Written by Jose Saldana, Komrade Z*, and Nadja Guyot

COVID-19, the novel coronavirus spreading across the globe, exposes the dangers of the U.S.’s eroded and underfunded safety net.

Inadequate public health infrastructure and a lack of access to health care, paid sick leave, and basic material needs leave us woefully unprepared to prevent the spread of the coronavirus and care for people who get sick in our communities.

But the threat to people incarcerated in jails, prisons, and detention centers across the United States is even greater.

The coronavirus crisis compounds the health crisis that incarcerated people across the country face every day, some for years and decades. This is especially true for elderly incarcerated men and women, who face heightened risk of death and injury from the virus.

For example, over 675 elderly incarcerated people have died in New York State prisons alone since 2011. The vast majority are people of color and the average age at death is 58 years old. This is a human crisis hidden behind prison walls.

People who are hyper-policed and disproportionately incarcerated—Black and brown working-class people, people who use drugs, homeless people, trans and gender nonconforming people, people with disabilities, and people with mental illness—come from communities most impacted by chronic illness and lack of access to medical care prior to being incarcerated.

Health services in jails may be a person’s first contact with medical personnel and where they first receive diagnoses. Once incarcerated, jails, prisons, and detention centers expose people to incarceration-specific health risks, exacerbating existing health conditions and provoking new ones.

While infectious diseases—from legionnaires disease to chickenpox, tuberculosis to scabies—circulate rapidly and regularly through correctional institutions, prisons are more concerned with maintaining order than ensuring health.

Prison staff minimize serious illness, deter incarcerated people from raising health concerns, neglect to take them to medical appointments, berate and punish them for being sick, and retaliate against them by withholding care. Health care co-pays make accessing healthcare nearly impossible, especially at the average wage for prison labor of 14 cents an hour.

In Florida, incarcerated people say when an infectious disease has been detected, physicians become agents of punishment, stripping incarcerated people of their clothes and belongings and quarantining them in crowded cells with other sick people.

Under non-pandemic conditions, incarceration makes already-sick people sicker and makes healthy people less healthy. Jails, prisons, and detention centers are notoriously deadly in their lack of medical care. Medical services are set up not to provide care but to guard against “costly” utilization and lawsuits.

Fundamentally, the physical facts of confinement—restricted movement, overcrowding, lack of access to sunlight and healthy food, and the severing of family and community ties—increase incarcerated people’s vulnerability to illness and reduce their capacity to fight infection.

COVID-19 and other recent crises bring these failures into dramatic and devastating relief. In 2019, for example, as Justice Department lawyers argued in front of the Supreme Court that access to soap wasn’t mandated by law, mumps rocketed through immigration detention centers across Texas. And incarcerated people are routinely left at the mercy of hurricanes and other dangerous weather conditions, even as they fill sandbags and fight fires to protect communities outside the prison walls.

So it should come as no surprise that jails and prisons across the country are woefully unprepared to protect incarcerated people from the unique threats posed by coronavirus.

There is currently no soap in the Metropolitan Detention Center, the federal jail in Sunset Park, Brooklyn that just last year was without heat, hot water, electricity, and medical care during the coldest days of winter. Hand sanitizer is contraband for incarcerated people in many jurisdictions (even as prison labor is being deployed to produce it) because it contains alcohol. In Florida, cleaning supplies like bleach are contraband and incarcerated people can be punished for possession.

Instead of prioritizing expanding access to coronavirus testing and comprehensive and humane medical care, jails, prisons, and detention centers are likely to rely on restricting family visits, putting potentially-infected people in “medical keeplock,” solitary confinement, and facility-wide lockdowns to ostensibly prevent the disease’s spread.

This is not healthcare, it is punishment, and it will increase incarcerated people’s vulnerability to illness, mental health distress, and suicide.

COVID-19’s impact on the elderly, who are already suffering from serious age-related chronic ailments, will be devastating. And people who are already housed separately (and inadequately) for serious health issues will be further marginalized, treated as second-class people in a third-class world, even as they will likely be the first to feel the effects of the coronavirus.

Prison clinics have demonstrated time and again that they will fail to provide adequate care to growing numbers of sick people as privatized health care services cut costs on regular medical needs.

Fortunately, the public health evidence is clear. If incarcerating people is bad for individual and community health and increases health disparities of race, class, ability, gender, and national origin, keeping people out of jail, prison, and immigration detention and releasing people who are currently confined is good for our health and safety.

In response to the threat to incarcerated people posed by coronavirus, local, state, and federal jurisdictions must use their powers, including pardon and clemency, to release people now, beginning with elderly, ill, immunocompromised, and pregnant people.

Jurisdictions also must seize this moment to reduce “jail churn”—the rate at which people cycle through local jails exacerbating the spread of illness—by reducing arrests, declining prosecution, decriminalizing conduct, eliminating pretrial detention, and releasing people to fight their cases from home. Providing life’s necessities instead of criminalizing survival strategies will help, too.

By pursuing a strategy of radical decarceration we can divest from the jails and prisons that are making our communities sick and sicker, and invest in community-based, humane, and dignified healthcare for all, in the face of COVID-19 and beyond.

Jose Saldana is the Director of Release Aging People in Prison Campaign.

*Komrade Z is an incarcerated organizer, abolitionist, and freedom fighter writing under a pseudonym to avoid retaliation.

Nadja Guyot is a graduate student and organizer in NYC.