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If Missouri Fails To Contain COVID-19 Outbreaks In Prisons, Outside Communities Will Be At Risk

An illustration by David Kovaluk from St. Louis Public Radio shows a rendition of a prison in black and grey. Prisoners are depicted in orange jumpsuits alongside guards in blue. Red waves and viruses are drawn among the figures to show a growing covid outbreak in the prison.
David Kovaluk
St. Louis Public Radio
An outbreak of COVID-19 cases at the Eastern Reception, Diagnostic and Correctional Center in Bonne Terre has some experts concerned about the conditions.

One Missouri inmate says prisoners feel "powerless" to control the spread of the coronavirus. He's worried guards are taking it home to their communities.

LeVar Aikens, a Kansas City man incarcerated in the Eastern Reception Diagnostic and Correctional Center in Bonne Terre, Missouri, says he is watching a COVID-19 outbreak happen around him.

“I mean, there’s no doubt about it. Everybody’s sick. So it’s here,” Aikens says.

In early July, there were only five confirmed COVID-19 cases in the Bonne Terre facility. By the end of the month, cases had peaked at 42, according to the Department of Corrections.

But the true number of COVID-19 cases at Bonne Terre may be much higher.

Like much of the country, Missouri prisons are seeing COVID-19 cases rise again. Staffing shortages, a lack of universal testing and a highly transmissible new variant only make an outbreak more dangerous inside prisons.

Aikens says inmates, who cannot physically distance themselves, feel like sitting ducks.

“We’re powerless. That’s what’s so crazy. We’re literally… we have no power to protect ourselves in here,” Aikens says.

But Aikens also worries an outbreak inside will eventually spread to nearby communities.

Prisons may be designed to be secure, but a virus has ample opportunity to escape.

Prisons ideal for coronavirus spread

The coronavirus spreads faster and better in prisons because of what public health policy experts call “churn,” the circulation of people through the system. Staff go in and out of prisons and bring the virus with them.

People in prison, which are in some cases already overcrowded, can’t socially distance. Plus, researchers say vaccines are weakenedin places with high rates of transmission.

Karen Pojmann, a spokeswoman for the Missouri Department of Corrections, says outbreaks occur at intake facilities where prisoners are brought in from county jails that don’t have the same testing, quarantine and isolation protocols that the DOC has.

But universal COVID-19 testing hasn’t happened at Bonne Terre in more than a year.

According to the Department of Corrections, universal testing — testing all the staff and inmates in the prison — hasn’t happened there since August 2020. Instead, prisons must offer surveillance testing — randomly testing 10% of the population. Pojmann says surveillance testing last happened in Bonne Terre in May.

Additionally, Pojmann also says all state prisons test and quarantine incoming and outgoing inmates as well as inmates who have symptoms.

“Everyone who has COVID symptoms is tested. Everyone who is a close contact of someone who tests positive is tested,” Pojmann says.

Furthermore, Pojmann says that regular wastewater testing has shown that COVID-19 is not prevalent enough at Bonne Terre to constitute an outbreak.

But Aikens says the reality is different. He says he’s not feeling well, but doesn’t want to get tested because of the repercussions of a positive test.

It’s the second time he’s experienced COVID-like symptoms. The first time was last winter.

“I went up to medical the next day and told Nurse Rick I have COVID. He said, ‘Do you want to go to the hole?’ I said, ‘no’.”

Aikens says the nurse told him to lie and return to his housing unit if he didn’t want to be put into temporary solitary confinement.

Pojmann clarified to KCUR that isolation for medical purposes is not the same as the segregated housing used to protect the general population from a violent or dangerous offender.

Eastern Reception Diagnostic and Corrections Center in Bonne Terre, Missouri.
Willis Ryder Arnold
St. Louis Public Radio
Eastern Reception Diagnostic and Corrections Center in Bonne Terre, Missouri.

Staffing shortages

Another factor in the spread of coronavirus in prisons is a severe staffing shortage. Lack of proper staff means medical appointments frequently get cancelled and overtime means medical staff quit faster.

