Tanzina Vega: It's The Takeaway, I'm Tanzina Vega. This week, a panel of CDC advisers voted on recommendations to determine who should get top priority once a COVID-19 vaccine is rolled out. Under these guidelines, healthcare workers and the elderly in long-term care facilities would get access to a vaccine first, and they would be followed by a group of essential workers from transportation workers to teachers and corrections officers.

Many of the people incarcerated in the prisons where those officers work, however, would not be prioritized under the CDC recommendations. That's despite the fact that at least 200,000 people in jails and prisons across the country have contracted COVID-19 during the pandemic. In federal prisons, many incarcerated people say that health protections have been alarmingly inadequate.

Speaker 1: I woke up out of my sleep hyperventilating and sweating, and stuff, and I went to the office and I'm like, "Yo, you got to get me out of here. I can't breathe. Something's wrong with me," and he told me to tough it out. It was like 2:00 in the morning, he said you got to tough it out.

Tanzina: That's a 35-year-old man who's currently incarcerated in New Jersey's Fort Dix prison. He recently spoke with WNYC reporter Karen Yi and asked that his name be withheld. Fort Dix is experiencing the worst COVID-19 outbreak of any federal prison in the United States. According to the Federal Bureau of Prisons, 289 people incarcerated at Fort Dix and 28 staff members have tested positive for the virus. The Bureau also says that no one at Fort Dix has died from the virus. Here to discuss the Fort Dix coronavirus outbreaks is Karen Yi a reporter covering New Jersey for WNYC. Karen, thanks for being with us.

Karen Yi: Hi, good to be here.

Tanzina: How did the outbreak at Fort Dix begin?

Karen: There were a couple of cases in the spring of COVID. I think it went up to 40 at some point and over the summer we saw those numbers come down, but then in October, we started to see those numbers creep up back again. What we've pieced together between speaking to people inside the prison, family members, and court records is it could have been either a big transfer of prisoners from an Ohio prison.

There was a huge outbreak in Ohio and about 300 prisoners were transferred to Fort Dix in late September and some of them had tested positive. The BOP says they were properly quarantined, but it's unclear if maybe some of those prisoners could have given the virus to the general population at Fort Dix. Also, around the same time, you had cases in New Jersey spiking and correctional officers coming in and out of the prisons. You also had visits resuming temporarily for a few weeks. Any of those ways the virus could come into the prison and you saw in October in one day cases tripling overnight from 50 to 200 and it kept growing from there.

Tanzina: We reached out to the Bureau of Prisons and in a statement, they told us that they provide "appropriate treatment" to anyone who tests positive for COVID-19 in its prisons, but in interviews with WNYC that you've conducted, people who are in Fort Dix and their family members described testing positive for the virus and then being left for hours in rooms with others who were negative. Tell us a little bit about that.

Karen: That's right. The BOP has a policy and procedure as to what happens when somebody tests positive, but in practice, that's a lot more complicated, right? Because at Fort Dix, specifically, these are dorm-style military barracks. You have 12 men to a room, 300 in a building and so often you have people quarantining who are positive on one floor, negative on the other.

You find out you're positive and it takes a few hours to move you to a quarantine or an isolation unit. You also have issues with the men sharing a lot of common spaces because this is a low-security prison. Generally, there's a lot more movement and flexibility. They share bathrooms on the same floor so you have 80 men using the same bathrooms, the same sinks, the same showers, bunk beds. There is generally in prison, social distances, nearly impossible, particularly in Fort Dix because of the setup. It's even more impossible.

Tanzina: What about the personal protective equipment? Things like masks, are those provided for the prisoners, and are there adequate places to wash your hands, for example, or hand sanitizer?

Karen: Masks were mandated in April by the Bureau of Prisons and the prisoners say that they have received masks. They receive cloth masks to generally a week. The issue is they get dirty, they get soiled and when they're being washed, they have nothing to wear. Some of the complaints that I've also heard from family members of those incarcerated and those inside is that the guards aren't always wearing the masks when they come in and if they're moving between buildings, that becomes a concern.

In terms of disinfectants and cleaning supplies, a lot of them have complained about this not happening. The BOP has said areas are thoroughly cleansed if somebody tests positive, prisoners have said flat out that's not happening; we're not seeing that. We're begging for cleaning supplies we're not getting it.

In one quarantined unit where at one point most of the inmates, 218 out of 231 from the last court records I saw had tested positive. A lot of the people in there were complaining about an infestation of gnats. Things not being cleaned, toilets not being cleaned. These are again, shared spaces. In terms of soap, the BOP has said they do provide soap if they can't afford it through commissary. Again, the inmates have said a lot of the soap dispensers are routinely empty.

Tanzina: Karen, there has been a lot of talk about a vaccine, and of course now there isn't just talk about a vaccine, but there's movement toward actually getting a vaccine in the hands of American citizens in terms of priority. When you were doing your reporting at Fort Dix, where any of the incarcerated people you spoke to aware of a vaccine, and did they have any feelings about whether or not they wanted to take a vaccine?

Karen: That's not something that came up. The vaccine conversation has really picked up in the last couple of weeks. I think the biggest concern from those incarcerated is immediate medical care. That is what they are desperate for. I think the reality is a lot of the people inside Fort Dix about 2,700 are going to ride out the pandemic in there. There are two ways to get out of prison.

