Health Officer Analyzes San Quentin COVID-19 Outbreak in Letter to Judge

By Pavan Potti

MARIN – In the tight and compressed environment of prison, a powerful virus like COVID-19 has an enhanced chance of spreading, it didn’t help San Quentin State Prison on June 1 when 122 new inmates from the Chino Institute of Men (CIM) were transferred to the facility.

Noticing the subsequent escalation of the Coronavirus cases over observations he made during his time at the facility as part of the Incident Command response team, Public Health Officer Matthew Willis of Marin County knew he had to inform higher authorities.

In addressing the severity of the issue at hand, Willis wrote to a Marin Superior Court Judge, suggesting new approaches to ensuring the safety of those working and incarcerated in San Quentin State Prison, noting that the increased population was only one of many factors, all of which are equal contributors to the virus outbreak currently impacting the facility.

Willis starts his letter by providing some background information. Despite having no jurisdiction over the San Quentin State Prison, the Marin County Public Health (MCPH) had been constantly in communication with the California Department of Corrections and Rehabilitation (CDCR), in order to provide required guidance.

Willis pointed out that when 122 inmates transferred from the CIM, and were not COVID tested, the MCPH knew that some had a high chance of being COVID-19 positive and needed to be isolated—and advocated for the newly transferred inmates to receive immediate testing and to be kept in separate areas from already existing San Quentin inmates.

Willis states, however, that the CDCR didn’t regard the recommendation with much gravity. Contrary to the received suggestions, the testing of new inmates was spread out over multiple days, and the transferred inmates were placed in a shared unit with preexisting San Quentin prisoners.

“Breaches in mask wearing, physical distancing and other fundamentals of infection control among staff still remains a concern. Approximately 300 correctional officers and other prison staff have

been infected during this outbreak, indicating the institutional challenges of strict adherence to personal protective equipment and physical distancing standards in routine operations,” Willis wrote.

To avoid more costly mistakes, Willis describes how the MCPH filed a petition with California Gov. Newsom in the hopes to establish an incident commander who not only had experience in outbreak management but would also oversee leadership over the MCPH and CDCR. An Alternate Care Site was also put in the facility to treat symptomatic inmates who didn’t need to be hospitalized.

Willis credits these implementations for creating a slight change in the facility’s outbreak.

But, as of this week, 2,200 out of the total 3,400 inmates have been infected, with the remaining 1,200 in high risk of becoming positive.

In tackling the present complication, Willis writes that the risk for inmates can be traced back to three different things: whether or not effective methods are being placed in order to prevent infection, the health of inmates themselves, and the presence of active healthcare at the facility.

First, Willis states that useful tactics need to be used in order to prevent infection; something which isn’t supported by the prison structure and inconsistency within the safety habits of prison staff. According to Willis, the low ventilated prison contains pairs of inmates in 4 x 8 cells, all of which have open bars.

That leaves no place for inmates to have personal space, and it only makes things worse when the staff members haven’t been sticking to social distancing rules themselves; so far, more than 300 correctional officers and staff have been infected, he said.

Second, Willis notes the wide diversity of inmates, with a wide range of age groups, ethnicity and health backgrounds, putting some inmates at a higher risk than others. The virus has shown to impact people of age more drastically, and with others having preexisting health conditions, the virus can prove to be fatal.

He argued, “Older individuals or those with underlying medical conditions are at higher risk for severe disease or death if they become infected. The San Quentin population has a high proportion of older inmates compared to other correctional facilities, especially men in the condemned unit. Further, due to the demographic makeup of the prison population, in income, race and education, there is high rate of underlying chronic diseases than place inmates at higher risk for mortality if infected.”

Lastly, taking into consideration the subjectivity of COVID symptoms, Willis stresses the importance of having a reliable source of transportation to a hospital which is willing to take in anybody from the facility in time of need.

“While the permanent San Quentin medical staff is excellent, the team was not designed to match the demands of a large-scale outbreak. There is no on-site hospital for critically ill inmates. The recent additional medical support brought on site is for the management of inmates who experience mild symptoms.

“All requiring higher levels of oxygen or intubation, or other critical care must be transferred out to a regional hospital by ambulance. This requires identifying a suitable receiving hospital and transportation in each case,” Willis said.

“On-site mitigation efforts to prevent transmission remain a challenge. Those 1200 inmates who have not yet been infected are at significant risk of becoming infected. Despite significant progress compared to the poor initial standards, the environment itself presents barriers that are nearly insurmountable within the existing architecture.

“The larger cell blocks, with pairs of men in hundreds of 4 x 8 foot cells with open bars, opening into common space with limited ventilation, have proven to be an especially high risk environment to all living there. Attack rates— defined as the proportion of Individuals infected in a given shared setting— have been extremely high and well above 50% in many of the buildings,” Willis noted.

Willis expresses optimism, claiming that the cure to easing the scenario is possible through long term persistence, and has asked for Judge Geoffery Howard of the Marin Superior Court to allow for Outbreak management experts to have full jurisdiction in making decisions at the prison.

“Taken together these factors sum to a picture of significant ongoing risk related to COVID-19 for inmates at San Quentin State Prison, despite progress over the past month to shift from a wholly under-prepared and under-resourced system. Most of the ongoing risk is attributable to factors that can, with concerted effort and resources, be addressed over time, but cannot be corrected in the short term.

“These include addressing crowding of inmates in single large settings, ensuring public health experts have institutional authority to manage outbreaks, and expanding clinical services in prisons to ensure timely access for all healthcare needs,” Willis wrote.

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About The Author

The Vanguard Court Watch operates in Yolo, Sacramento and Sacramento Counties with a mission to monitor and report on court cases. Anyone interested in interning at the Courthouse or volunteering to monitor cases should contact the Vanguard at info(at)davisvanguard(dot)org - please email info(at)davisvanguard(dot)org if you find inaccuracies in this report.

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