In prisons and jails across the deep south, coronavirus threatens to overwhelm chronically underfunded, understaffed and overpopulated facilities

In the five years that Richard has been incarcerated at Easterling correctional facility in Clio, Alabama, his wife, Deana, has watched his health deteriorate.

He went into his 16-year sentence at age 59 with a number of health problems dating back to his time in the military in the 1970s: diabetes, hypertension, post-traumatic stress disorder and neuropathy that has left him using a cane.

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It was manageable before prison, but lack of treatment at the facility has left him in considerable pain. “It’s horrible. As we speak right now, he does not get his medications, half the time his sugar is not checked,” said Deana. Her calls to the facility to demand better medical treatment have been repeatedly ignored.

Now, with the coronavirus pandemic sweeping across the country, Deana is terrified that Covid-19 will spread unmitigated at her husband’s prison. Nor is she alone in her fears.

In prisons and jails across the deep south, America’s incarceration center, the pandemic threatens to overwhelm chronically underfunded, understaffed and significantly overpopulated facilities. In Alabama, the department of corrections (DOC) has only tested 46 inmates, with no cases confirmed. In Mississippi, it was announced on Monday that an inmate who tested positive for Covid-19 died at the state’s notorious Parchman prison. The department declined to specify the number of inmates who have been tested. In Louisiana, 60 inmates have so far tested positive.

In Richard’s prison only one inmate has been tested at the facility, and it came back negative. But Richard suspects many inmates have the virus. His bunkmate, who sleeps just a couple of feet above him, in rows of beds just 2ft apart, developed a fever and a cough earlier in the week. When he went to seek treatment, the medical staff told him that they were short-staffed and that unless he wanted to go to the hospital, there was nothing they could do. He chose not to go, and was instead sent back to his bunk with a mask.

The prison was already 170% of the designed capacity in January, and became even more crowded when prisoners from a maximum security prison, Holman, were transferred from that facility after a justice department inquiry found the facility to be “cruel” and “objectively unsafe”.

Alabama’s department of corrections did not respond to a request for comment.

In Alabama, medical care was already severely insufficient for the number of prisoners before the pandemic hit. According to the Southern Poverty Law Center (SPLC), which filed a lawsuit against the DOC in 2014 for providing constitutionally inadequate healthcare, the department faced a severe shortage of doctors to provide care for the 25,055 prisoners in the state’s custody, with DOC doctors shouldering an average caseload of 1,648 patients.

Inadequate access to medical care poses a severe threat to a population that is already more vulnerable to coronavirus: there are about 10,000 people over 60 in federal custody, and about a third have pre-existing conditions, according to federal defenders.

“You don’t forfeit your right to healthcare simply because you’re incarcerated,” said Mercedes Montagnes, a lawyer with the Promise of Justice Initiative in New Orleans.

Her organization is representing inmates at the Louisiana state penitentiary, known as Angola, in a lawsuit against the department of public safety and corrections alleging that inmates have suffered physical harm and even death as a result of “grossly deficient” medical care.

The state of Louisiana spends less on healthcare an inmate than any other in the country: just $1,396 a year from 2010-15. “It’s just a top to bottom – I find it very difficult to identify areas in which they are succeeding medically,” said Montagnes. “We’re looking at a state that has divested from its responsibility to folks who are incarcerated for so long.”

In Mississippi, where the US justice department recently launched a civil rights investigation into the prison system after a spate of deaths, the situation is similar.

“We know in a lot of these facilities, people die early and often of medically preventable deaths,” said Paloma Wu, deputy director of impact litigation at the Mississippi Center for Justice, adding that inmates at Parchman prison had reported a lack of access to hand sanitizer and, in some cases, running water in their cells.

Past incidents of negligence offer a disturbing lens into what an outbreak might mean in Alabama’s prisons.

In 2014, St Clair correctional facility experienced a severe tuberculosis outbreak after a prisoner was misdiagnosed and lived with the disease untreated for a year. Eight people were infected.

That year, the SPLC and the Alabama Disabilities Advocacy Program filed a lawsuit against the Alabama department of corrections for putting the health and lives of prisoners at risk by providing unconstitutionally inadequate care. A federal judge ruled in 2019 that the prison system had violated the constitution with “persistent and severe shortages of mental-health staff and correctional staff, combined with chronic and significant overcrowding”.

Advocates remain particularly concerned about understaffing. Bill Van Der Pol, an attorney with Alabama Disabilities Advocacy Program, estimates that the corrections staff numbers about 35% of that mandated by staffing requirements.

A department of corrections planning document obtained by AL.com acknowledges these acute risks. The 263-page document, dated 1 April, outlines a worst-case scenario in which systemwide lack of staffing and supplies could result in widespread infection, emergency staffing by the national guard and nearly 200 inmate deaths.

While some states such as California are addressing the public health crisis in prisons by releasing prisoners, pushback to such solutions has been strong in conservative southern states.

In a 1 April letter to Louisiana’s governor, the state’s attorney general, Jeff Landry, wrote that since there had been no significant outbreak among prisons, “any discussion of releasing prisoners is premature and could create a public-safety problem more dangerous than the potential public-health issue that exist in our prisons. A new crime wave in these perilous times would be disastrous.”

That week, four prisoners at a federal prison in Oakdale, Louisiana, died from the virus. There are now 38 confirmed cases at the prison and two more people have died. In the meantime, people are taking what limited measures they can to minimize their risk.

Meanwhile, inmates at Angola prison report a similar situation of alleged medical neglect. Ricky Angelain, whose father has been held at Angola since 2008, said the facility had consistently denied him adequate medical care for acute back and leg pain.

“He is taking precautions, just with what he’s eating and washing his hands, if and when he can.” Angelain said. “At this point, when you can’t control things, your faith is the thing that keeps you in a calm state.”