Healthcare for inmates: how COVID-19 is further revealing the problems in an inadequate system

COURTENEY MALIN – Last fall, before the vaccine rollout, ethicists debated who should receive the vaccine and in what order. All agreed that healthcare workers should receive the vaccine first, but after this group, the guidelines were cloudy. Should we vaccinate young people to reduce infection? Should we vaccinate older people to reduce deaths? What about essential workers? People with underlying conditions?

Lower on the list, you would find inmates.

Each state is responsible for its own vaccine protocol. Each state released separate vaccine rollout guidelines. All states designated the first doses to healthcare workers. Many designated second doses to the eldery and their caregivers, followed by patients with immune problems or risk factors. However, New Jersey is currently the only state to mass-vaccinate prisoners.

In the United States, there are both private and government-run prisons. Private prisons have come under scrutiny for profiting off of incarceration, leading President Biden to terminate private prison contracts. When less money is spent per prisoner, these companies earn more money, so the health and safety of their inmates is frequently neglected. To maintain helpful company images, private prison companies, such as the GEO Group, commonly reduce the number of COVID-19 deaths in their facilities or never report them. Information about prisoner healthcare in private prisons typically comes from the prisoners rather than the companies. Therefore, the number of deaths and infections from COVID-19 are unknown in private prison systems.

Federal and state prisons have a set protocol and are required to report COVID cases. According to the Bureau of Prisons (BOP), inmates should be regularly screened for COVID-19, including temperature checks and COVID testing. Inmates must be quarantined for at least 14 days if exposed and can only be taken out of quarantine after testing negative with a blood test.

However, reports from federal prisons, which should follow BOP COVID-19 protocols, show that inmates have been left to fend for themselves. Sick inmates are ignored or left without medications to treat symptoms. Some do not receive adequate treatment until they struggle to breathe. Quarantine areas are not equipped with essential items, such as beds, blankets, showers, etc., and prisoners are often told that “they have the flu” rather than testing them for COVID-19.

The death percentage from COVID-19 for federal inmates is higher than the general population death percentage. In prisons, there is a fatality rate of 39 per 100,000 inmates, compared to 29 per 100,000 in the general population. When accounting for sex and age differences between inmates and the overall population, the death rate in prisons is 3X higher. COVID-19 also spreads more quickly through prison populations than the general population. Prison cases jump by 8.3% each day when COVID cases increase by 3.4% in the general population.

Inmates have no control over their exposure to others, how often they can wear masks, and if they can access treatment for COVID-19. Committing a crime may have resulted in a prison sentence, but it was not supposed to jeopardize their lives. With the current slow and confusing vaccine rollout, the guidelines to determine who receives the vaccine have been set by the states. Eleven states currently do not have vaccine plans for inmates, and most states with plans have not specified when inmates will be vaccinated. Even in New Jersey, where the most inmates have been vaccinated, inmate vaccinations have slowed due to public controversy.  Americans express lower empathy for inmates and rate them lower on the list to be vaccinated. Prisons are not a top priority for vaccination in the United States.

Until state governments make clear decisions on inmate vaccination, prison populations must deal with COVID-19 by themselves. Without proper resources, they must hope that they do not catch the virus, hope that they are strong enough to recover, and hope that they will outlive their prison sentences. 

Copy Editor: Sophia Bartell

Photography Source: Shweta Mistry, https://www.theatlantic.com/politics/archive/2019/09/private-equitys-grip-on-jail-health-care/597871/