By Elizabeth Thompson

Editor’s note: This story mentions suicide and thoughts of suicide. If you or someone you love is having thoughts of suicide, call 800-273-8255.

This story was updated with additional information from North Carolina Department of Public Safety.

Susan Rouse feels lucky that she hasn’t gotten COVID-19 yet. But that’s not the only thing she’s worried about anymore.

The 74-year-old from Wake County is incarcerated at Raleigh’s North Carolina Correctional Institution for Women (NCCIW), which, like many of North Carolina’s prisons, experienced a surge in cases as the Omicron variant swept across the state in early January. North Carolina Health News previously reported on the toll the new variant could have on the state’s prison system.

Rouse was moved from NCCIW’s minimum security Canary Unit to the prison’s main campus shortly after the Omicron surge began, and the Canary Unit was closed, due to staffing levels.

More than 700 out of the prison system’s roughly 13,000 staff members are currently not able to go to work after testing positive for COVID or being exposed to someone with the virus, according to the North Carolina Department of Public Safety spokesperson Brad Deen.

Even though she is still considered an “honor grade” prisoner, many of the privileges that came with being housed in a minimum security facility – some as simple as being able to get a good night’s sleep, have access to a microwave or work outside the prison – are gone.

As the latest Omicron surge has upended people’s hopes that the pandemic was winding down and caused widespread frustration, the two-year anniversary of the pandemic’s appearance in the U.S. means something different to incarcerated people. 

It has meant lockdowns limiting their already sparse communication with the outside world. It’s also meant fragmented — or eliminated — visits with family and friends. Every time a new surge has started, rules have changed: now you can’t touch your loved one, now your visits are limited to 30 minutes, now your visit is canceled.

The pandemic has made life more unpredictable for everyone, but for prisoners, the lack of predictability has gone up yet another notch. And no matter how much some incarcerated people work toward gaining more privileges with good behavior, COVID outbreaks come and go, completely upending their status quo. 

NC Health News spoke to incarcerated people and their loved ones from across the state as the Omicron variant permeated throughout North Carolina’s prison system. 

After two years of outbreak after outbreak, something is different this time. Some incarcerated people say they’re reaching a breaking point. 

The numbers tell the tale. 

On Jan. 20, the state prisons reported a high of 1,086 active cases, the most cases the state Department of Public Safety has reported at least in the last six months.

Three incarcerated people have died by suicide in North Carolina’s prisons since the beginning of 2022, according to press releases from DPS.

It’s not even the end of January. According to DPS official press releases, there were a total of eight suicides in the North Carolina prison system in 2021.

‘Hard time’ during COVID

As the Omicron variant began to surge in North Carolina prisons, the DPS took temporary actions to stop the spread on Jan. 12 — this included suspending work release programs and suspending visitation at some prisons.

Much of NCCIW is now locked down, which means that incarcerated people spend almost all of their time in their dorms, Rouse said.

“The tension gets higher,” Rouse said. “There’s nothing good about being enclosed all but one hour a day.”

Another woman incarcerated at NCCIW who asked NC Health News to omit her name because she was afraid of retaliation from prison staff said her anxiety was reaching a “fever pitch.”

“None of the women are getting the mental health therapy they need,” she said. “They’re getting worse because they’ve not been able to visit or do anything.”

“You’re really doing hard time right now during COVID.”

Some prisons in the state have isolated people who have tested positive for COVID by placing them in cells typically used for solitary confinement, a practice which is considered psychological torture by the United Nations. Incarcerated people in North Carolina who were placed in solitary confinement were found to be 24 percent more likely to die in the first year after release, in a study by researchers at the University of North Carolina at Chapel Hill. 

DPS spokesperson John Bull said in an email that incarcerated people who have tested positive for COVID and placed in those cells “keep all their privileges as possible.”

“They are not put there for punitive reasons, but for logistical reasons,” Bull said.

Deen said incarcerated people put in cells used for solitary confinement for “health risk mitigation measures” should have access to make phone calls, recreation time and receive mail “unless pandemic safety reasons dictate otherwise based on a prison’s layout.”

Laura Garrett’s boyfriend, who is incarcerated at Greene Correctional Institution, spent Christmas in solitary. He spent a total of 17 days in a cell alone, all the while he wasn’t able to use the phone, she said.

“He didn’t receive my mail while he was down there,” Garrett said. “And he thought that I’d left him… I got letters where he talked about suicide.”

‘Will you still love me if I break?’

Many people outside of prison have experienced times of deprivation during each wave of COVID, but there is generally something to look forward to, said Eric Reinhart, resident physician at Northwestern University Department of Psychiatry and Behavioral Sciences. 

“People in jails and prisons are enduring much more severe deprivations that corrode the basic conditions for life, for sanity,” Reinhart said. “And they don’t have much to look forward to. Maybe in six months they’ll be allowed to go into a slightly bigger cell. But that’s not really so sustaining.”

Jane, whose boyfriend is incarcerated at Johnston Correctional Institution, asked to use a pseudonym for fear her boyfriend would face retaliation. Since the Omicron wave hit his prison, his dorm has been in quarantine. He was sick for more than three weeks but said he was never tested for COVID.

Even though he is supposed to be released in a couple of months, Jane’s boyfriend told her he wasn’t sure he was going to make it.

“‘He’s like, ‘Will you still love me if I break?’ and I said of course,” Jane said.

Incarcerated people are already more likely to have experienced trauma and suffer from mental illness than the general population. One study found that almost half of incarcerated people in Iowa’s Corrections Offender Network were diagnosed with a mental illness.

Not to mention incarceration itself is traumatic, and it often re-traumatizes already traumatized people, exacerbating that past trauma.

That was before COVID. Now, inmates agree that the prison system is worse, from the threat of getting sick with COVID, staffing shortages and restrictions.

Deen said mental health is a priority for prisons, “including what may be manifestations of these conditions — such as fighting and suicide.” He said medical and custody staff are both trained to “recognize and react to these concerns.”

Not just long COVID

As waves of COVID spread throughout the prison, fewer incarcerated people are leaving unscathed.

Deen said DPS “will continue to follow the science and do what is possible to prevent COVID-19 from getting into the facilities, to help prevent it from spreading to other facilities and to confine it within a facility if it does get in.”

NC Health News previously reported on the confusion around testing at NCCIW, during the Delta variant wave.

It’s likely many more people contracted COVID during that wave and the current Omicron surge than were reported, given stories such as the one told by Jane’s boyfriend, and it’s likely many people reentering society from prison will have long COVID, Reinhart said.

“The way that COVID is going to affect them is not just through what the general population we’re referring to as long COVID,” Reinhart said. “It’s going to affect them by synergistically interacting with chronic diseases from which incarcerated people suffer disproportionately in part due to lack of access to good health care.”

Long COVID is not the only thing formerly incarcerated people might bring home with them, Reinhart said. The trauma of being incarcerated during the pandemic will be coming home too. 

“The psychic weight of the pandemic is a lot heavier on people who live in conditions like we find in U.S. jails and prisons,” Reinhart said, “and there is also an aggregate effect over time.”

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