State prisons have potential for nearly 100% infection rate

Row of bars and American old prison cells

The Arizona Public Health Association is urging the state’s health director to do more to prevent the spread of coronavirus in the prisons as studies and public health officials predict a nearly 100% infection rate.

The state currently houses more than 41,000 inmates who have no way to socially distance themselves from behind bars and are not permitted to wear any face protection, which could lead to a high number of positive cases over the next three weeks.

Will Humble, executive director of the Arizona Public Health Association and the state’s former health director, said if inmates end up in a more serious medical situation, they would end up in the regular community hospital system.

“How’d you like to be a hospital trying to deal with COVID patients from the community and now you have a contract with DOC, and you have all the extra security things that you have to deal with?” he said.

The private health organization, which wrote a letter on behalf of the American Friends Service Committee, urged Department of Health Services Director Cara Christ to make sure the prisons are doing enough to protect the health of inmates and employees.

“I urge you to direct your team to ‘…evaluate the medical and health-related facilities and services that are provided to inmates to determine that the facilities and services meet the applicable standards that are adopted by the director of the Department of Health Services,’” the they wrote on April 21.

Caroline Isaacs, the program director for American Friends Service Committee-Arizona, said her group and the health department held a call on April 24 to go over measures the prisons could take to become safer.

“They heard our concerns and agreed to provide us with some information, including what specific direction they have given ADC,” Isaacs said.

Will Humble

Humble said his expert advice for the corrections department would be to ask DHS to “lend me one of their most talented epidemiologists to come in and do advisories at all the prisons and just create a checklist form.” Granted, Humble said he does not know what measures prisons are taking, since he no longer is at DHS.

“But I do know, what I would want is to have somebody who’s a professional at Infection Control and Prevention to come in and give me some pointers about how to change our processes from how they operate all day long,” he said.

A spokesman for DHS said the department has had an epidemiologist assigned to serve as a liaison to the Department of Corrections “since the beginning of the outbreak.”

“They helped draft the Arizona specific correctional facility guidance and continue to provide technical assistance, as needed,” spokesman Chris Minnick said. “At this time, our understanding is that ADCRR is complying with CDC recommendations for COVID-19 in correctional settings.”

Minnick did not go into further detail or express any inclination that Christ would sway corrections into including infection information about prison employees.

At least one staffer and one inmate at Perryville prison, both of whom work in the kitchen, have tested positive for COVID-19, but the corrections department hasn’t allowed any other inmates there to be tested, and refuses to release data about testing employees.

The only reason the information about the staffer came to light was due to public records that ABC15 obtained showing the employee in the prison contracted the virus, and after prison officials circulated a memo saying that nobody else was at risk, ABC15 received a tip from a union worker that the employee who tested positive worked in the kitchen where they have repeated contact with inmates. The prison would neither confirm nor deny that claim.

Carlos Garcia, the executive director for the Arizona Correctional Peace Officers Association, described a kitchen employee being infected as a worst-case scenario.

“The worst person who can catch this is a kitchen officer…They’re having contact with inmates left and right, staff left and right. It’s close proximity,” Garcia said.

Citing federal medical privacy laws, the Arizona Department of Corrections has refused to release information on the number of staff and officers who have tested positive for COVID-19. Other states have been routinely releasing that information – either meaning those states aren’t following the law, or Arizona is applying it too broadly. The Governor’s Office does not seem likely to force the department to release testing information about its employees, either.

Patrick Ptak, Gov. Doug Ducey’s spokesman, said via text that agencies are “prohibited from disclosing information that would reveal an employee’s identity or confidential medical information.”

Of course, nobody is seeking their names, only the number of guards who have tested positive – the same information the department already provides about inmates daily. Ptak did not respond to any follow up questions including the legal basis for withholding information. Corrections Director David Shinn previously acknowledged that prison staffers have tested positive, but he did not know the number of such cases.

One prison reform organization said the lack of information and transparency coming from corrections is “unconscionable.”

“There seems to be an inordinate amount of desire by government leaders to keep the public in the dark as much as possible about what is truly transpiring in our nursing homes and prisons,” said Donna Hamm, director of Middle Ground Prison Reform. “These are the places where our most vulnerable populations live.”

