Haymarket Books
In 2020, prison and jail administrators turned to solitary confinement and lockdown as their primary means of preventing the spread of COVID-19. At first glance, the practice might make sense. After all, cities, states, and nations had shuttered schools, workplaces, and businesses in an effort to encourage people to stay away from one another. But unlike people sheltering at home, those behind bars could not escape human contact or deadly respiratory particles.
For some, lockdown increased their dangers. In January, “Nancy,” a trans woman in a federal men’s prison, was moved into a new cell. Initially, she wasn’t worried. She already knew her cellmate, who had never hassled her. Once they were in the same cell, however, he repeatedly pressured her for sex. She dodged him by staying off the unit—attending her work assignment and programs. The COVID-19 lockdown cut off those escape routes. During the next several weeks, he raped her multiple times. Nancy never reported these attacks. Although the Prison Rape Elimination Act of 2003 mandated that prison officials investigate all sexual harassment and assault allegations, these complaints were rarely addressed. If she lodged a complaint, staff would place her in solitary and she would face further danger from her attacker and his friends.
The rapes ended when he was moved to another unit for a work assignment. But Nancy’s respite lasted less than a day. Her next cellmate, enraged at being housed with a trans woman and boiling with resentment from his own six years in prison, turned her into his personal punching bag. The beatings stopped after he was placed in quarantine just before his release. Nancy remained in prison and hoped that her next roommate would be less abusive.
In all prisons, including those in which people are locked down, supposedly for their own protection, staff remained a constant threat of transmission. Even when prison administrators attempted to stave off this possibility, other agencies undermined their efforts. In April 2020, Arkansas prisons mass tested both staff and incarcerated people. But the state’s health department issued a memo instructing asymptomatic staff who had tested positive to continue reporting to work. Four days later, 826 incarcerated people and thirty-three staff tested positive. Later, the Arkansas prison system, which incarcerated roughly 16,000 people, had the nation’s tenth-largest outbreak. Similarly, Texas prison officials had initially ordered staff to report to work, even if they had been exposed or tested positive, so long as they were asymptomatic.
From the start of the pandemic, health experts stressed that medical isolation should not mirror punitive solitary. They warned that isolating people would deter them from reporting symptoms, cause additional stress, prevent identifying those who had COVID-19, and ultimately worsen the crisis. Health professionals urged instead that quarantine and isolation be overseen by medical staff and that the patient be allowed their belongings and daily access to medical and mental health staff. Jails and prisons that could not follow these recommendations needed to de-carcerate to prevent COVID-19 outbreaks. The experts especially urged California officials to reduce San Quentin’s population—then at 3,547 people—by 50 percent.
Their recommendations were largely ignored. Instead, lockdowns became normalized as the primary response. Conditions mirrored those in punitive solitary. By mid-April, people under some form of lockdown increased 500 percent from 60,000 to over 300,000 within a matter of weeks. Those lockdowns failed to stem the spread, particularly in the prisons already identified as potential hot spots. By June 2020, San Quentin had more than 1,400 active cases, becoming a nightmarish landscape of disease and death.
During the day, nurses went from cell to cell to check vital signs, ask if patients were experiencing symptoms, and call for emergency responses. They repeatedly heard complaints about weakness, pain, difficulty breathing, dizziness, and collapse. Each night, cries of “Man down!” were repeated from cell to cell, alerting the guard on duty to call for medical help.
“Ambulances stationed outside the prison gates awaited fallen COVID-19 victims day and night,” recalled prison journalist David Ditto. “A tent city was set up on the recreation yard to temporarily house about 100 infected residents. Incarcerated people were moved into the gymnasium. Four chapels were converted into temporary housing. A factory was converted into an Alternative Care Site and a supplemental medical team was contracted to house and care for over 200 of San Quentin’s sickest patients.”
That same month, the prison began using its death row—which bore the Orwellian name of the “Adjustment Center”—for quarantine and isolation. Known as a “prison within a prison,” the Adjustment Center was also used to isolate people whom officials considered a threat to prison security. “No warning shots are fired in this unit or in the exercise yards,” cautioned the first page of the orientation manual.
