Courthouse News reached out to experts about the dangers of being incarcerated and unvaccinated, and how policies can shift to ease health disparities compounded by the coronavirus.
Graphic courtesy of the Center for Justice Research and the Black Public Defender Association in a report on how the Covid-19 pandemic is devastating Black communities in the United States. (Image via Courthouse News)
(CN) — Jail and prison populations are at a particularly grave risk for Covid-19, but incarcerated people are absent from many state vaccine distribution policies, and federal authorities have stayed silent.
While the United States works to roll out coronavirus vaccines, operating with too little supply to meet demand, experts say detention centers carry severe health hazards that compound existing health disparities.
The underlying disease risk is clear: Covid-19 infection rates in prisons are four times as high as those in the general population. In many facilities, it’s impossible to achieve the steps that health officials say are vital to slowing the pandemic’s spread — frequent handwashing, universal mask-wearing and staying 6 feet apart, ideally outdoors.
With a virtually uncontrollable spread, prison conditions also make the coronavirus between two and seven times more deadly than it is in surrounding communities. At least 2,446 prisoners have died of Covid-19, which has killed more than half a million Americans.
But narrow definitions of Covid deaths in prisons mean that the count could be far higher.
Renaldo Hudson, recently released from an Illinois detention after being incarcerated for 37 years, told The Guardian that people in prisons face life-or-death stakes.
“Most states do not have death sentences,” Hudson said. “But being incarcerated can be a death sentence if you die inside. They’re putting people in body bags.”
In San Diego, where the Hispanic population faces a disproportionate rate of infection from the novel coronavirus, the county has partnered with the city of Chula Vista and Sharp HealthCare to open a mass vaccination site geared for that underserved community at a former Sears department store. (Courthouse News photo/Barbara Leonard)
States Set Vaccine Rules
The heightened danger of being incarcerated and unvaccinated has prompted the American Medical Association among others to call for prioritizing vaccines for prisoners.
“Recognizing that detention center and correctional workers, incarcerated people, and detained immigrants are at high risk for Covid-19,” the AMA wrote in November 2020, the organization’s policy “makes clear that these individuals should be prioritized in receiving access to safe, effective Covid-19 vaccines in the initial phases of distribution.”
Two and a half months into the vaccine rollout, the Bureau of Prisons reported that as of Monday, 10,446 prisoners — out of the 138,213 in BOP-managed facilities — had received a vaccine.
When it comes to federal parameters, however, the Centers for Disease Control and Prevention has not updated the vaccine guidelines it handed states to create their own playbooks. Rather than mandating a priority, the website uses bold letters say “jurisdictions are encouraged to vaccinate staff and incarcerated/detained persons of correctional or detention facilities at the same time because of their shared increased risk of disease.”
Across state policies, inconsistencies abound.
Right now, 24 state plans include incarcerated populations in their first phase of vaccination, while 13 list those groups in phase 2, according to the Covid Prison Project. Five states specifically prioritize people serving time who are also vulnerable to the coronavirus, meaning people who are older than 65 and have two or more chronic conditions.
While some states like Massachusetts have said from the start that prisoners would be among the first to get vaccine access, many more will see advocates seek to change policies through litigation.
Oregon in February became the first state in which a judge demanded that the state vaccinate prisoners. A lawsuit in New York aims to achieve the same outcome.
Wanda Bertram, communications strategist at the Prison Policy Initiative, noted in an interview that issues remain, however, even when official rules put prisoners on the list for vaccination. Sometimes vaccines aren’t actually being delivered, or there are questions about how they’re being implemented.
“There’s obviously also the issue of people in prison understandably not trusting the prison health care system, which is notoriously abusive and neglectful,” Bertram said.
Outreach programs have seen some success in improving vaccine acceptance rates in California prisons. The state recently announced that 40% of prisoners had received the Covid-19 vaccine.
But vaccine access remains the major barrier to reaching vaccination levels that can slow the pandemic’s toll on prison populations.
