The State of COVID-19 in U.S. Prisons

Due to overcrowding, lack of resources, and little access to medical care, incarcerated people have been at high risk for contracting COVID-19. Now, as the highly transmissible Delta variant circulates widely, they may be even more susceptible to the virus.

Josh Manson, a researcher at the UCLA Law COVID Behind Bars Data Project, tells Verywell that there have been few efforts to curb the Delta variant and COVID-19 overall, making prisons deadly places for transmission. “When the pandemic first hit in March 2020, prisons were not taking the situation seriously,” Manson says. “We know that it’s even more transmissible than it was the first time a year and a half ago. We’ve seen thousands of people die in jails and prisons.” 

So far, at least 2,718 people incarcerated in state and federal prisons, including ICE custody, have died of COVID-19, making prisons a lethal setting during the pandemic.

According to Manson, the current death count is an underestimate. “There’s evidence emerging that the counts that have been recorded are actually undercounted,” Manson explains. “So we don’t even know the true totals of how many people died.” 

Early on, the Centers for Disease Control and Prevention (CDC) identified people in prison as vulnerable to COVID-19 infection. At the height of the pandemic, public health practitioners and civil rights organizations demanded the release of people in prison due to overcrowding and the lack of access to medical care.

According to the Prison Policy Initiative, the Federal Bureau of Prisons released over 24,000 people over the course of the pandemic, with sentences to be served in home confinement.

While some prisoners were released, a portion of the releases were deathbed releases—or the release of incarcerated individuals who are near death.

“It’s basically just taking the handcuffs off while they’re [incarcerated people] on a ventilator and then saying, 'oh, you’re free,' and then they die,” Manson explains. 

Deathbed releases have made it difficult to determine the number of deaths that occurred within prisons, Manson adds. In fact, the New York Times reported this week that dozens of these cases around the country have been excluded from official counts.

Collecting COVID-19 Data From Prisons Remains Challenging

Data collection within prisons has been no easy feat, according to Manson.

Homer Venters, MD, epidemiologist, clinical associate professor at New York University’s College of Global Public Health, and former chief medical officer for the New York City jail system, tells Verywell that to track and promote better health outcomes, he believes data should be collected by the CDC and state departments of health. 

“Some of the recommendations that I really advocated for in the Biden Harris task force have explicitly called on the CDC and the state department’s of health to become much more involved in tracking health outcomes,” Venters says. 

“All health data from prisons right now is really all over the place,” Manson adds.

For example, prison systems report vaccination differently. Some prisons have reported the number of incarcerated people who have received only the first dose, while other systems have reported the number of staff and incarcerated people who received both doses.

Vaccination Rates for Staff Lags Behind

Manson says that vaccine efforts within prisons aren't as robust as they should be. While 446,079 incarcerated individuals (or 66%) have received at least one dose of the COVID-19 vaccine, carceral facility staff are vaccinated at much lower rates.

Across all U.S. prisons, only 110,946 correctional staff (45%) have been vaccinated in comparison. Venters says that low vaccination rates among carceral staff are a national problem.

“You’ll see that the vaccination rate for incarcerated people is higher than for staff,” Manson says. “That is not because incarcerated people have had easier access, but because staff refusal rates have been high.” Because the Delta variant is highly transmissible, staff can serve as transmitters of the virus if they are unvaccinated. 

“When you have such an overcrowded facility, which these facilities are right now, it only takes one case,” Manson says. “So if a member is not vaccinated, they can very easily transmit the virus.”

Experts Say More Needs to Be Done to Curb Hesitancy

According to Venters, the most basic strategies for curbing vaccine hesitancy—like addressing people's concerns about safety—are not being employed.

Incarcerated people have declined vaccinations because their questions about the vaccines were left unanswered, Venters says. 

“Often behind bars, the way that the vaccine is offered is through these big mass events, there’s very little attention to finding the people who have questions, and really sitting down and talking to them,” Venters adds.

These questions typically arise for people in prison who have complicated health problems. “We have this paradoxical situation where some of the sickest people who really just had a lot of normal, genuine questions about vaccinations remain unvaccinated because of the way in which the vaccine has been offered,” Venters stresses. 

For correctional officers, some have rejected the vaccine because they were worried about not having enough paid time off, Venters notes.

“Correctional settings decided they were going to give people five or 10 days of COVID off, and that would include if they got sick from COVID, or if they had a side effect of the vaccine,” he adds. “But many correctional officers blew through that time a year ago when they got sick.” 

Correctional officers expressed worry to Venters that if they experienced side effects, they wouldn’t have any sick time, underscoring the financial concerns for carceral staff and their families. This suggests a need for policy change within the prison system, Venters says.

Regardless of a vaccine mandate, curbing the Delta variant will require engaging with carceral staff.

“I think the first step that most places have failed to do is to figure out what the issues are,” Venters says. “It starts with a survey to ask what are the problems people have?”

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