There's home confinement and there's compassionate release, not everyone is eligible, so they're not necessarily pushing to get a vaccine from what I heard, they're pushing to get very basic medical care; see a doctor, see a nurse, get access to their medical records, get more than Tylenol, those very basic steps. That's really what the conditions that they want to change right now.

Tanzina: Karen, you also spoke with family members of people who were incarcerated at Fort Dix, and here's what Karen Gasper, whose son Chris is incarcerated there and tested positive for COVID-19 had to say you.

Karen Gasper: I feel helpless. I feel totally helpless. My son calls me and says, "Mom, just give up on me." He said because I don't think I'm ever coming home. He doesn't even call his children anymore because he said, "I don't want to give them some false hope, it breaks my heart."

Tanzina: How typical is that Karen for family members who have incarcerated family members who are dealing with COVID-19?

Karen: I heard that's sentiment time and time again, I think, especially for Karen, she's a mom and when your child is sick, you are able to take care of them and she can't. She can't visit, she doesn't know what's going on. She has no access to his medical records. I think that feeling of helplessness is what I heard echo throughout many families. They feel like their pleas for help are falling on deaf ears.

Tanzina: Are they?

Karen: I haven't seen any movement from the BOP since I've reported this story, no changes to their conditions. Just yesterday, I was hearing again of somebody who had recently tested positive and only getting Tylenol. Things like this are continuing and even as I reported the story two weeks ago, we've seen another 50 cases. This pandemic is not under control at the BOP.

Tanzina: Karen Yi is a reporter covering New Jersey for WNYC and Gothamist. Karen, thanks for joining us.

Karen: Thank you so much.

Tanzina: We're not just seeing major COVID-19 outbreaks in Fort Dix prison; cases have been popping up across the United States since the pandemic began back in March. Now we're going to zoom out and get an update on the national picture of COVID-19 in our nation's prisons and jails with Lauren Brinkley-Rubinstein, an assistant professor of social medicine at UNC-Chapel Hill and head of the COVID-19 Prison Project. Lauren, thanks for being with us.

Lauren Brinkley-Rubinstein: Thanks for having me.

Tanzina: How quickly has COVID-19 spread and the prison population compared to the general population?

Lauren: It's spread very quickly. At the very beginning of the pandemic, we saw cases skyrocketing in prisons and jails across the country. Seven of the 10 largest single-site cluster outbreaks currently are in jails and prisons. About 10% of the incarcerated population has been infected with COVID-19 and we see that the gap between the general population and the incarcerated population in terms of rates continues to rise.

Tanzina: We've been talking a lot about vaccine development and now implementation and distribution here in the United States and so far, it's recommended that correction staff get vaccinated before incarcerated people. What's your thought on that?

Lauren: First I'd just like to say that I think it's really important that we're having these conversations and that these recommendations are considering the incarcerated people and staff at all. I think that in some ways is unprecedented. I do worry though, that staff are being prioritized above incarcerated people. In some settings that make some sense, right? In prisons there tends to be a pretty stable incarcerated population and staff are really the people who are moving in and out.

If we think about jails, 11 million people churn through our country's jails each year and so that same issue of communication, in essence, between jail settings and the community exists for people who are incarcerated in local jails. I think there just needs to be a little bit more nuance to the conversation. I would argue that people who are incarcerated ought to also be considered in phase 1.

Tanzina: Let's talk about the ethics of that, incarcerated folks lose a lot of their rights when they are incarcerated. Are they able to, for example, say they were not interested in taking the vaccine? Would it have to be mandated for the population? What are the rights of incarcerated people when it comes to a vaccine?

Lauren: The rights of people who are incarcerated you're right are diminished, and there are lots of ethical issues that come up when you're thinking about the concept of consent in prisons and jails. What I would say is that incarcerated people ought to have the same rights when it comes to vaccines, certainly than the general population so they ought to have the right to refuse a vaccine. Prisons and jails have to think about implementation, the challenges that are inherent in these facilities, and think about how to overcome many of those challenges.

Tanzina: To your earlier point about the difference between jails and prisons, prison populations tend to be more stable. Those are people who have actually been convicted and sentenced of their crimes. Jails on the other hand, not so stable, people could be in and out for a couple of days, two weeks, two months, depending on their ability to pay for their bail. With a vaccine that needs at least right now, that needs high storage capacity in terms of very cold storage facilities, and also two doses at least in this iteration, is that even possible to have a vaccine in a jail versus in a prison?

Lauren: Yes, it's a really good question. You're right, that the average length of stay in jails is very short. I think that it's going to require robust collaboration between departments of health and the jail entities. I think we've really gotten our feet underneath us relevant to contact tracing and being able to find people in the community when they've had an exposure. I think much of the lessons that we've learned relevant to contact tracing could really be applied to trying to find people in the case if they are released in the community. It really underscores the importance of if jails are going to start the process and departments of health have to be at the table and have to also be able to find people in the community if they're released.

Tanzina: Lauren Brinkley-Rubinstein is an assistant professor of social medicine at UNC-Chapel Hill and the head of the COVID-19 Prison Project. Lauren, thanks so much for joining us.

Lauren: Thank you.

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