Adam Coy, a former Columbus, Ohio, police officer charged in the December 2020 police shooting death of Andre Hill, a Black man, is seen remotely on television during his initial appearance on Feb. 5, 2021, at the Franklin County Common Pleas Courthouse. (Joshua A. Bickel/The Columbus Dispatch via AP)
Politics and Prison Vaccination
Not all states are even moving in the direction of vaccinating people in prisons. North Carolina recently did the opposite: In early February, the state’s health department moved prisoners down on the list, instead prioritizing only prison staff.
Although medical experts are clear that prisons are among the riskiest possible settings during the pandemic, vaccine shortages — even as the U.S. on Saturday authorized its third Covid-19 vaccine for emergency use — continue to shape the conversation. The lack of federal guidance, experts say, has allowed politics to fill in the gap and dictate how states make decisions.
“People who are incarcerated are not a particularly popular group of people,” said Maria Morris, senior staff attorney at the American Civil Liberties Union’s National Prison Project.
“As long as we have a shortage, and the issue can be essentially framed as, ‘Grandma gets a vaccine or this guy who robbed a liquor store gets a vaccine,’” Morris said, “I think Grandma is going to win out.”
Colorado Governor Jared Polis applied that logic when asked in December about state policies.
“There’s no way it’s going to go to prisoners before it goes to people who haven’t committed any crime,” Polis said. “That’s obvious.”
But that way of thinking is flawed, said attorney April Frazier Camara, who co-founded and chairs the Black Public Defender Association.
“Comments like that are very alarming,” Camara said, “because it plays into the dehumanization of people who come into contact with the criminal legal system.”
The thought that a person’s life matters less because they are living in prison “is troubling on so many levels,” she said.
Overpolicing in Black neighborhoods, and racial disparities in sentencing and bail, all contribute to the disproportionate number of Black people in prisons and jails.
“If you play out the logic from (Governor Polis),” Camara said during a phone interview, “it’s troubling because it does not acknowledge the root and the role that racial inequities have played in understanding why certain communities are incarcerated and/or convicted.”
It’s important to apply the lens of racial equity to understand why people are detained in the first place, Camara said.
“It is not based on behavior,” she emphasized. “It is based on who we target and who we convict.”
This January 2021 photo from outside of the White House shows a peaceful music-filled gathering juxtaposed against flags emblazoning harsh messages for the outgoing, twice-impeached President Donald Trump. (Courthouse News photo / Brandi Buchman)
Prison and Community Health Disparities
The combined effect of racial inequities in both incarceration and health have been highlighted during the pandemic.
Americans’ overall one-year drop in life expectancy during 2020 was much worse in minority communities: Hispanic Americans saw a drop of two years, and Black Americans lost three years from expected life spans.
Life expectancy sets a baseline for health experts to follow health trends. Covid-19 has created a six-year gap between Black and white Americans’ life expectancies — the largest divide since 1998.
Incarceration policies are amplifying health divides in the community. Camara said that, anecdotally, she has observed that Covid-related releases tend to benefit those convicted of white-collar crimes, who are more typically white and represented by private counsel.
“People who are represented by public defenders, who are Black and brown people — they’re not getting the same release from the federal system,” Camara said.
A recent example came from New York’s Eastern District, where a former HSBC investment banker was allowed to push his surrender date “until either August 1, 2021, or three weeks after his final dose of a Covid-19 vaccine, whichever occurs first,” according to a 10-page order.
“Who are we letting out right now? The racial disparities are just glaring,” Camara said.
Camara said the pandemic has created a “perfect storm” to reinforce underlying disparities, devastating Black communities. But she also sees an opportunity to improve the system.
In a report Camara co-authored last summer, she makes the case that, for policies to effectively undo that damage, they cannot be race-neutral. The report also advocates for reforming disparities in who’s getting released from prison in an effort to alleviate overcrowding.
Those programs have to take into account issues like how someone gets home: Where it may be typical to call a family member to pick up someone released from incarceration, that could be ill-advised during the pandemic, so there needs to be an alternative in place.
Noting that litigation can move slowly, and Oregon’s court-ordered prison vaccination may be an outlier, advocates look to the federal government.
“The biggest thing for moving the needle would be if the CDC came out very clearly about it, and made that announcement,” said the ACLU’s Morris. “That would be incredibly helpful.”