Valley Fever Declared a Public Health Emergency at Two California Prisons; Court Orders Prisoner Transfers
On April 25, 2013, Dr. John Galgiani, an expert hired by attorneys representing prisoners in the long-running Plata v. Brown class-action lawsuit over medical care in the California Department of Corrections and Rehabilitation (CDCR), filed an 80-page affidavit with the federal court overseeing the case in which he described conditions at Central California facilities where prisoners have been afflicted by a disease known as Valley Fever.
Valley Fever (coccidioidomycosis) is a potentially fatal fungal infection that causes flu-like symptoms. It is contracted by inhaling spores from infected soil, but is not contagious once a person is infected. The spores frequent the southwestern United States, with about a quarter of reported infections occurring in California and over 70 percent in Arizona, according to the Centers for Disease Control and Prevention.
The disease has been an ongoing problem at the CDCR's Pleasant Valley and Avenal State Prisons, where the soil contains Valley Fever spores that are spread through dust and when the dirt is disturbed. [See: PLN, July 2010, p.22; June 2008, p.22; Aug. 2007, p.1]. Other state prisons are located in the area where Valley Fever is prevalent but have not experienced as many infections; those facilities include the California Correctional Institution, CSP Corcoran, Kern Valley State Prison, North Kern State Prison, SATF at Corcoran and Wasco State Prison.
The CDCR reported 640 cases of Valley Fever in 2011, including 535 at the Pleasant Valley and Avenal facilities. There is no vaccination to protect against the disease. At least eleven prisoners have filed Valley Fever-related claims with the state's Victims Compensation and Government Claim Board; all have been rejected.
Dr. Galgiani, a professor of medicine at the University of Arizona who founded a center where the disease is researched, stated in his affidavit that the prevalence of Valley Fever at the Pleasant Valley and Avenal facilities is a "public health emergency."
"Prison officials should be, but apparently are not, acting in a manner consistent with a situation where the lives of individuals are at substantial risk," he said after reviewing records of four prisoners who died due to Valley Fever, finding that prison medical staff had delayed for months before testing for the disease.
Galgiani stated in his affidavit that 62 state prisoners died from Valley Fever between 2006 and January 2013. He did not indicate how many of the deaths occurred at Pleasant Valley and Avenal, but noted that those facilities had by far the highest rates of the disease – with Pleasant Valley's infection rate being 1,000 times greater than the statewide average and Avenal having an infection rate 189 times higher.
Valley Fever pervades the communities surrounding the prisons in the southern San Joaquin Valley as well, but Dr. Galgiani observed that the infection rates at both the Pleasant Valley and Avenal facilities are notably higher than in the local community. A pernicious characteristic of the disease is that blacks and Filipinos are particularly vulnerable; 71 percent of the prisoners who died of Valley Fever between 2006 and 2011 were black.
Galgiani stated, "In my opinion African-American prisoners should be excluded from these two prisons along with Filipinos, Inuits, persons with diabetes, HIV, or any immunocompromising condition, and that decision should be implemented immediately. Not to do so will keep these groups at risk of severe complication from new Valley Fever infection. Moreover, there should be no transfers of any inmates with these ethnicities or medical conditions to either Pleasant Valley State Prison or Avenal State Prison for the same reasons."
On April 29, 2013, Medical Receiver J. Clark Kelso, appointed by the federal court to oversee healthcare in California prisons, ordered prisoners with an increased susceptibility to Valley Fever to be transferred from the two facilities. Kelso directed the CDCR to remove non-white and non-Latino/Hispanic prisoners, as well as prisoners with certain medical risk factors and prisoners over age 55 because they are at higher risk of contracting the disease.
Joyce Hayhoe, a spokeswoman for the Receiver's office, noted that in addition to causing prisoner deaths, Valley Fever has hospitalized about 40 percent of the more than 8,200 prisoners housed at the Avenal and Pleasant Valley facilities.
She added, "The state of California has known since 2006 that segments of the inmate population were at a greater risk for contracting Valley Fever, and mitigation efforts undertaken by CDCR to date have proven ineffective.... As a result, the Receiver has decided that immediate steps are necessary to prevent further loss of life."
Those steps include a mass transfer of an estimated 3,250 susceptible prisoners out of Pleasant Valley and Avenal, and refilling the beds with presumably less-vulnerable prisoners who still will be at risk of Valley Fever infections. While falling short of conceding they will select prisoners by race, that is tantamount to what the CDCR will likely have to do to keep the facilities full.
Governor Jerry Brown's administration wasted no time in objecting to the Receiver's order, complaining, "It is premature to move more than 3,000 inmates out of two state prisons until more is known about an airborne fungus that is being blamed for nearly three dozen inmate deaths and hundreds of hospitalizations."
CDCR Secretary Jeffrey Beard claimed that the transfers may result in increased racial violence within California's prison system, presumably because the prisoner transfers from Pleasant Valley and Avenal would be partly based on race.
State officials further argued that transferring prisoners was premature until they could learn whether other steps taken by the CDCR would be effective in limiting the exposure of prisoners and staff to the disease. To that end, the CDCR stated it was trying to control dust during construction, is supplying surgical masks to prisoners and employees who ask for them, and is providing educational materials about Valley Fever. Prison officials are also installing air filters and considering ways to cover up and screen out dusty areas, and agreed to move 600 high-risk prisoners by August 2013.
Apparently not wanting to wait to determine the effectiveness of the CDCR's efforts while prisoners continue to contract Valley Fever, sometimes fatally, the U.S. District Court over the Plata litigation entered an order on June 24, 2013 directing state prison officials to comply with the Receiver's directive to transfer increased-risk prisoners out of the Pleasant Valley and Avenal facilities. The CDCR was ordered to complete the transfers within 90 days.
The district court rejected the state's argument that an order to transfer prisoners from Pleasant Valley and Avenal constituted a "prisoner release order" under the Prison Litigation Reform Act, and noted that the CDCR had admitted it was "aware that Valley Fever presents a serious risk to inmate health."
However, the court limited the Receiver's directive by removing Inuit prisoners, prisoners over the age of 55 and prisoners who had already been infected with Valley Fever from the list of offenders to be transferred from the two facilities. "Perhaps at one point, Defendants' wait-and-see approach might have been reasonable. Under current conditions, however, they are not.... An exclusionary policy is now the only reasonable response," the district court wrote. See: Plata v. Brown, U.S.D.C. (N.D. Cal.), Case No. 3:01-cv-01351-TEH.
"The order is absolutely necessary to preserve people's lives and health because state officials have been simply unwilling to take appropriate action when there's a clear and imminent danger to prisoners' lives. It's the most recent example of the state's inability to protect the health of prisoners," said Don Specter, director of the Prison Law Office, which represents prisoners in the Plata litigation.
The Centers for Disease Control and Prevention and the affiliated National Institute of Occupational Safety and Health have agreed to study problems related to Valley Fever at the Avenal and Pleasant Valley prisons; however, there is no projected completion date for their review, which amounts to more government stalling. They could save themselves both time and money – and perhaps prisoners' lives – by simply reading Dr. Galgiani's affidavit and taking heed of the findings of the Medical Receiver and the district court.
Sources: Huffington Post, Associated Press, Los Angeles Times, ABC News, www.wsws.org
Related legal case
Plata v. Brown
|Cite||U.S.D.C. (N.D. Cal.), Case No. 3:01-cv-01351-TEH|