With more than half a million infections behind bars and over 3,000 deaths, America’s response to COVID-19 in prisons and jails has been a failure. Federal, state, and local governments ignored public health guidance, refused to implement even the most basic mitigation strategies, and failed to reduce their incarcerated populations to the level necessary to avoid these catastrophes.
As we enter the third year of dealing with the virus, public health experts increasingly agree that eliminating it completely is unrealistic; instead, they say COVID-19 will become endemic, meaning the disease will continue to impact the U.S. population for the foreseeable future, with new variants springing up, acute outbreaks, and ongoing threats to public health. They warn that the country needs to learn to live with the virus. However, learning to live with the virus doesn’t mean accepting that prisons and jails have to be Petri dishes where the virus — along with widespread illness and death — is left to run wild.
Successfully navigating this new normal will require deep reductions in prison and jail populations and concerted efforts to improve carceral healthcare. Governments have the tools and strategies to do this; what is needed is the will of leaders to use them.
The United States got the pandemic response wrong in prisons and jails, but it isn’t too late to get the endemic response — and future pandemics — right.
The most effective way to mitigate the devastation of endemic COVID-19 in prisons and jails is to reduce the number of people behind bars. The United States locks up a larger portion of its population than any other nation in the world. While it is true that the incarcerated population is lower than it was at the beginning of the pandemic, it is still far too high and trending back up.
When the pandemic struck, it was instantly obvious what needed to be done: take all actions possible to “flatten the curve.” This was especially urgent in prisons and jails, which are very dense facilities where social distancing is impossible, sanitation is poor, and medical resources are extremely limited. Public health experts warned that the consequences were dire: prisons and jails would become Petri dishes where, once inside, COVID-19 would spread rapidly and then boomerang back out to the surrounding communities with greater force than ever before. There were widespread calls for governments to decarcerate. Unfortunately, these calls went unanswered.
Despite initial hopes that leaders would respond to the pandemic by releasing people, on the whole prisons released almost no one. Only three states — New Jersey, California, and North Carolina — released a significant number of incarcerated people from prisons. Parole boards also approved fewer releases in the first year of the pandemic than the year before. The response of governments was so bad that, in total, 10% fewer people were released from prisons and jails in 2020 than in 2019. As a result, at the end of the first year of the pandemic, 19 state prisons systems were at 90% capacity or higher. Even states that reduced prison populations didn’t necessarily reach “safe” population levels (if any prison can be called “safe”). At the end of 2020, 1 in 5 state prison systems were at or above their design or rated capacity. And there is plenty of evidence that these numbers have gotten worse since then.
Jail populations dropped early in the pandemic, mostly due to reduced admissions. However, as the pandemic drug on, jail populations steadily climbed, nearly back to their pre-pandemic levels.
Jails were particularly ill-prepared to respond to the pandemic. People generally don’t stay in jails for extended periods. There is a constant churn of people entering and leaving, creating a significant public health threat to people on both sides of a jail’s walls. Much like prisons, jails also saw an initial decline in their populations due to reduced admissions. As the pandemic drug on, though, jails populations slowly approached their pre-pandemic levels.
So, if governments failed to undertake the large-scale releases necessary to confront a pandemic, how is it possible that the incarcerated population is lower now than it was in 2019?
Reductions in the number of people in our nation’s prisons were not the result of goodwill for incarcerated people, concern for their health and safety, or a concerted effort to end mass incarceration. Instead, they were primarily an unintended consequence of court delays and suspension of transfers from local jails early in the pandemic. Many of the same factors that snarled our nation’s supply chain and made it more difficult to get appointments for various services also slowed down the process of sending people to prison.
These delays have already begun to ease. As governments adapted to the new normal, they quickly returned to business as usual, and prison and jail populations began creeping back up.
The failure to reduce incarcerated populations had ripple effects that worsened the pandemic far beyond the prison walls. At the onset of the pandemic, areas with higher incarceration rates experienced significantly higher COVID case rates. Our analysis showed that in the summer of 2020, mass incarceration resulted in half a million more cases nationwide. The study revealed that not only do prisons not improve public safety, they also harm public health.
The changing nature of the fight against COVID-19 demands that our nation abandon its addiction to mass incarceration. The virus is going to remain an ongoing threat. The criminal legal system must change to ensure that a short stint in jail or prison does not become a de facto life sentence.
Because the United States has locked up so many people behind bars, it has many strategies at its disposal to reduce its prison and jail populations relatively quickly, including:
The most important thing governments can do to stop the spread of COVID-19 is reduce the number of people behind bars. However, they must also take steps to ensure those they continue to incarcerate are safe. That will require dramatic improvements to health care protocols in prisons and jails.
Health care in prisons and jails is notoriously bad. It is plagued with poor care, inaccessible treatment, and mistrust. Recognizing that COVID-19 will be an ongoing threat, cities, states, and the federal government must address these deficiencies head-on. Here are a few ways they can do that.
States that do not charge copays | States that suspended all copays for incarcerated people in response to the pandemic | States that suspended all copays for respiratory, flu‑related, or COVID‑19 symptoms | States that rolled back previous suspensions and now charge medical copays on non‑COVID‑19 related symptoms | Governments that rolled back previous suspensions and now charge all medical copays | States that suspended some or all copays in response to the pandemic, but it is unclear if those suspensions are still in place | States did not suspend copays in response to the COVID‑19 pandemic |
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California Illinois Missouri Montana Nebraska New Mexico Oregon Vermont Virginia Wyoming |
Connecticut Massachusetts New Jersey Rhode Island West Virginia |
Alaska Colorado Delaware* Florida Hawaii Indiana Iowa Michigan New Hampshire North Carolina North Dakota Pennsylvania South Carolina Utah Wisconsin |
Idaho |
Alabama Federal Bureau of Prisons Minnesota Texas |
Arkansas Arizona Georgia Kansas Kentucky Louisiana Maine Maryland Michigan Mississippi Ohio Oklahoma South Dakota Tennessee Washington |
Nevada |
The United States’ response to COVID-19 in prisons and jails was a failure. The refusal to reduce jail and prison populations resulted in unnecessary illness, suffering, and death, both inside and outside prison walls. Abysmal prison and jail medical systems failed to distribute vaccinations effectively and did little to detect and address outbreaks when they occurred.
The damage and death already caused by these failures cannot be undone, but as the world realigns its approach to COVID-19, government leaders have an opportunity to change course to prevent future death and suffering among incarcerated people.
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