by Eike Blohm, MD
A special report issued by the Bureau of Justice Statistics (BJS) in August 2022 tracked the first year of the COVID-19 pandemic in state and federal prisons. It found they suffered high rates of infection and death despite lockdowns and suspended visitation. There was also a plunge in the number of prisoners held, though that was due to court slowdowns rather than expedited release.
The dynamics of the pandemic within the walls of prisons cannot be compared with what occurred among the un-incarcerated public. Prisoners live in semi-isolated communities. They are younger than the average U.S. population. Both males and minorities are overrepresented. Most importantly, close quarters and overcrowding facilitate disease transmission with high viral load inoculation, potentially causing a more severe disease trajectory.
BJS collected data covering the period from March 2020 to the end of February 2021. During this period, 1,644,043 prisoners were at risk of contracting COVID-19: 181,300 in custody of the federal Bureau of Prisons (BOP) and the remainder held by state departments of corrections (DOCs).
Prison populations decreased during the assessment period, dropping by 16% nationwide. But this was mainly a function of reduced admissions due to court closures rather than expedited releases. Nationwide, admissions that had averaged about 54,000 per month nearly ground to a halt by April 2020; BOP admitted just 37 prisoners, while California, Georgia, North Dakota, and Oklahoma each admitted fewer than ten. Meanwhile, just 5.8% of releases were expedited on average. BOP had no expedited releases; Iowa was an outlier, expediting 89.2% of its releases.
Infection rates varied widely. Some prison systems tested all prisoners, which increases observed infection rates because asymptomatic cases get captured. Others tested only prisoners who were sick. This makes direct comparison challenging. It should nonetheless be noted that Vermont (one of those with universal testing) had an infection rate of 31 per 1,000 prisoners.
Nationally, the death rate from the disease averaged 1.5 deaths per 1,000 prisoners. Michigan had the nation’s highest prisoner COVID-19 mortality rate: 3.2 deaths per 1,000 prisoners. No prisoners died in Vermont.
The difference between Michigan and Vermont warrants further examination. Both states had access to the vaccine simultaneously, and both states prioritized vaccination of prisoners before staff. In fact, Michigan did better, vaccinating 13.8% of its prisoner population in the first month of vaccine availability, while Vermont only inoculated 1.4%. The primary driver behind Michigan’s astronomical infection rate may have been this: There was no universal implementation of quarantine for new admissions and no universal facility-wide lockdown of prisoners in their cells. Vermont, on the other hand, implemented these two measures rigidly.
New Mexico had a different problem: Its prisoner infection rate was about 150% of the national average, 329 per 1,000 compared to 219 per 1,000 for the U.S. as a whole. But the virus spread among DOC staffers like wildfire. Even though New Mexico was the first state to bring vaccines to its prisons and inoculated almost all its personnel, the infection rate among guards was 647 per 1,000 persons, 240% of the national average. No other state came close. Unfortunately, the data provided by BJS do not provide a ready explanation for this outlier.
The survey data do not allow for determination of whether various measures taken or not taken in jurisdictions were causative of the differences in infection and mortality rates observed or merely correlated. It is also unclear to what degree external factors contributed. Overall, 196 prison guards and 2,490 prisoners died of COVID-19 during the study period — and many more since. See: Impact of COVID-19 on State and Federal Prisons, March 2020–February 2021.
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