By Elizabeth Thompson

It’s easy to ignore prisons and jails if you’re on the outside.

Inside and outside seem like different worlds, but they aren’t. The COVID-19 pandemic’s impact on North Carolina’s prison system demonstrated the interconnectedness of the inside and outside communities as the number of cases behind the barbed wire ballooned through 2020 and 2021.

The North Carolina Department of Public Safety (DPS) has now reported 58 incarcerated people who have died of COVID since the pandemic began. 

But deaths are only one way that incarcerated people have felt the toll of the pandemic. 

Incarcerated people have also been more isolated from family and friends, as visits were put on hold during COVID surges. Many incarcerated people got sick with COVID, unable to protect themselves in a communal living environment or secure their own cleaning supplies and personal protective equipment. And communication between the inside and outside – difficult in the best of times – became an additional trial for inmates and their families. 

Advocates for incarcerated people and public health experts have been reflecting on the lessons learned during the pandemic, and pondering how the lessons of the pandemic can inform the future of incarceration in North Carolina and the United States.

Communicating behind the veil

It was already difficult to get in contact with people behind bars before the pandemic, but as different surges closed prisons to the outside world, it became even more difficult, said Kristie Puckett-Williams, the Statewide Campaign for Smart Justice manager for the American Civil Liberties Union of North Carolina.

Communication between incarcerated people and the rest of the world is always restricted by limited visits, paid phone calls and the mail system. These restrictions were exacerbated by the implementation of a new mail delivery method, inmates say. Part of the problem was that illegal substances, such as fentanyl – a potent opioid that only needs a few grains to produce a dangerous high – could be hidden in envelopes.

“They liquify the drugs and they put it on the paper,” John Bull, a spokesman for the state prison system, told WFAE radio in Charlotte. “They put it in what is appearing to be birthday cards or other children’s drawings.” 

He told the radio station that the prison system intercepted 568 pieces of mail that included drugs or paraphernalia over a one-year period out of a prison population of more than 28,000.

Now, incarcerated people no longer received physical cards and notes from family, but scanned copies. The system eliminates the sensation of touching something handled by a loved one. The impact on incarcerated people, who look forward to handwritten mail, was palpable, Puckett-Williams said. 

She referenced the devastation of one incarcerated man: “As somebody who’s serving life, who never had the hope of getting out his only lifeline to the outside world is through his mail and through phones.”

Crystal Poole, program director of North Carolina Citizens United for Restorative Effectiveness (NC CURE), said the transition away from physical mail was particularly hard for incarcerated people who also weren’t able to see loved ones in person.

“They weren’t getting any of that outside contact whatsoever,” Poole said. “They’re getting copies of cards from their families on top of not being able to leave or go to work or do anything, any kind of social support.”

DPS said the new system was implemented in order to stop drugs from being smuggled into the prisons via mail. Puckett-Williams argued that drugs continue to be smuggled in — by staff.

“They’ve been bringing stuff in,” Puckett-Williams alleged. “You don’t think they don’t bring drugs? They brought COVID in, and people died as a result.”

Epidemiological connection behind the veil

Jails and prisons across the country faced exchanges of the coronavirus as a result of the pandemic, said Eric Reinhart, an anthropologist of prisons and public health and a resident physician at Northwestern University

Reinhart is the author of a study illustrating the early impact of the pandemic cycling between Chicago’s Cook County Jail and the larger community. The study found that people cycling out of the Cook County Jail were associated with 15.7 percent of the documented COVID-19 cases in Illinois as of April 19, 2020.

“We are not interrelated simply by space, by spatial proximity such that you could hold somebody up behind a wall and a cage [and] now they’re separate,” Reinhart said. “We’re also interrelated by all these complex biological and epidemiological processes … even if we never see the other.”

Once inside prisons and jails, diseases such as COVID fester, said Amanda Klonsky, research and policy fellow at the UCLA Law COVID Behind Bars Data Project.

“The crowded, poorly-ventilated, and unsanitary conditions in most American jails and prisons provide ideal conditions for this virus to spread,” Klonsky said in an email, “which is why we have seen massive, fast-spreading COVID outbreaks behind bars with every new COVID wave.”

And what happens in prisons impacts what happens on the outside, even if they appear separate, Reinhart said. One tangible example of that connectedness is the reality that about 98 percent of people incarcerated in North Carolina’s prisons will one day reenter society, according to DPS.

When those people come home to their families and neighborhoods, their health will likely have been impacted by their incarceration. One study has found that each year in prison reduces a person’s life expectancy by two years

People leave prison often experiencing health problems such as mental health issues, diabetes or heart disease, and now, the possibility of long COVID. They’ll be seeking treatment for those conditions in the community.

Opportunity for change

Sandra Hardee, executive director of NC CURE, said that right now, COVID numbers are low in the prisons, so now is the moment to prepare for the next surge.

Hardee said she also hopes that with less virus in circulation there can be more opportunities for incarcerated people to be connected with programs that will help them reenter, such as the successful Sexual Offender Accountability and Responsibility Program.

People are being warehoused,” Hardee said, quoting a letter from an incarcerated person. “They’re not being offered restoration, redemption, rehabilitation.”

Puckett-Williams said there should be more opportunities for incarcerated people to be connected to the community, including more opportunities for education.

“COVID has really exposed a lot of fissures in efficiencies and effectiveness of locking people up,” Puckett-Williams said. “It would be my hope that we continue to make transformational changes that actually get us to what we’re looking for.”

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Elizabeth Thompson is our Report for America corps member who covers gender health and prison health topics. Thompson is a UNC Chapel Hill graduate who has covered Texas politics for The Dallas Morning...