Preventing outbreaks in the future will require a comprehensive list of fixes, from reducing overcrowding in the state’s 34 adult prisons to improving old buildings. Vaccination drives and methods for rapid detection are also necessary, researchers said.
"We found that many California prison officials and staff did heroic work under incredibly difficult circumstances," said study co-author Dr. Brie Williams, a professor of medicine at University of California, San Francisco.
"But in many cases, it still wasn’t enough," Williams said.
When the U.S. national COVID-19 emergency was declared in March 2020, the California Department of Corrections and Rehabilitation (CDCR) held about 120,000 inmates and employed about 50,000 staff.
By December 2021, inmates had 50,000 documented COVID cases, as did 16,000 prison staff. About 240 inmates died from COVID, as did 26 workers.
The report was produced by researchers at University of California, Berkeley as well as UCSF, under the auspices of CalPROTECT, a joint project between the two universities investigating COVID transmission in California prisons.
"The CalPROTECT effort underscores the important role that cross-campus multidisciplinary teams of researchers can play in providing feedback to state agencies through academic-state partnerships," study co-author Dr. Stefano Bertozzi said in a Berkeley news release. He's a professor of health policy and management at Berkeley’s School of Public Health.
California's prisons were at a disadvantage because of old and sometimes antiquated buildings, the researchers found. The institutions house thousands more inmates than they were designed to hold, making it nearly impossible to practice preventive measures like social distancing and isolating ill inmates.
The team also found inadequate heating and air conditioning systems, which meant inmates and staff alike were more likely to breathe air that contained the virus.
Policymakers should have prioritized the early release of prisoners because of the building conditions, especially those who were elderly or at higher risk of infection, the authors said.
"In the United States, which holds a quarter of the world's incarcerated population, nearly half of state prisons reported that confirmed cases among incarcerated people were four or more times [and up to 15 times] higher than the rate found in the state's general population," the report said.
Risks may have been elevated because vaccinations are not required among prison staff, and many have declined to be vaccinated, the study noted.
Also, "every CDCR prison exceeded the case rate in its surrounding county," the authors said.
Death rates among prisoners were higher than in the state of California and the United States as a whole, even though the prison had a lower proportion of older inmates than the local population.
More than 1,000 inmates too sick to be treated in prison health facilities were admitted to local community hospitals during the pandemic. More than 150 were admitted to intensive care units. Inmates of color had higher risks of hospitalization than white inmates.
"We believe that state policymakers and prison managers should look closely at the lessons learned in this crisis to help assure we're better prepared in the future. This includes giving attention to massively reducing the prison population in our state in the interest of public health, as overcrowding is likely the single greatest health threat in a respiratory pandemic," Williams said.
The COVID Prison Project tracks data in prisons during the COVID-19 pandemic.
SOURCE: University of California, Berkeley, news release, July 5, 2022