Shacarey James was six weeks pregnant when she reported to the Federal Correctional Institution in Danbury, Conn., last summer to serve a sentence for a parole violation.
At risk for severe illness if infected with the coronavirus, Ms. James kept her mask on at all times, except when she was sleeping. In December, a woman assigned to the next bunk developed a hacking cough.
Ms. James, 25, suspected a coronavirus infection, but officers at the prison at first dismissed her concerns, saying pregnancy “hormones” were making her anxious, and they refused to test her bunkmate.
Four days later, the woman’s temperature spiked, and a diagnostic test came back positive. “She was three feet from me — we were eye-to-eye,” said Ms. James. “I thought she was going to pass away in front of me.”
Ms. James escaped infection, but whether she should have been in the prison at all remains a pressing question. When the pandemic erupted last spring, federal prisons were told to move quickly to grant home confinement to medically vulnerable inmates who did not pose a risk to the public.
Inmates like Ms. James, who was convicted of cashing fake checks, were to serve out their sentences at their residences, with an electronic bracelet monitoring their movements. The goal was to protect them, reduce prison overcrowding and minimize the risk of outbreaks. But the Federal Bureau of Prisons has been slow to act.
The coronavirus has infected more than 620,000 inmates and correctional officers in the nation’s prisons, jails and detention centers, according to a New York Times database. Nearly 2,800 inmates and guards have died, making correctional facilities among the most significant battlefronts of the pandemic, along with nursing homes and schools.
Yet just 7,850 of the 151,735 people serving federal sentences right now have been granted home confinement — about 5 percent. State prison populations have fallen by 15 percent since the pandemic began, according to the Prison Policy Initiative, but not because inmates are being released to home confinement. Instead, many state prisons simply have stopped accepting transfers from county jails.
The Danbury compound, one of 122 federal prisons, offers a prism into the bureau’s failure to contain the virus. Though Danbury was singled out for prompt action by former Attorney General William P. Barr because it had seen an outbreak, only about 100 inmates have been granted home confinement so far, many as recently as December. At least 550 are still under consideration, most of them convicted of nonviolent offenses like fraud or drug possession.
In December, cases at Danbury rebounded as more than one in 10 inmates at the complex tested positive for the virus. In a minimum-security women’s facility called the Camp, where Ms. James was held, 34 of the 50 inmates were infected.
Court declarations and interviews with inmates who were granted home confinement shed light on the missteps that contributed to the outbreaks.
Symptom checks were cursory in the prison, and suspended altogether for a period of about a week after Thanksgiving for no apparent reason, inmates said. Virus tests were administered only when inmates were acutely ill, which is the Bureau of Prisons’ policy despite the fact that people without symptoms are most likely to spread the disease.
Under a settlement reached last July with inmates who sued, prison authorities agreed to re-examine the cases of some 600 prisoners with medical problems like diabetes and obesity who had been denied home confinement. They face a Friday deadline to report back.
“What’s frustrating about our case is that we have a settlement agreement and the Bureau of Prisons is disregarding it,” said Marisol Orihuela, co-director of the Criminal Justice Advocacy Clinic at Yale University, who is representing the inmates, along with attorneys from law schools at the University at Buffalo in New York and Quinnipiac University in North Haven, Conn., and the firm Silver, Golub & Teitell in Stamford, Conn.
“They knew what they needed to be doing in order to mitigate another outbreak, and they simply didn’t do it,” she added.
Neither the former warden named in the lawsuit, Diane Easter, nor the federal lawyers representing the prison in the case responded to repeated requests for comment.
Justin Long, a spokesman for the Bureau of Prisons, said federal facilities have taken steps to control the spread of the coronavirus, including educating inmates and staff about preventing transmission, maximizing social distancing to the extent possible, and providing surgical and cloth masks, soap and cleaning supplies to incarcerated people.
