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Editor’s note: This article, originally posted Aug. 26, 2020, was updated Aug. 28 to reflect new information from the N.C. Department of Health and Human Services.
The women’s prison in Raleigh has had the most consistent and widespread outbreak of the new coronavirus, which causes COVID-19, of any prison in the state.
Even without a pandemic raging inside its walls, women who have been in the prison describe poor conditions.
The N.C. Correctional Institution for Women does not have air conditioning. Fans and coolers with ice are put out, but prison staffers take them away to punish inmates, according to Anna Crim, who was released from NCCIW on July 17 and is now on post-release supervision.
The soap and disinfectant are watered down to make them last longer. The women do not have access to hand sanitizer.
“Raleigh in general is very inhumane,” Crim said. “You have moldy, mildew walls and showers, bathrooms. The prison is falling apart. You have roaches everywhere.”
Since April, the women in NCCIW have also had to worry about a pandemic. Now, in an effort to control the spread of the virus, the women are confined to their dorms, where they live and sleep within an arm’s reach of each other, 23 hours a day.
The prison staff has organized the women into cohorts, or small groups, that are in theory isolated from one another to limit transmission of COVID-19 and to help trace who it could have spread to if someone tests positive.
So far, NCCIW’s strategies do not seem to be working.
To date, 267 women at NCCIW have tested positive for the disease, and one woman has died. According to the N.C. Department of Public Safety, 51 staff members have tested positive.
According to DPS online data, 22 women are currently ill with the disease. As of Friday, DPS reported 17 staff members were off work because they tested positive for COVID-19.
A continuous outbreak since April?
DPS reported the first nine cases of COVID-19 at NCCIW on April 21. By May 10, there were 91 cases. The outbreak was contained in one low-security housing unit.
There were no more reported cases from May 10 to July 2.
The N.C. Department of Health and Human Services monitors COVID-19 outbreaks, defined as two or more laboratory-confirmed cases. If 28 days pass from the last symptom onset or the latest test of an asymptomatic case and no one else in the prison develops symptoms or tests positive, the outbreak is considered over.
Presumably, the gap in reported cases from May 10 to July 2 would indicate that the first outbreak ended and a new one began when new cases appeared.
At the time of this article was initially posted on Aug. 26, neither DPS nor DHHS was able to answer questions about how many outbreaks had occurred at the prison.
DHHS reached back out to CPP on Aug. 28 to confirm that the outbreak at NCCIW has been continuous. DHHS confirmed that DPS reported cases at NCCIW between May 10 and July 2. Those cases were not reported on DPS’ public dashboard. DPS has not responded with an explanation.
DPS is being sued in Wake County Superior Court for failing to provide humane prison conditions during the pandemic. On June 16, Judge Vinston Rozier Jr. declared the state’s prison conditions to be likely unconstitutional, in part because DPS “failed to provide the sufficient COVID-19 testing.”
At the time, DPS was testing only when people developed symptoms. While this policy was in line with DHHS recommendations at the beginning of the pandemic, DHHS changed its recommendations on May 15 to test any person in prison suspected of having COVID-19. That would include exposure to COVID-19, not only symptom onset.
DPS did not provide any information to the court or to CPP that it changed its testing strategy in response.
On July 2, one test came back positive. Within a week, DPS reported 55 more cases.
On July 8, due to a court order, DPS tested every woman in custody at NCCIW.
Then, the numbers go sideways. DPS reported to the court and CPP that mass testing revealed 138 cases, but only 73 were reported on July 10. Cases are reported when test results are returned to DPS, and another nine cases came in over the next week.
It is not clear whether DPS changed its reporting method, but the only way to account for all 138 cases is to include the cases that were found in the week before mass testing was administered.
If that is what happened, then DPS has inconsistent reporting of positive tests and its mass testing numbers.
In contrast, CPP recently reported on the mass testing at Lumberton Correctional Institution, where the cases that were discovered immediately before mass testing were not reported in the mass testing numbers.
More problems with the state data
In his July 10 order, Rozier chastised the defendants in the case, including DPS, Gov. Roy Cooper and the Parole Commission, because they “failed to comply with the court’s directions in several meaningful ways.”
One failure was in not providing all the information the judge asked for. Another was that “the data defendants provided was inconsistent in its application to the various institutions maintained by DPS, incomplete and potentially incorrect.”
The plaintiffs in the case, represented by the American Civil Liberties Union of North Carolina and several other civil rights organizations, have repeatedly complained to the court about the state’s either lack of data or inaccurate data.
On June 16, the state provided the court with a description of all the cohorts in all of the prisons in the state.
Though more than 1,000 women are incarcerated at NCCIW, the state accounted for only 250 women at the prison. Cohorts are supposed to be manageably small groups of people. At the time, the state described one cohort of 159 women.
In an updated document on July 27, DPS seems to account for all the women in its custody at NCCIW, though it accidentally labeled half the prison population as male.
On Aug. 17, the ACLU asked Rozier to enforce his orders. The state, the group argued in its motion, has failed to act on several court directions, including providing adequate information about its actions.
The next hearing in the case will be Friday.
