COVID-19 still rages in America's prisons. Here's how states can save lives behind bars.

Few places are more welcoming to a highly contagious virus than prisons and jails. Densely populated, with high rates of chronic disease, a lack of sanitary supplies and little space for physical distancing, correctional facilities have proven especially vulnerable to COVID-19 — with deadly consequences for inmates and staff.

More than 250,000 people behind bars in the United States have been infected with the coronavirus, according to the latest available data, and at least 1,450 incarcerated people and staff have died. While corrections officials have taken measures to reduce viral transmission, the response varies dramatically by state and results have been mixed.

Last month, an appeals court in California issued what may be the most far-reaching judicial statement yet on the handling of the pandemic behind bars, and it was not flattering.

We serve on the National Commission on COVID-19 and Criminal Justice, and we hope the ruling will refocus attention on the perils the coronavirus presents for incarcerated people, prompting state leaders to dig deeper to protect those in custody and the staff who oversee them.

The case involves San Quentin State Prison, where 29 people have died and, at one point, 75% of the population tested positive for COVID-19. Concluding that officials showed “deliberate indifference” to the health of the prison’s 2,900 occupants, California’s First District Court of Appeal took the unprecedented step of ordering at least half of those incarcerated transferred or released. The ruling said the prison’s conditions violated the Eighth Amendment, which prohibits cruel and unusual punishment, because of insufficient space for physical distancing.

We find this story sadly predictable — and in many ways preventable. Infections spread through respiratory droplets are especially difficult to contain in prisons, where tight quarters and poor ventilation are the norm.

Double celling, dormitories, dining halls, and the churn of people in and out also elevate risk, and the prevalence of chronic health conditions that increase vulnerability to COVID-19 is significantly higher among incarcerated people than in the general population.

Such factors help explain why the coronavirus death rate in prisons is twice that of the general population, after adjusting for the sex, age, and race/ethnicity of those incarcerated, and that in five states it’s eight times the overall rate.

Virus swept through San Quentin

The unfolding events at San Quentin, which opened in 1852 and once housed Charles Manson and Sirhan Sirhan, add up to a nightmare that has likely haunted every corrections director during the pandemic. The prison was free of coronavirus cases until late May, but experienced an outbreak after 121 inmates were transferred in from another facility heavily infected by the virus.

Few, if any, of the transferred individuals had been tested for COVID-19 in the days or weeks before the move, and the new arrivals shared communal showers and dining areas.

Before long, the virus had rampaged through the prison and San Quentin became the largest known COVID-19 cluster in the nation.

To avoid such episodes, prisons must adopt public health mitigation efforts proven to work: universal mask use, increased hand hygiene, extensive and frequent testing, isolating infected individuals, quarantining those exposed to known cases, improving ventilation and accommodating physical distancing.

That last measure is critical, but can be nearly impossible in densely populated facilities. As a result, some states have taken steps to decrease prison populations. Most have acted by reducing prison admissions, though some governors, including California’s Gavin Newsom, have gone further, authorizing early release for people convicted of nonviolent crimes and near their scheduled release date.

New Jersey to release thousands

Last month, one state with prisons experiencing high rates of COVID infections and deaths, New Jersey, took a bolder step by adopting legislation that creates a systematic approach to early releases for use during the pandemic and future health crises.

Under the bill, signed into law by Gov. Phil Murphy, sentences will be cut by up to eight months in recognition of the danger posed by COVID-19. The law, which excludes certain violent offenders, is the first of its kind in the nation, and releases, which began last week, will reduce New Jersey’s prison population by about 3,000 people — or nearly 20% — over the coming months.

Traditionally, early-release initiatives like this one have drawn opposition from lawmakers warning of public safety risks — and so it went in New Jersey. But several studies have found little or no evidence that longer prison terms prevent people serving time for nonviolent crimes from committing new offenses once released.

Given such findings, and given the country’s ominous new spikes in COVID-19 cases, we urge policymakers to safely reduce density in correctional facilities — and to adopt other key public health measures to decrease risks for incarcerated people, staff and their families and communities.

Taking such steps will help prevent large prison outbreaks. It’s also the responsible and humane thing to do.

Jo-Ann Wallace is president and CEO of the National Legal Aid & Defender Association. Tom Inglesby, M.D., is director of the Center for Health Security at Johns Hopkins School of Public Health. Both are members of the National Commission on COVID-19 and Criminal Justice.