“We understand these are stressful times for both staff and inmates,” Mr. Long said in an emailed statement. “It is our highest priority to continue to do everything we can to mitigate the spread of COVID-19 in our facilities.”
Because of crowded conditions and vulnerable populations, prisons and jails have long been known to be breeding grounds for infectious diseases like tuberculosis, influenza and hepatitis C.
Prisons are more densely populated than nursing homes, according to the Prison Policy Initiative; one study found that the coronavirus spread almost four times as quickly in a large urban jail as it had aboard the Diamond Princess cruise ship, which saw one of the most terrifying outbreaks of the early pandemic.
Minimum- and low-security settings like the federal prison at Danbury, where many inmates live in large dormitories separated by partitions that don’t reach the ceiling, are even more conducive to the spread of the virus than maximum-security prisons with cells that house only one or two inmates.
Many incarcerated people are medically vulnerable, suffering from conditions like obesity and Type 2 diabetes that increase the risk of serious complications or death should they be infected with the virus and develop Covid-19. “They’re like sitting ducks,” said Elizabeth Blackwood, an attorney with the National Association of Criminal Defense Lawyers.
At the same time, medical care for chronic conditions has been disrupted by personnel shortages — Danbury had seven vacancies on its medical staff last summer — and delayed access to specialists outside the facility.
Throughout the fall, Ms. Orihuela and her colleagues warned that the prison was in danger of becoming a hotbed of infections, documenting their concerns — including a lack of hand soap in the women’s bathrooms during the Covid-19 outbreak in December — in a series of letters and affidavits addressed to the court.
Prisoners’ requests to be seen by the medical team, known as sick call slips, weren’t being collected, the lawyers wrote on Oct. 30. Screening for Covid-19 symptoms, which was supposed to be done every day, was inconsistent.
Several inmates who complained of Covid-19 symptoms, like cough, chest pain and loss of smell and taste, said in interviews with The New York Times that medical personnel dismissed their symptoms as a cold or flu. When they were finally tested, getting the result could take a week.
oseph Heim Jr., a 45-year-old inmate in the men’s prison, submitted a sick call request on Nov. 28, when he started coughing, lost his sense of taste and smell, and developed chest pain “that felt like a heart attack,” he said in a declaration filed with the court.
A nurse told him it was “probably the flu,” and Mr. Heim was not seen by a doctor or tested for the coronavirus until Dec. 4. When Mr. Heim, who has chronic lung disease, was found to be infected and placed in isolation, he told staff he couldn’t breathe.
“They said there was nothing they could do for me,” he said in a declaration to the court. “The first four days I was in isolation, I laid there thinking I was going to die.” He remained there for 20 days, during which he was seen only three times by a physician, he said.
Isolation is critical to curbing the spread of infections, but almost a full year after the pandemic started, the prison did not have appropriate isolation quarters prepared for women who became infected.
In December, when dozens of women tested positive, they were housed in makeshift quarters in the prisons’ visiting rooms, according to the accounts of seven female inmates provided through written court declarations and phone interviews.
The rooms had no beds, only rudimentary restroom facilities, and no showers. (Temporary shower units were eventually installed.) The women were moved hastily; many said they did not have time to pack important items like medications, asthma inhalers and feminine hygiene products. Several said they were without their prescriptions for days.
On arrival, the infected women taken to the visiting room of the men’s prison, some of them visibly ill, were told to assemble metal cots to sleep on. Mattresses were not available at first, and bedding was scarce, according to numerous accounts. The room was cold, especially at night.
“I was freezing, actually, and they didn’t want to give us extra blankets,” said Stacy Spagnardi, 53, who was recently granted home confinement. She is serving a sentence for tax evasion and insurance fraud.
“Some women were so sick they couldn’t eat and could hardly move. One woman could not stop coughing,” said a written declaration by Jasmir Humphrey, who had spent nearly two weeks in the visiting room but was recently released for home confinement.
Mr. Long, of the prisons bureau, said in an email statement that all inmates who test positive or have symptoms are “provided medical care in accordance with C.D.C. guidance.”
