By Elizabeth Thompson
Until last week, North Carolina’s most recent surge of COVID-19 cases had largely spared the state’s prisons.
Even as the fast-spreading Delta variant turned the state entirely red on the Centers for Disease Control and Prevention’s community transmission map — denoting “high” rates of spread — the state’s prisons facilities had a modest number of cases.
Cases in the state’s prisons had been hovering around 20 cases on the state’s COVID Dashboard for much of July and early August among close to 29,000 people incarcerated.
More recently that number has increased to 78 cases across the prison system, as of Aug. 26. The Department of Public Safety has tested an average of 217 offenders per day in the past week, according to its dashboard, as of Aug. 26.
What’s driving the increase? Delta in the state’s 97 jails.
In the weekly North Carolina Department of Health and Human Services report regarding outbreaks in congregate living settings released Aug. 24, there were a total of 639 positive COVID-19 cases caused by ongoing outbreaks reported among staff and detainees in jails, 98 more cases than the previous week.
John Bull, spokesperson for the Department of Public Safety, said contact tracing has linked about 80 to 85 percent of new cases to COVID in the state’s jails.
“These offenders arrived positive for COVID-19, and did not contract the virus in the prisons,” Bull said in an email to North Carolina Health News.
Out of the state’s 55 prisons, the facility with the most cases — 27 as of Aug. 26 — Piedmont Correctional Institution, is a processing center for new arrivals from the jails, Bull said. Inmates transferred to the prisons are placed in quarantine upon arrival, and other inmates who test positive for COVID are separated from the rest of the population and put in medical isolation, Bull said.
While prisons have a relatively static population with a relatively high vaccination rate among those incarcerated, jails experience more churn, which could lead to more COVID cases in those institutions. These cases can spread to both the prisons and the communities as jail detainees get moved around.
Over the past three weeks, close to 400 new cases have been reported in outbreaks across the state’s jails.
COVID clusters in jails
Johnston County Jail has had a total of 105 cases since its most recent outbreak started, according to DHHS data.
The outbreak numbers reported on the DHHS COVID website don’t indicate total positive cases for that day or total active cases, only the number of cases reported since the outbreak began around mid-June, said Johnston County Jail Administrator Mike Carson. Three new cases were reported from Aug. 17 to Aug. 24. That’s a problem in the enclosed environments of jails and prisons especially since the Delta variant has been found to be two to three times more transmissible than the original strain of COVID-19.
Some of the state’s correctional institutions have also reported over 50 people testing positive since their outbreaks started this summer.
The Alamance County Detention Center reported 62 positive COVID cases since its most recent outbreak began, Rowan County Jail reported 68 and Davidson County Detention Center reported 79.
“Once it gets one place, it seems to be growing and growing,” said Johnston County Jail Administrator Mike Carson.
In order to limit spread, jails have different procedures to screen the population. In Johnston County Jail, Carson said detainees are not necessarily tested at the door, but they are screened for symptoms and sent to an intake block where they stay until they are tested. Once they are tested and show no symptoms, they are reassigned to a different location.
At Alamance County Detention Center, arrestees are screened and tested for COVID at intake, said Michelle Mills, the facility’s director of communication. Then they are quarantined, no matter the results, before being released to the general population.
Fluidity between jails and the community
While prisons are more closed off, jails are interlaced with their communities. At the Johnston County Jail, like many others, new intakes are people who are arrested off the street and can’t make bail, or who are given a secure bond. During times of COVID, there are a lot of implications to that, said Eric Reinhart, lead health and justice systems researcher at Data and Evidence for Justice Reform at the World Bank.
There is a large influx of people going into jails who could bring the virus into the facility, Reinhart said. Many times unbeknownst to them — they could be asymptomatic, or recently exposed to the virus.
“There’s all these kinds of dynamics that every single day you have hundreds of people going into each of these facilities, who could be infected, and they’re new to that facility,” Reinhart said. “Whereas in prisons, people are typically serving sentences longer than one year, they have been convicted of crimes, as opposed to 75 percent of people who are in jails who have not been convicted.”
Kristie Puckett-Williams, North Carolina Campaign for Justice manager at the American Civil Liberties Union, said she thinks jails are more dangerous than prisons, when it comes to the virus.