A new cluster of COVID-19 cases
After the mass testing on July 8, DPS returned to its previous policy of testing people who have a temperature of over 100 degrees or if a medical provider diagnoses respiratory problems consistent with COVID-19.
DPS is also testing cohorts exposed to COVID-19 and testing “based on contact tracing,” according to spokesperson John Bull.
In the last two weeks, DPS reported 22 new cases among women at NCCIW.
“The housing units they previously occupied are under medical quarantine with close medical observation and twice daily temperature checks,” Bull wrote in an email to CPP.
DPS has tested 41 people over the same period. That means that over half of the people tested have tested positive.
When CPP first reached out to DPS, the department’s internal database for positive COVID-19 cases had not caught up to the publicly reported number of positive cases on DPS’ website, causing Bull to identify fewer cases than were actually active. DPS updated its information after CPP pointed it out, though it highlights the patchy reporting of COVID-19 cases within DPS’ own system, let alone at the local health department and DHHS systems, which all receive, update and confirm the data at different times.
The number tested at NCCIW over the last two weeks roughly corresponds with the number of people in a cohort. However, Bull told CPP that he did “not have information on which offender tested positive, on which day, in which housing unit, nor do I have the current cohorting information at NCCIW you requested.”
Bull noted that “DPS and DHHS work together in this pandemic. Our medical teams routinely consult with the experts at DHHS.”
DHHS said it provides guidance to DPS, though it also could not describe aspects of the outbreak and directed CPP back to DPS.
In addition to the cases among the women in state custody, 17 staff members were off the job due to COVID-19 as of Friday.
DPS said staff illness was consistent with community spread of COVID-19. NCCIW has 791 staff members, according to documents the state submitted to the court. The rate of staff illness with COVID-19 is much higher than Wake County’s community spread of COVID-19 would suggest.
“Staff continue to be strongly encouraged to be tested with no copays through the statewide FastMed partnership,” Bull wrote to CPP, referring to an agreement DPS has with FastMed to test staff.
DPS reports the number of tests staff members have taken at FastMed. They are not representative of the number of staff cases, as most staff members seem to take tests at other locations. While 68 staff members across the entire state’s prison system have tested positive for COVID-19, with no more than 25 cases from any region of the state, NCCIW alone has had 51 staff members report positive COVID-19 tests.
DPS continues to decline to post data on the number of staff members who take a COVID-19 test at locations other than partnering FastMeds and test positive.
When looking at the big picture, Lauren Brinkley-Rubinstein, a professor of social medicine at the University of North Carolina and an expert witness for the plaintiffs in the lawsuit against DPS, thinks there could be more than 22 cases of COVID-19 at NCCIW right now.
“There’s probably many more infections than we know about,” Brinkley-Rubinstein said. “And because, you know, they haven’t come up with a long-term testing strategy to mitigate risk when they’re in outbreak, that those numbers aren’t that accurate.”
Rozier ordered DPS to come up with a plan to do “surveillance testing,” which is a strategy to randomly test people in prison to check for the presence of COVID-19. That only works after an outbreak has ended, Brinkley-Rubinstein said.
When there is an ongoing outbreak, as is the case in NCCIW, much more testing needs to be taking place.
Mass testing across all the prisons in the state revealed hundreds of COVID-19 cases that the state did not know about. At least in the case of NCCIW, DPS has returned to the strategies it was using before mass testing, when it was failing to identify significant numbers of people with the disease.
“Pray to cool off”
Since the beginning of the pandemic, women in NCCIW have complained that when they get sick, they are put in solitary confinement. They have also complained that they are not seen by medical staff when they complain of illness, or when they are seen, they are not treated properly.
The ACLU has documented these complaints in legal statements provided to the court by women who are or were recently incarcerated at NCCIW.
Rozier ordered the state to stop putting people who are sick in solitary confinement, as that is a punishment.
“When you’re sick, all they do is take you to segregation,” Crim said.
The ACLU submitted two affidavits to the court last week describing conditions in NCCIW. Crim and the women in the affidavits, Wendi Barefoot and April Wright, tell the same story.
All three women were released about the same time, so there is a chance that NCCIW changed its practice in the last month.
The quarantine time is 14 days for COVID-19. After that, as long as the person is not hospitalized, DPS follows DHHS guidance and presumes the person to be recovered and puts her back into the population. That is 14 days locked in a cell while sick with COVID-19.
“I feel like I have to speak out because it is so bad in that prison,” Wright said in her declaration. “I just hope that they don’t come get me and take me back to prison.”
In response to previous reporting about potential retaliation, Bull told CPP that “offenders have First Amendment rights just like any citizen” and that he is unaware of any instances of retaliation for talking to the press.
Crim said she is speaking out because she is out of prison now and can give a voice to the people still inside. They fear what the staff would do, Crim said. CPP has talked with a number of people in the state’s prisons who refuse to use their names for fear of retaliation.
Small retaliations can have dire consequences. Temperatures in the units are easily over 100 degrees, Crim and the others said. When staff members are mad at an inmate, they can take the water coolers away or simply not refill them with ice.
“A heat index of 105 or higher, and you’re having to get in cold water in the shower, just to get your clothes wet and go lay on the bed in front of the fan and pray to cool off,” Crim said.
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