Hamm said though at least in nursing homes patients are in separate rooms with clean showers and bathrooms and have plenty of soap and can wear protective gear if they so choose. The same cannot be said for inmates.

Donna Hamm

“The vast majority of prisoners live in dormitory and bunk bed style open rooms separated by about three feet,” Hamm said.

She said she has also heard reports from prison staff that inmates don’t have soap at all or worse.

“Inmates [are] being turned away when attempting to report to medical; coughing/wheezing inmates filling the dorm space at night; staff members not wearing masks; staff not changing gloves even after conducting strip searches; dining halls filled with people and no attempt to social distance,” Hamm said.

Meanwhile, Shinn continues to repeat his unsubstantiated claim that prisons are safer than the general community. In a letter to Hamm and later on KTAR, Shinn said, “The greatest threat that we face right now is not within our prisons; it is truly within our communities.”

Humble disagreed.

“The virus comes in with the staff and once it’s in, then it’s gonna spread, and it’s in close quarters,” Humble said. “It’s an environment much like a cruise ship, to be honest.”

And in prison, social distancing is not an option. Plus inmates are prohibited from wearing face protection despite them being put to work to make masks for prison staff and other law enforcement throughout the state and “each and every state employee.” Though at first, employees were told to not wear masks because it would scare the inmates.

Now, while prisoners are separated from the public, employees come and go from their respective communities, likely spreading the virus inside and outside the prison walls even if they don’t show symptoms.

“They could still be asymptomatic and spread it to the inmates,” Humble said.

But inmates still are not being tested.

Perryville, the all-female prison complex in Goodyear, houses roughly 4,100 inmates, one of the most populated facilities in Arizona. But it didn’t test a single inmate there until April 25. The test came back positive two days later.

Testing rates at other prisons are abysmally low, while rates of infection among those tested are more than double the statewide average. Only 0.5% of inmates have been tested so far.

The most recent testing numbers show the Department of Corrections, which houses 41,500 prisoners statewide, has conducted 210 tests on prisoners showing symptoms of the coronavirus – 50 came back positive and eight are still pending. That means prisons have a 25% positive rate of COVID-19, which is 2.5 times the statewide rate (discounting the pending tests). As of April 30, the rate of positive results among those tested statewide is just roughly 10% (7,648 positive cases and 71,786 people tested).

One simple improvement the corrections department could make would be to take the temperatures of prison staff every day to monitor the situation. However, it needs to do a lot more to prevent the virus from rapidly spreading throughout the prison communities. Humble said it really comes down to testing.

“You have to have the testing capacity in order to identify who’s got the illness and who doesn’t. And then you put mitigation measures in place,” he said.

Hamm agreed that testing is the most important practice to be done, but also suggested other measures.

“The ADCRR could take vastly more aggressive measures to reduce the spread by simply temporarily issuing alcohol-based cleaners, plenty of soap, masks to each prisoner, and requiring staff to wear gloves that are changed frequently and to wear masks themselves. Finally, testing, testing, testing of both staff and inmates,” she said.

A recent study estimates roughly 99% of the state’s prison population will test positive for COVID-19.

FWD.us based its projections on the Recidiviz COVID-19 Model for Incarceration, which uses “incarceration-specific” measures of how COVID-19 would likely spread within a prison or jail, along with state data on incarcerated populations to generate a likely estimate of total future COVID-19 cases in the incarcerated population, and related hospitalizations and deaths.

“Without population reductions and more protective measures within prisons, COVID-19 will peak in Arizona’s prisons in about a month,” the model predicted, estimating 41,000 inmates testing positive and 3,100 employees. Though staff numbers are currently unknown, union workers and some employees have provided estimates that roughly 30 employees have tested positive.

Advocates have been calling on Ducey to release nonviolent inmates to help save some lives, but that option does not seem to be likely. Under its current projection, FWD.us estimates at least 1,400 incarcerated people will be hospitalized, utilizing 12.6& of Arizona’s total hospital bed capacity.

“Over its course, and without action, the virus is projected to kill 360 individuals incarcerated in Arizona prisons, three times as many people as are currently on Arizona’s death row,” it says.

And if numbers get that high, there’s no telling if the prisons will be equipped to handle that many hospitalized inmates at their facilities.

“I hope they [projections] are dead wrong, but we should be acting as though they are spot on,” Hamm said.