Medical Experts Raise Questions About COVID-19 Data From Mass. Jails And Prisons

Despite a surge in COVID-19 cases in jails and prisons around the country, Massachusetts public safety officials are touting few cases behind bars. But some doctors are raising questions about the testing — and the data.

Some questions came up after a recent study from a researcher at Brigham and Women's Hospital. The study's lead author, Dr. Monik Jimenez, found that the infection rate in Massachusetts correctional settings is three times higher than the rate in the community.

"The rates of COVID in carceral facilities in Massachusetts is exceptionally high," Jimenez says, "higher compared to the general population of Massachusetts and the general population of the United States."

Her study looked at COVID-19 rates in Massachusetts jails and prisons from April to early July that are published weekly as mandated by a state Supreme Court ruling. Jimenez says while Massachusetts is unique compared to other states in at least providing some testing data, it isn't standardized. So not all facilities test or report the same way.

"Because there is a lack of oversight and a lack of transparency, you don't know what you don't know," Jimenez says. "This lack of transparency further cripples an adequate public health response."

Jimenez says that lack of transparency also raises questions about all correctional testing. Some epidemiologists agree.

Dr. Stephen Kissler, a postdoctoral fellow at Harvard T.H. Chan School of Public Health, has been looking at the data provided by the SJC ruling. Kissler wonders why the positive COVID-19 rate in state prisons isn't even higher, especially after some widespread testing.

"That did cause me to raise my eyebrows to some extent," Kissler says. "Whether it's the timing of the tests, because of how the tests were administered or the issue of people in the prisons not getting tested when they show symptoms — any one of those things could be in play. But I think one of them must be."

The court documents say that in Department of Correction (DOC) facilities, there were more than 2,700 prisoners tested since the end of May, with 12 new positive cases. At the same time, the report lists 124 more correctional officers tested with 12 new positive cases.

"Because there is a lack of oversight and a lack of transparency you don't know what you don't know. This lack of transparency further cripples an adequate public health response."

Dr. Monik Jimenez

Kissler believes more frequent testing should be required in correctional facilities, as it is in other congregate living situations.

"We know these are settings where COVID can spread explosively," Kissler says. "That's been shown clearly in nursing homes, and the evidence is mounting with the universities' reversals of opening plans — so that's absolutely true in universities as well."

Many prisoners and their advocates are concerned.

One man — held at MCI-Norfolk for more than a decade who didn't want his name used because he's concerned about retaliation by prison staff — says so far, it appears the virus has been contained there. After a prisoner collapsed in the prison kitchen this summer and tested positive for COVID-19, many of those incarcerated were quarantined. The prisoner says despite MCI-Norfolk appearing to have the virus under control, he thinks there should be more testing, and it should be required for correctional officers.

"We're worried about the future," the prisoner says. "We know if COVID comes in — somebody from the outside would have to bring it in. With no requirement to get tested and no mandate for prison workers to get tested, that seems to be a problem. If it gets in here and is able to spread, it's going to decimate a lot of this community."

The DOC says it encourages staff testing and that an officer with symptoms or known exposure to COVID-19 cannot return to work without medical clearance. The state correction officers' union did not respond to requests for comment.

In June, the DOC began allowing more prisoners to have more time out of their cells. In July, the department began allowing limited visits at four of its 16 facilities.

As for all testing, the DOC says its medical provider is testing symptomatic prisoners and their close contacts on an "as needed " basis. The department says it has contained the virus behind bars by thoroughly cleaning facilities and continuing to restrict some prisoners' movements.

But those measures are subject to a lawsuit alleging that a prolonged lockdown should not be the virus containment strategy.

Elizabeth Matos, with Prisoners' Legal Services of Massachusetts — the group that filed the suit — says she's getting increased reports of mental health issues because many prisoners have been locked in their cells for more than 20 hours a day since March. She also says more planning is needed as the number of prisoners, especially in county jails, is on the rise.

"The courts are more active now, there are more people coming into the system, so it's a more transient population, and the likelihood of transmission is just going to go up," Matos says.

Matos also believes the data reported because of the SJC ruling contain discrepancies. She says since the SJC reports were issued in April, there have been different numbers and those should clarified to understand the effects of the virus behind bars.

The federal Centers for Disease Control and Prevention published a report this month recommending more broad-based testing in jails and prisons. The report says widespread testing "provides a more accurate assessment of disease prevalence than does symptom-based testing and generates data that can potentially help control transmission."

Also on the federal level, Sen. Elizabeth Warren co-sponsored a bill calling for more transparency in testing data from jails and prisons.

Researchers like the Brigham's Dr. Monik Jimenez are also doing more work to add to the data by conducting research with those directly involved with correctional facilities.

"Departments of corrections and other carceral facility governing bodies may say they're doing x, y and z, but how that's executed, based on what we're hearing from our community groups, is that those do not match," Jimenez says.

Jimenez is surveying those recently released from incarceration and their loved ones, and hopes to have that data shortly.