Eight months into the coronavirus pandemic, prisons across the country are still grappling with how best to control a virus that is intensifying nationwide.
The coronavirus has continued to spread widely in detention facilities, despite officials taking a host of measures to stem it. Prisons have released thousands of inmates to ease overcrowding, stepped up health screenings among visitors and adopted protocols from the U.S. Centers for Disease Control and Prevention such as mask wearing for inmates and staff.
The number of infections inside the nation’s state and federal prison systems has varied over the past six months, largely mirroring the nationwide spread. Between April and June, prisons recorded an average of 17,700 new cases a month. That climbed to more than 30,000 new infections a month in July and August, before dipping slightly in September to 25,031, and 26,290 in October, according to the Covid Prison Project, a group made up of interdisciplinary public health scientists from universities around the country tracking the virus’s spread in correctional facilities.
Through mid-November, the U.S. prison system has already recorded more than 20,000 cases, putting it on track for the highest number of monthly cases since the pandemic began. Reporting standards vary among institutions and localities, meaning the exact number of infections could be higher.
Health experts worry that Covid-19, combined with flu season, could soon overwhelm prison health resources.
“Prisons are going to continually be tested, with multiple Covid introductions, until we get this thing under control,” said Zinzi Bailey, a social epidemiologist at the University of Miami’s Miller School of Medicine.
Limiting those introductions, or the ways in which a virus enters an enclosed environment like a prison, is a focus for prison officials. Court documents show the transfer of 121 inmates may have been to blame for a severe outbreak over the summer in California’s San Quentin State Prison in which approximately 75% of inmates caught the virus.
The California Department of Corrections and Rehabilitation in August mandated that all prisoners transferred between institutions complete a quarantine. Some prisons without cases are conducting random testing of inmates and mandatory testing of all staff every two weeks. At facilities with increasing cases, staff is tested weekly and movement between housing units is limited as much as possible.
A recent outbreak at the Utah State Prison in Draper is believed to have been caused by a visiting medical professional, according to a prison official.
“We don’t have the option of sending everybody home,” said Mike Haddon, executive director of the Utah Department of Corrections.
Early in the pandemic, to reduce risk, some prison systems sent low-level offenders and elderly or sickly inmates home. California released more than 21,000 people, resulting in the lowest prison population in decades, said spokeswoman Dana Simas.
But not all elderly and ill patients have been granted release. Gloria Taylor, who is serving a life sentence for drug offenses at Homestead Correctional Institution in Florida, was hospitalized with Covid-19 in April. Her roommate in the hospital, also an inmate, eventually died, Ms. Taylor said.
A request for conditional medical release for Ms. Taylor was rejected by the Florida Department of Corrections in May.
Ms. Taylor’s attorney, MiAngel Cody, fears her 64-year old client, who has HIV, could be susceptible to reinfection. Ms. Cody is the founder of the Decarceration Collective, a law firm funded in part by Kim Kardashian West that is dedicated to the defense of federal prisoners serving life sentences for nonviolent drug offenses.
“There’s nothing in place to keep her safe,” Ms. Cody said of Ms. Taylor.
The Florida Department of Corrections said it is following all CDC safety guidelines for correctional facilities.
Even with mitigation measures in place, more than 212,000 inmates in the U.S. have contracted the virus since the pandemic began, according to the Covid Prison Project, which compiles data from prison systems in all 50 states and Puerto Rico, the Federal Bureau of Prisons and U.S. Immigration and Customs Enforcement, along with a number of jails.
Inmates have been infected at a rate that is more than four times higher than that of the general population, data from the Covid Prison Project shows.
Despite that, the case-fatality ratio, or the percentage of coronavirus cases that are fatal, is lower among inmates than the broader population. A total of 1,491 inmates have died since the start of the pandemic, which puts the case-fatality rate at about 0.7%. That figure is at 2.1% for the U.S. as a whole.
Lauren Brinkley-Rubinstein, an assistant professor of social medicine at the University of North Carolina at Chapel Hill, and co-founder of the Covid Prison Project, said this is partly attributable to demographics. Although the prison population is aging, overall it skews younger than the broader population.
However, amid this latest surge, Dr. Bailey of the University of Miami said, hospitalizations and fatalities are likely to rise, given the prevalence of comorbidities such as hypertension or diabetes among inmates. Covid-19 poses more risk to people with chronic illnesses.
Dr. Bailey said prisons should take broader steps to reduce crowding. Avoiding jailing those who are unable to pay cash bail, especially those with comorbidities, would also help alleviate the spread, she said.
But outbreaks continue to plague other parts of the nation’s system, including at two upstate New York prisons in mid-October. In Montana, the state’s Army National Guard was deployed last month to assist with an outbreak in the prison system.
In Utah, which has reported 952 infections to date at the prison in Draper, Mr. Haddon said the state had been lucky to avoid an outbreak until this point.
“We knew eventually our number would be called,” he said.
Write to Talal Ansari at Talal.Ansari@wsj.com