That guidance says Covid patients recovering at home should rest, get plenty of fluids, take over-the-counter medicine for symptoms, stay in touch with their doctor and be alert for warning signs that the disease was getting worse.
But infected women who were placed in a men’s visiting room said they were not given over-the-counter drugs like acetaminophen for fever and body aches, despite their requests. Bright overhead lights were turned on at 6 a.m. every day, and inmates said that the guards threatened disciplinary action if anyone turned them off.
There was a water fountain in the room, but cups were not provided until numerous requests were made, and the women were not given tea, soup or any other hydrating foods, they said.
“It was about a week until we got Tylenol,” Ms. Spagnardi said. She said she got some acetaminophen after asking for it repeatedly, but it was not distributed to all the sick inmates.
Temperatures were checked daily on weekdays, but not weekends. Staff “didn’t check our other vital signs or listen to our lungs,” Ms. Humphrey wrote.
Mr. Long said that the isolation area was appropriately heated and that inmates had medical care, but he declined to comment on the other conditions described by inmates and their lawyers.
Sick women who were placed in another visiting room, at the women’s prison, said that once the guards left the room and locked the door behind them, they had no way to call for help in the case of an emergency. There was a phone, but it was useless.
“A sign by the phone said, ‘In case of emergency, dial this number,’ but the number didn’t work,” said Jacqueline Torres, 33, whose complaints of shortness of breath and body aches were ignored for several days in early December. She was finally given a rapid test on Dec. 7 and tested positive.
“The only way we could get in touch with anyone was if a guard walked through the hall, and we banged on the wall to get their attention,” she said in an interview.
On Dec. 9, Rae Haltzman, who is 65 and has high blood pressure, started vomiting but was unable to summon help. She lay down by the locked door of the visiting room with a blanket “waiting for someone to come,” she wrote in a statement filed with the court. When she spotted a psychologist leaving the building, “I banged on the door and asked him to get a medic.”
Ms. Haltzman was eventually hospitalized for nine days. After being discharged on Dec. 18, she was placed alone in a locked room “that is usually used for suicide watch, or drug withdrawal cases,” she wrote. She was kept there until Jan. 2, even though the hospital’s infectious diseases specialist had said it was not necessary for her to be isolated.
“I had panic attacks from being left in the room alone for so long,” she said. “I felt as though the whole time I was being punished for getting sick.”
Another inmate, Denise Bonfilio, also became acutely ill in the visiting room of the men’s prison. Her lips turned blue, and she was sent to the hospital. She was found to be dehydrated but was not admitted, and she returned to the room.
Because of her food allergies, Ms. Bonfilio often could not eat the meals that were provided, which may have contributed to her dehydration. In an interview, she described the treatment in the isolation room as “physically and emotionally brutal.”
“It was like survival of the fittest,” Ms. Bonfilio said.
The inmates had to order items they needed from the commissary, recalled Ms. Torres, who was granted home confinement on Dec. 23. “We literally bought Halls, ibuprofen and hot tea,” she said.
“We were all scared,” Ms. Spagnardi said. “We were all thinking we were going to die in there, and nobody would know until count.”
It’s not clear why prison officials have been so resistant to granting home confinement to inmates in the middle of a pandemic.
Most people incarcerated in federal institutions are nonviolent offenders. The minimum-security facility for women at Danbury, the Camp, is not even surrounded by a fence.
Yet experts say the bureau has an aversion to home confinement because of the “Willie Horton effect,” a reference to the infamous case of a convicted murderer who raped a Maryland woman and stabbed her fiancé while on furlough from a Massachusetts prison. The crimes served as the basis for attack ads that helped derail the 1988 presidential campaign of former Gov. Michael Dukakis.
Last March, the day after a former inmate was released from a prison in Florida to alleviate overcrowding and prevent an outbreak, he shot and killed a man in Tampa.
