An inmate in the California prison system has tested positive for COVID-19, as have several corrections officers. California invests more than any other state in prisoners’ health, due to ongoing federal oversight mandating that the California Department of Corrections and Rehabilitation (CDCR) provide adequate health care. But overcrowded conditions where social distancing is improbable could intensify COVID-19 outbreaks in California’s prisons.
To limit the spread of COVID-19 between local communities and prisons, Governor Newsom has issued an executive order halting prison admissions and transfers to community-based reentry programs. Inmates who fall ill are being isolated, and those who work in prisons, including corrections officers and health professionals, are being screened before entering. Similar efforts to contain outbreaks are not unusual in CDCR. However, they usually apply to one prison, rather than to the entire system.
Overcrowding may exacerbate the potential for COVID-19 to spread rapidly though prison systems, threatening prisoners, corrections officers, and prison health professionals alike. According to the Bureau of Justice Statistics, about half of the country’s prison systems operate at or above capacity. In California, a court order mandates that the prison population remain under 137.5 percent of capacity. Currently, the prison population stands at just under 123,000, and the prisons are at 134 percent of capacity.
Prison environments also limit inmates’ and prison workers’ ability to practice social distancing. Dormitories present special challenges. The inmates who live in them and the correctional officers who supervise them must safely navigate open space in concert with each other. However, the cells in which most prisoners are housed present social distancing challenges of their own. While some inmates live alone, most have a cellmate. In some prisons, cell sizes fall short of the standard 25 to 35 square feet of space per person. Cellmates also typically sleep in bunk beds, which do not have six feet between the top and bottom bunks.
In addition, California’s prisoners may be particularly susceptible to COVID-19 because they are older or have preexisting medical conditions. In 2018, more than 30,000 inmates (24%) were over age 50, and over 5,000 (4%) were over 65. Prison populations tend to be far less healthy than the general public—9% of California’s inmates were classified as high clinical risk in 2012, meaning they had serious medical conditions that required significant resources to manage.
During COVID-19 infections, even mild or moderate chronic health problems that would usually be manageable could lead to serious complications. Illnesses that compromise the immune system or weaken the lungs can increase the risk of poor outcomes associated with COVID-19. According to California Correctional Health Care Services, more than 10,000 inmates were treated for hepatitis C in 2018. Approximately 8,000 of California’s inmates are diabetic. Twelve percent of male and one in five female inmates used medication to treat asthma in 2010—about double the rate among Californians. In 2015, 0.8 percent of California’s inmates were HIV positive—also more than double the rate among Californians. The heightened vulnerability of California’s prisoners to serious COVID-19 infections also puts the corrections officers who work alongside them and the health professionals who care for them at elevated risk for contracting the illness.
While older people are at greatest risk of severe outcomes related to COVID-19, younger people, particularly those with preexisting conditions, are also vulnerable to severe outcomes. If an outbreak happens within the prison system, many CDCR workers and inmates—young and old—may be at higher risk of experiencing serious complications as living conditions, age, and preexisting medical conditions combine to amplify the threat from COVID-19.