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What can the COVID-19 prison crisis teach us?

President John F. Kennedy in 1959 said, “The Chinese use two brush strokes to write the word ‘crisis’. One brush stroke stands for danger; the other for opportunity. In a crisis, be aware of the danger-but recognize the opportunity.”

As a retired prison medical doctor who spent 30 years behind bars I’m interested in how the different players in the prison world are approaching this crisis as an opportunity, and what it can teach us about the crisis and them.

The NCCHC, National Commission on Correctional Health Care, is working with researchers from Harvard University to gather information on how COVID-19 is affecting correctional facilities and wants to distribute that information to promote best practices in correctional institutions. They are doing this with a survey, and on their site, you can find their weekly report.

This week's data reveal that 13% (51 of 389) of inmates tested for COVID-19 are positive with 104 tests pending; 17% (99 of 580) of correctional officers tested are positive with 74 awaiting results and 18% (21 of 118) of health staff tested positive with 14 results pending.

What’s interesting to me is that they caution interpreting the results since the facilities are not necessarily representative. You will find that the majority of the data comes from jails (70%) followed by prisons (20%).

What this demonstrates is that if you want true data to make decisions in the correctional world you need to have a designated health authority at each facility that can give accurate information to a central source. It makes the most sense for it to go to the CDC, The Center for Disease Control. The NNCHC which supports itself by accrediting correctional staff, institutions, and offering conferences would be better served if the information it is basing recommendations on came directly from a central source like the CDC.

One player that everyone tends to know in the correctional world is the ACLU. The ACLU works to ensure that prisons treat prisoners in accordance with the Constitution, ‘that prisons can not be deliberately indifferent to serious medical need.’

Marion prison in Ohio found that 78% of it’s inmate population is positive for COVID-19 and Cook County jail in Chicago is now one of the top hot spots for coronavirus in the country. It is no surprise that the ACLU is using the crisis to push it’s agenda to reduce incarceration rates. It has launched a nationwide television and ad campaign to save the most vulnerable from COVID-19 and where they haven’t seen action they’ve sued, lobbied and mobilized their supporters.

The unique opportunity that COVID-19 brings to the ACLU is that the community and the correctional world both suffer from it. Therefore, they can emotionally use it to make the community more aware of the individuals behind bars and call attention to the crowding that makes social distancing to reduce the spread of the virus unworkable.

In every crisis leadership is crucial. The Association of State Correctional Administrators, now called CLA, Correctional Leadership Association has stated that, ‘Correctional leaders in particular have a responsibility to keep individuals in our custody and care, as well as our correctional staff and professionals who work inside of our institutions, safe.’ It isn’t just the inmates who are dying. As an example on 4/21 it was reported that the Warden and the Medical Director died at a state prison in Avoyelles Parish, Louisiana.

Each correctional system is trying to follow the advice of their State Health Departments, guidelines set forth by the CDC and the directives of their Governor. How effective each state prison director will be in accomplishing that task will be a function of their ability to communicate clearly, listen with empathy and make decisions based on what is best for the individuals under their care.

Since every state prison director will be doing something different in addressing the COVID-19 crisis the opportunity exists to learn what is the best approach in keeping inmates and staff safe by analyzing all the data.

When I was placed in the Nevada Department of Corrections as a doctor in 1987 by the National Health Service Corps and turned it into a career we didn’t have the technology to access, analyze and share data on the level we do now. The COVID-19 crisis in prisons offers a unique opportunity to use the technology we have today to make more informed decisions on what’s best for inmates and staff based on data and science.

It is also my hope that the COVID-19 crisis in prisons will help teach the public to really understand and feel how devastating mass incarceration is as a public policy. I understand the public is interested in safety, but when you lock up people, separate them from their loved ones, shame them ,don’t address what caused their behavior that put them in the prison in the first place and then release them without a place to stay, a job, etc it doesn’t keep society safer. If we want to combat crime or viruses we have to focus on preventing them from getting a foothold first.

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