“It’s people coming in and out of community coming in and out, in and out and disrupting the continuity of the community,” Puckett-Williams said.
Jails are transient, Puckett-Williams said, so it is harder to keep those spaces infection-free than in prison, where there is less movement. Prisons also have a lot more space for quarantine than jails do.
“You have people who have been dealing with chronic homelessness coming into a jail facility,” Puckett-Williams said, “have not seen doctors that may have TB, that may have Hep C, all these things that we see overrepresented in the carceral community.”
Disease spread among the state’s incarcerated population does not only affect those who are detained, Reinhart said. Staff move in and out of these institutions too. There was a 23-case increase in staff cases reported in jail outbreaks this week.
A study Reinhart published in 2020 found that almost 16 percent of documented COVID cases in the entire state of Illinois in April 2020 were linked to the Cook County Jail in Chicago.
“We’ve known this for a very long time, that jails and prisons are extremely high-risk spaces for the spread of infectious disease,” Reinhart said. “They effectively act as incubators for bacterial and viral illnesses that spread among people who are detained at these facilities, spread them with them as they leave and also spread among staff.”
“It’s inevitable that if you have an outbreak of infectious disease in a carceral facility, it spreads to surrounding communities,” he said.
Tools to reduce spread
Research shows that incarcerated people are more likely to be uninsured and more likely to have chronic health problems, putting them at risk for hospitalization due to COVID. Two people in the state prisons were recently hospitalized, according to DPS data.
Reinhart advocated for carceral institutions to reduce populations to reduce transmission rates, beyond the 3,500 that the Cooper administration were told to release by the courts. He also called for proper ventilation and use of air purifiers with HEPA filters or germicidal UV lamps.
It’s hard to know just how many detainees across the state’s jails are vaccinated, since not all jails check vaccination status and there is so much movement in and out of the facilities. Staff ise not required to get the vaccine either, but both Alamance and Johnston County jails require staff to be masked up at all times.
Alamance County Sheriff Terry Johnson said the jail’s most recent outbreak was caused by an unvaccinated person, the Burlington Times-News reported.
“We have quite a few [employees] that have not been vaccinated, and we have clusters of COVID in our jail right now, and my concern is that individuals that are in the jail, they don’t have a choice to get out and go,” Johnson said at a recent Board of Commissioners meeting, according to the Times-News. “What’s in our jail, it was brought in by a person that was not vaccinated.”
‘Working through protocols’
The prison system’s Chief Medical Officer Arthur Campbell attributed some of the prisons’ success in keeping COVID out to vaccination, Piedmont-Triad public radio station WFDD reported.
The state’s prison system launched a robust vaccination effort among prison leadership to encourage vaccination for both staff and inmates, Bull said.
Videos featuring the prisons’ chief medical officer and other medical staff educating and encouraging people to take the vaccine continue to be played across all prison facilities.
Approximately two-thirds of the state prison system’s inmates are vaccinated, and Campbell said an estimated 16 percent have already had COVID and thus have some immunity. By contrast, about half of prison staff remain unvaccinated.
“I would absolutely, without hesitation, argue that every public employee who is charged with protecting vulnerable populations, should absolutely be mandated to get a vaccine in order to keep their job,” Reinhart said. “It is part of their job to protect people.”
Prison employees are included in the group of state employees covered by Gov. Roy Cooper’s executive order requiring those in cabinet departments to provide proof of vaccination or mask up and get tested weekly for COVID. Jail employees, who work for individual counties, are not.
When asked how masking will be enforced for unvaccinated state employees throughout the state at a media briefing with the Coronavirus Task Force last Wednesday, Cooper said that supervisors will be responsible for making sure masking is being observed.
“They’re also working through protocols on what are the consequences for employees who just simply are not going to get tested and not gonna wear masks,” Cooper said. “…The idea here is to get people vaccinated, and we’re using this period of time to work to talk with people to hear their concerns and convince them to get vaccinated.”
Whether staff and inmates are vaccinated or not, Puckett-Williams advocated for good personal hygiene and the ability for those who are incarcerated to social distance — which can be a challenge in a communal living facility such as a jail or prison.
“I just want people to remember that incarcerated people are people, that we’re not talking about cases with numbers,” Puckett-Williams said. “We’re talking about people. What do people deserve? Do they deserve to live?”