US prisons are woefully unequipped to deal with coronavirus

The rapid spread of the coronavirus has created a worldwide public health crisis, but its effect will be most devastating on some of the most vulnerable and powerless – those being held in our prisons.

As a deputy public defender who has practised for more than 10 years in Riverside, California (where, as of today, they have at least two confirmed cases of coronavirus), I am among those on the front line.

I practise incompetency law, representing clients who have difficulty understanding legal proceedings or who cannot assist a lawyer with their case due to the severity of their mental illness or cognition issues. These are the most powerless of all clients; they are sometimes so impaired that they often cannot even speak on their behalf.

In addition to visiting clients who are in custody in county jails and state hospitals, I interact with my clients in court. I typically have court two days a week and can see as many as 15 clients in custody in one day.

I am one of the five attorneys in my unit. The volume of cases we handle is huge. I am required to fully represent my clients so I lean in and talk to them and explain to them the process and see how they are doing. They are in chains and in orange or red jumpsuits (red signifies that they have a special classification) and are often dishevelled.

My goal is always to represent them with integrity and grace, leading them through a strained system.

Often, they have no idea what is happening to them. So I must be both their advocate and their voice.

Frankly, I am terrified about how this coronavirus crisis will affect them.

The risk factors for the imprisoned are patently obvious. Inmates are confined in close proximity to one another and come from high-risk communities. They have high rates of trauma, chronic illness, abuse, experience of homelessness and mental illness. These issues often result in crime as they are just looking for a place to sleep or stealing to eat or reacting to the voices in their head.

In addition, they have high rates of substance abuse and drug addiction (estimated by some at 50 percent and poverty – to qualify for our services, you must be below the poverty line) making them particularly susceptible and vulnerable.

Once the coronavirus enters, the jails will be a petri dish for the spread of the virus. In fact, it has been reported that in some jails the virus is already suspected.

While the media and the government have focused almost exclusively on the high risk that coronavirus poses to elderly people, there has been no focus at all on those people jailed in our state prisons and county jails.

There are more than 2.3 million people being held in prisons, jails and state psychiatric facilities in the United States.

The World Health Organization (WHO) has placed the mortality rate for coronavirus at 3.4 percent – it is likely to be higher for this at-risk group. We could, therefore, be talking about a massive number of infections and many deaths within prisons.

Prisoners are already at a higher risk of respiratory infections such as tuberculosis, which has been documented by the Centers for Disease Control and Prevention (CDC) as well as the flu. There are estimates that tuberculosis is 17 times more prevalent and Hepatitis C nine times more prevalent among jailed people. About 40 percent of all imprisoned people have at least one chronic health condition, such as asthma or diabetes.

Poor nutrition and sanitation are also at play; county jails and state prisons are notoriously dirty. This is something I have witnessed first-hand – there is often no access to running water or proper ventilation.

County jails are bad, and even worse than prisons when county funds are stretched thin, with no outdoor time for inmates. As a result, sometimes, our clients would prefer state prison. Jails and prisons are also woefully understaffed, overcrowded and in disrepair with broken-down air conditioners and staff shortages creating safety issues.

Overcrowding and staff shortages are problems faced in most, if not all, states: in Delaware, such problems resulted in a prison takeover and the death of a prison guard in 2017.

Moreover, many jails and prisons lack sufficient healthcare under normal circumstances, much less at a time of a potential pandemic. While funding has recently increased in certain areas, there are still complaints that resources are lacking.

Riverside County settled a lawsuit in 2015 alleging that it failed to give adequate care to the inmates.

How local, state and federal authorities should react in times of crisis to address these risks and protect prisoners is not an easy question to answer. But finding an answer is crucial, especially in the US, which has the largest prisoner population in the world.

Such answers must come top-down, from state governors, from state and local officials and institutions and from the federal government (I am not holding my breath on that one).

One question is, should we release some inmates? It is not unthinkable; some countries are doing just that.

I have personally witnessed that these jails are utterly unprepared for any kind of mass contagion. In fact, I was shocked when I visited a county jail in California last week.

After arriving at the jail at 9am, I went to wash my hands, but was dismayed to see that the visitation centre’s toilet was without hand soap or sanitiser and that the toilet’s soap dispenser had a sign on it reading “the soap dispenser is broken”.

When I questioned the deputy on duty, he said the issue was “the janitor’s job” and that he would inform the janitor in the afternoon. When I asked if I could bring my sanitiser bottle inside with me for my contact visit, the deputy informed me that it was not allowed. If the outside visitation centre is without soap and hand sanitiser, it is unlikely that the picture is any better for prisoners themselves – they may have nothing except, if they are lucky, a small bar of soap and perhaps water.

Once the virus enters the facility, as it most certainly will, it will spread like wildfire unless protective measures are taken.

In California, a new law passed in 2011, allowing prisoners to be moved from state prisons to county jails to decrease prison populations, has created a perfect storm in which this pandemic can flourish. That is because all the new law has done is create overcrowded and under-resourced jails which are ill-equipped to handle the influx of inmates staying for longer sentences. The jails are ill-equipped because counties simply do not have the funds to house all of the inmates, ones that previously went to prison as the jail was reserved for pretrial detention and probationers serving less than one year.

I fear that these institutions are not equipped to protect my clients. The jails are routinely unable to address a client’s health concerns, such as diabetes and epilepsy, until I or the court intervenes.

It often takes a court order to guarantee that my clients see a doctor at all and I am lucky that I work in a court with a judge who is dedicated to protecting safety and wellbeing.

The reality is that jails simply cannot handle any more stressors than they already have and coronavirus could be the breaking point.

The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.