Tim Cutt, executive director of the Missouri Corrections Officers Association, says prison staff are regularly working 12-hour days, five days a week and he predicts the shortage will only get worse. Recruiting, Cutt says, is “almost impossible.”

That shortage means staff resort to holding inmates on extended and frequent “lockdowns.” People on lockdown can’t leave their cells, not even for medical appointments.

To make matters worse, few staff actually wear masks or other personal protective equipment designed to keep them safe.

Nathaniel Ruffino is a former corrections officer at Bonne Terre.

When Ruffino arrived at Bonne Terre in March, he says staff didn’t use any PPE, even when bringing psychologists to visit sick patients.

“The psychologists and stuff came in with, like, full PPE on and stuff like that,” Ruffino says. “But the staff, we didn’t really do anything like that.”

Aikens has filed a lawsuitagainst the prison superintendent over the lack of PPE work by staff at Bonne Terre.

Ruffino was recently on leave because he obtained a note from his doctor saying he couldn’t wear a mask for medical reasons. He has since been terminated. But Ruffino says not wearing a mask wasn’t a problem for his supervisors before.

“I’ve worked with over 400-plus offenders that had, that supposedly tested positive (without a mask), and that’s okay,” Ruffino says.

The Beacon previously reportedthat corrections officers have been allowed to keep working even while unprotected or sick. And some staff at Bonne Terre — including Ruffino — refused to get vaccinated.

“There’s a good number of us that said, if we were forced to, we’d just quit,” Ruffino says.

Vaccines have been available to all inmates since April. While 65% of incarcerated Missourians are vaccinated, no one knows for sure how many staff got the vaccine. Pojmann says the DOC can’t ask staff to report their vaccination status. Instead, the department encourages staff to get vaccinated by offering free vaccines at vaccine clinics at any time.

A threat to outside communities

Aikens isn’t just worried for himself. He says staff are also endangering the surrounding community.

“They take it to the communities and spread it to, you know, your mom or your dad or your grandma or your kid and these people may die because of these staff’s actions or inactions,” Aikens says.

Eric Reinhart is a researcher at the Data and Evidence for Justice Reform (DE JURE) and resident physician at The World Bank. They say prisons and jails are porous, meaning diseases enter and exit prisons easily. As a result, coronavirus in prisons inevitably spreads to the outside world.

“We’ve just seen 610,000 deaths, tens of thousands of which are attributable to spread from jail. I have no doubt about this. Perhaps more than that,” Reinhart says.

The threat is even greater for rural communities. A report from the Prison Policy Initiative showed that, in communities far from cities, the larger the population of prisoners, the worse the COVID-19 outbreak. For rural areas with the highest prison populations, COVID-19 cases due to spread from prisons was about 1 in 100 people.

In Missouri, from May to August 2020, PPI found that 3,381 COVID-19 cases were attributable to proximity to prisons.

Reinhart says public health officials don’t think of prison health and community health as related, but they should.

“A lot of these people who get sick and die will not be in carceral facilities,” Reinhart says. “You will wash your hands of it as administrators and think you’re, you've gotten off scot free. But these will be cases that will present in communities.”

Now advocates anticipate a second outbreak inside prisons worsened by the highly transmissible delta variant, which accounts for 95% of Missouri’s new COVID-19 cases.

“I am terrified for what’s going to happen, and what’s probably already happening inside carceral facilities with the delta variant.” Wanda Bertram, spokesperson for PPI, says.

According to Aikens, it’s not a matter of if, but when.

“If somebody walked through an animal shelter and this was going on, they’d close it down. But we’re human beings and this is just… we’re being made to suffer through it,” Aikens says.

Correction: A previous version of this story stated that regular COVID-19 testing has not occurred at ERDCC Bonne Terre in more than a year. While regular testing has happened, universal testing has not occurred since August 2020.

This story has also been updated to include information about wastewater testing at the facility and to clarify the difference between solitary confinement and medical isolation.

Jamie Jiang is a news intern for KCUR 89.3. You can reach her on Twitter @jambojiang
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