On Monday, Mo Korchinski drove to pick a woman up from prison. Korchinski is the project administrator for Unlocking the Gates Peer Health Mentoring Program, which provides support for formerly incarcerated people during the first 72 hours of their release. Korchinski had wasted the trip. The woman she had come to collect wasn’t able to leave custody. Due to extra security measures put in place during the global outbreak of Covid-19, she will have to wait a further 14 days before she can travel from prison to a post-correctional treatment facility, just in case she has been exposed to coronavirus while incarcerated. “It’s hard enough to find somewhere to go after prison any time,” Korchinski says. “Now with Covid-19, it’s way harder.” The woman will have to wait, and hope she doesn’t get sick.

While deferring long-awaited freedom is depressing, the idea of coming down with coronavirus in prison is even worse. “For the inmates I’m working with, there’s a lot of fear,” Korchinski says. In New Jersey, people detained by ICE have gone on hunger strike, demanding to be released rather than stare down a coronavirus outbreak they see as impending, inevitable. In Italy and Colombia, those fears have turned violent, sparking riots that resulted in dozens of deaths. It isn’t only those who are incarcerated who have begun to worry about the enormous risk Covid-19 presents to the world’s incarcerated population, who, because of factors like being kept confined in close quarters, are unable to take many of the disease-prevention measures other people are now practicing. Many advocates and health care experts are calling for mass releases to prevent the potentially lethal outbreaks that may already have begun.

After weeks of anxious waiting, each day now brings news of new coronavirus cases among correctional officers and incarcerated people: in Los Angeles, in San Francisco, in Leesburg, Georgia, in Waupun, Wisconsin, in Oakdale, Louisiana. In most states, cases are in the low single digits, but in New York, especially on Rikers Island, numbers are beginning to climb. At least 38 people involved in the New York City correctional system have tested positive for Covid-19. (Convicted rapist Harvey Weinstein is currently incarcerated at Wende Correctional Facility in western New York state, but the disgraced Hollywood mogul has reportedly tested positive, and was previously being held at Rikers.) During a press conference on Sunday, President Trump was asked about the possibility of releasing nonviolent elderly federal prisoners who are at high risk of experiencing severe symptoms if they contract Covid-19. “We have been asked about that, and we're going to take a look at it. It's a bit of a problem,” Trump replied. “But when we talk about totally nonviolent, we're talking about these are totally nonviolent prisoners. We're actually looking at that, yes.”

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The widespread concern about coronavirus outbreaks inside prisons is well-founded. Covid-19 is dangerous anywhere, but the illness is poised to be especially destructive among the incarcerated population, for whom social distancing is impossible. “Prisons are crowded. In California, they’re at more than 130 percent of capacity,” says Lizzie Buchen, criminal justice project director for the ACLU of Northern California. While some inmates are housed two to a cell, many are in open dormitories. “They sleep and live in very close proximity, sharing toilets, sharing showers,” Buchen says. “It is extremely unsanitary.” Many prisons are short on soap, and, even if they do have it, it’s not necessarily free. In many facilities, hand sanitizer is contraband due to its high alcohol content.

The steady influx of new people into prisons and especially jails makes an outbreak more difficult to prevent. According to Daniel Lopez Acuña, a public health physician who helped craft the World Health Organization’s guidance for managing Covid-19 outbreaks in prisons, new arrivals are a frequent vector for prison outbreaks. During the 1918 influenza pandemic, a single new prisoner precipitated a mass outbreak in California’s San Quentin prison. “The new folks who are arriving every day tend to be of low socioeconomic status,” says Matthew Murphy, who studies infectious disease risk in the criminal justice involved population at Brown University. “Their incarceration might be one of the first times they are interacting with the health care system.” Even if the disease doesn’t arrive with a newly incarcerated person, the comings and goings of prison staff create a similar risk of exposure.