“Everybody’s worried that if they make a mistake, and someone gets out and commits a heinous offense, they will be blamed,” said Shon Hopwood, a law professor at Georgetown University. “They all live in fear of that one horrible case.”
As new variants of the virus spread, a race is on to vaccinate the public to protect against potentially more dangerous strains
By David Abel Globe Staff,Updated January 29, 2021, 11:19 a.m.
As the coronavirus mutates and new, more contagious variants spread with alarming speed, the United States and the rest of the world are racing to vaccinate as many people as possible before potentially more dangerous strains emerge.
The overriding concern is that the continuing spread of COVID-19 — more than 1 million new infections every week in the United States alone — will allow the virus to evolve in more insidious ways that could defy the protections of existing vaccines, epidemiologists say.
“We’re absolutely racing to get prevalence down as quickly as we can, because we never know what the next mutation might be,” said Dr. Paul Biddinger, medical director for emergency preparedness at Mass General Brigham and chair of the state’s COVID-19 vaccine advisory group. “The more virus in the community, the more chances there are for the virus to mutate.”
Viruses naturally mutate as they proliferate, but the mutations are typically minor and don’t have a material impact on how they affect people. But when multiple mutations occur and the new virus succeeds in propagating, it’s considered a variant.
In recent months, variants of COVID-19 have been discovered in the United Kingdom, South Africa, and Brazil. They have raised growing concerns among epidemiologists because they appear to be more infectious and potentially more virulent, although the latter remains unclear.
Some preliminary evidence suggests the existing vaccines may provide less protection against the variants that have emerged in South Africa and Brazil, both of which were recently discovered in the United States. Those variants may also be able to infect people who previously contracted the dominant strain of COVID-19, which emerged in China.
On Friday, Johnson & Johnson announced that its closely watched COVID-19 vaccine prevented 66 percent of moderate and severe cases in a large clinical trial. But that number fell to 57 percent in South Africa, where the highly contagious variant is the dominant strain.
“It’s not the same pandemic as it was a few months ago,” said Dr. Dan Barouch, who runs the virology center at Beth Israel and is one of the world’s leading vaccine developers. “This is very strong efficacy data against a complex pandemic involving multiple resistant variants circulating globally.”
But even if the current vaccines don’t provide the same level of immunity against the new variants, they still appear to defend the body and are likely to reduce the severity of an infection, said Erin Bromage, a biology professor who studies infectious diseases at the University of Massachusetts Dartmouth.
For example, if a person requires a certain level of antibodies to fight off the dominant strain of the virus, he or she may need five times that to fight off some of the new variants, he said. But the vaccines are likely to generate significantly more antibodies than the body needs to defend itself.
“There seems to be enough of a buffer to provide sufficient protection,” Bromage said.
That said, Moderna, Pfizer, and other vaccine producers have been studying the variants to determine whether they need to adjust their vaccines or prepare additional booster shots to increase their effectiveness.
The greater concern is what could come next, as the virus spreads like wildfire across the planet. This week, the virus passed another milestone, having infected more than 100 million people, a quarter of them in the United States.
On Thursday, health officials said the variant identified in South Africa had been found in the United States for the first time, with two cases diagnosed in South Carolina. Neither of those infected had any history of traveling or any connection to each other, officials said, suggesting the variant has been spreading through the community.
“I am worried,” said Dr. David Hamer, an infectious disease specialist at Boston Medical Center. “There’s a lot of disease being transmitted, and that sets the stage for vaccine-resistant mutations. If we had better control, that would reduce the opportunity for the rapid evolution of the virus.”
For that reason, he and others said, it’s too soon to relax restrictions and they questioned plans announced by Mayor Martin J. Walsh Tuesday to allow Boston fitness centers, movie theaters, museums, and other indoor recreational venues to reopen.
Most businesses will remain subject to the 25 percent capacity limit, which the state extended through Feb. 8, and other gatherings will remain capped at 10 people indoors and 25 people outdoors.