Inside the Adjustment Center, men spent nearly twenty-four hours a day in six-by-eight-foot cells. Their sole windows were two slivers in hollow steel doors facing the corridor; there was no daylight or air flow. At waist height sat a small slot, locked from the outside and unlocked only to deliver food or to handcuff a person before bringing them out of the cell. Mental health visits were also conducted through that slot. A nurse stood outside the cell with a laptop opened so that the men could have telehealth visits with a doctor. While people in other units could use headphones to ensure that the doctor’s remarks remained private, the headphones did not fit through the slots in the Adjustment Center doors, allowing everyone within earshot to hear the entire appointment.
Even for those who avoided both COVID-19 and the onerous quarantine conditions, lockdowns felt like further punishment. In California State Prison, Corcoran, Mwalimu felt as if he were back in the Special Housing Unit. This time, he also had to grapple with the ever-present threat of death. The corridor reeked of disinfectant and chemical sprays. Nurses, blanketed in protective gear, went from cell door to cell door. Some men could barely walk to their door for the temperature check. Others had temperatures so high that they were immediately wheeled from their cells to the prison’s medical unit.
“It felt like death was all around us, but you didn’t know who was next,” Mwalimu recalled. He wasn’t wrong. Later, he learned that some of the men who had been wheeled off had died.
Death wasn’t limited to prison walls. When the virus exploded behind bars, each departure carried the probability that staff would bring it home to their families and neighbors. The Prison Policy Initiative, a nonprofit research organization, estimated that, during the summer of 2020, prisons and jails contributed to more than half a million additional COVID-19 cases nationwide—roughly 13 percent of all cases during that stretch of time. Had policymakers heeded the admonitions of public health officials and allowed large-scale releases, they could have averted both outbreaks behind bars and hundreds of thousands of cases in the surrounding areas.
“Solitary confinement has significant medical consequences,” noted Eric Reinhart, a political anthropologist who has studied COVID-19 outbreaks in jails and prisons. People locked in cells frequently cannot flag the attention of the officer on duty. Many people told me that the cell’s emergency call button, if one existed, had long been broken. Their only way to call for help was to bang on the door and shout. Sometimes others in neighboring cells would join in, hoping to create a cacophony that could not be ignored. But, like so much about the goings-on behind bars, there is no data about acute incidents in solitary that go unaddressed.
Even when call buttons work, assistance might not arrive in time. Even when staff do respond, they may not actually help. For several years before the pandemic, I had been corresponding with Heather, a trans woman incarcerated at a federal men’s prison. Heather had been physically and sexually assaulted by prior cellmates and had been pressing, unsuccessfully, to be transferred to a women’s prison. When the prison was locked down—first as a COVID-19 prevention measure and then in response to the Black Lives Matter protests sweeping the nation—she told me that she considered herself lucky that her cellmate treated her with respect. She turned her energies from transferring to a women’s prison to preparing for her anticipated release date, peppering me weekly with questions about housing options for formerly incarcerated trans women in New York City.
In October, I stopped hearing from her. Wondering if she had been transferred, I looked her up on the federal prison database. I was stunned to find her listed as deceased. No cause was given. Shortly after, I began receiving e-messages from her cellmate, who told me that Heather had been in increasing pain all month. “Whenever Heather tried to get medical’s attention, they wouldn’t even look through the door,” he told me. He assumed that she had had a stroke, but the few times they were able to cajole a nurse into examining her, the nurse ignored anything he said.
On the day that Heather died, he told me, a nurse had made rounds in the housing unit offering flu vaccines. Both he and Heather attempted to tell him about her chest pains, but the nurse did nothing. Later that afternoon, when Heather’s chest pain worsened, her cellmate hit the emergency call button. It worked—and brought the officer on duty to their cell. The officer took Heather’s plight seriously and called for medical help. That brought a nurse, who took her blood pressure and pronounced her fine. One hour later, Heather began throwing up blood and bile. Medical staff gave her acetaminophen and a shot of Maalox, but did not bring her to the medical unit for further examination. Several hours later, Heather collapsed and died.
Another man at that prison wrote to me later. His cellmate had witnessed medical staff stopping at Heather’s cell throughout the day, then leaving without having done anything. He himself had noticed the deadly hour-long lapse between hearing the alarm from her cell and emergency services arriving.
As far as I know, Heather did not have a next of kin who could press to learn the cause of her death, let alone attempt to hold the federal prison system—including its medical staff—accountable for its inaction. Instead, Heather became another statistic among the 505 deaths in federal prisons that year.
Excerpted from the book Corridors of Contagion: How the Pandemic Exposed the Cruelties of Incarceration by Victoria Law. Copyright © 2024 by Victoria Law. From Haymarket Books. Reprinted with permission.