the use of home confinement and expedite releases of inmates deemed to be at high risk for COVID-19 infection. California announced that it was releasing 3,500 inmates. New Jersey has moved to release up to 1,000 people from county jails. Internationally, Iran has set free over 80,000 inmates and in Poland, up to 12,000.

Yet, it seems that Connecticut has not quite followed suit. 

“I think politically, there’s always a concern that some of those released recommit a crime — a very narrow, self-interested concern that it will hurt [politicians’] political standing and reputation,” Ethnicity, Race, & Migration professor Daniel HoSang told the News in an interview. “But there’s no direct correlation between prison construction and incarcerations rates and episodes of violent harm or offense. You can see that because there are states that have lower incarceration rates with similar demographics and they don’t necessarily have higher rates of crime.” 

However, some staff at correctional facilities told the News that mass releases were not the solution. Howard told the News that he “strongly disagreed” with decarceration, as he believed it would put a strain on public safety. 

Durkos echoed Howard’s sentiment, saying that some of the inmates she saw at Northern would be unable to integrate back into the general population due to mental illness or lack of impulse control. Others, she said, have substance abuse addictions that prison rehabilitation programs might be able to help keep at bay. 

“Our parole officers in the field are already overworked; their caseload is already very heavy,” Wales said. “If we add [mass releases] to them, and then these guys aren’t properly monitored, I think that’s a bad thing for public safety.” 

COMMUNITY AND REFORM

“It’s growing inequality within our society, and New Haven is one of the most economically polarized cities with a large concentration of people who lack basic social and economic support.”

—Alicia Schmidt Camacho, chair of Ethnicity, Race & Migration

In recent weeks, Lamont and Cook have also emphasized the importance of ensuring that anyone who is released from a correctional facility has a solid plan for reentering into society. Releasing inmates during a pandemic is complex: individuals are facing the typical difficulties of integration compounded by a world facing economic instability and mass unemployment. However, activists explained that their demands encapsulate robust reentry support for released individuals.

“We demand and will fight for a world in which all people have access to healthcare, housing, education, income, restorative justice systems and all the basic necessities of life,” Davidson said. “The current lack of housing for people [outside of] prisons and jails is not a reason not to decarcerate. It’s a reason to couple decarceration with massive investment in public resources.” 

According to HoSang, prison has become somewhat of a “catch-all” for social problems over the years: poverty, joblessness, drug abuse and violence. Instead of directly addressing those problems through meaningful social investment — for example, through education, housing or mental health services — society has generally turned towards the punitive route of incarceration. 

“It’s growing inequality within our society, and New Haven is one of the most economically polarized cities with a large concentration of people who lack basic social and economic support,” Camacho said. 

The problems of overworked staff, inadequate healthcare and unsanitary facilities have been voiced by unions, inmates and prison advocacy organizations for decades. While COVID-19 has certainly exacerbated the issues that predated the disease, the pandemic has critically shown that the boundary between correctional facilities and their communities is easily permeated — according to correctional doctor Josiah Rich’s sworn affidavit in the ACLU-CT’s lawsuit against Cook and Lamont. 

Visitors, healthcare staff, correctional officers, contractors and vendors are constantly moving between correctional facilities and the rest of society, Rich said. As public health resources run dry, sick inmates become a concern for everyone as increased COVID-19 infections pose a greater threat of exposure for the general public. According to Rich, as ICU beds and ventilators are already running short, a surge of critically ill inmates transferred to hospitals could overwhelm public health resources. 

Calls for alleviating the immediate pressure on the prison system have included advocating for mass releases or increasing support within correctional facilities, so staff are better equipped to handle outbreaks and prevent community spread. Others have used this as an opportunity to speculate on ways to fundamentally reshape the justice system — for example, by decriminalizing certain activities and investing the money used for mass incarceration into public resources. Looking forward, however, it still remains to be seen whether the COVID-19 pandemic will spark long-term prison reform, or eventually fade from social and legislative agendas once the crisis has passed. 

“I do think there is an opening here to get people to imagine a world where you can be safe and free of harm, which doesn’t rely on just warehousing people,” HoSang said.

(Wikimedia Commons)

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