By RICK JURGENS
Granite State News Collaborative
November’s COVID-19 surge in New Hampshire saw the first outbreak of cases among inmates of the state prison system, including 10 cases in a Concord unit that treats mental illness and substance use disorders.
Although multiple prison employees had tested positive for COVID-19 before then, no evidence had surfaced indicating that the virus was present and circulating in the prison population.
Soon after, the state Corrections Department’s tweaked its testing policy. During much of the pandemic, the policy has been to test “residents who are symptomatic and any resident identified during contact-tracing to have had close, prolonged contact with an infected person.”
On Thursday, the following wording was added to the Corrections Department’s website description of testing policy: “The NHDOC is in regular communication with NH Public Health for consultation to determine when if appropriate to engage in surveillance testing or point prevalence testing. The NHDOC is in constant examination of testing strategies with residents for COVID-19.”
Corrections Commissioner Helen Hanks said in an email that the wording change was “a mix of both updates and elaborations” of existing policy.
The wording was changed after what Hanks described as two “testing events” in Concord identified a cluster of COVID-19 cases among inmates of the department’s behavioral health units and two more cases in the main state prison for men. A third “test event” found no cases in the prison’s reception and diagnosis unit.
Hanks said the testing events were examples of point prevalence testing that applied a strategy suggested by the Centers for Disease Control and Prevention of “testing asymptomatic individuals with recent known or suspected exposure to SARS-CoV-2 to control transmission.” SARS-CoV-2 is the coronavirus that causes COVID-19.
CDC epidemiologists have also suggested expanding testing. A study published by the agency in August concluded that mass testing, regardless of symptoms, and periodic retesting can prevent widespread transmission in jails and prisons. The study, based on a review of 16 prisons and jails, found that COVID-19 prevalence increased by a multiple of 12 after symptom-based testing was replaced by mass testing.
According to epidemiologists, congregate living situations — buildings and institutions that house multiple residents — pose high risks for the rapid spread of infectious diseases like COVID-19. Nursing homes, which mostly house seniors and people with disabilities, have accounted for a vast majority of New Hampshire’s 544 COVID-19 deaths. As nursing home deaths mounted, state officials implemented a surveillance program that required testing and periodic retesting of all nursing home employees and residents.
Prisoners also are especially vulnerable because of their “restricted movement, confined spaces, and limited medical care,” the >italic<New England Journal of Medicine>res< reported in April.
Nationwide, nearly 198,000 inmates of state and federal prisons had tested positive for COVID-19, and 1,454 had died, according to a Nov. 17 tally by the Marshall Project, a nonpartisan, nonprofit news organization that reports on the U.S. criminal justice system.
But until recently, the disease hadn’t taken a large toll in New Hampshire prisons, which house about 2,150 inmates and employ 827 staff. Ken Norton, executive director of the National Alliance on Mental Illness’ New Hampshire affiliate, said that officials had done “a pretty phenomenal job of keeping COVID out of the prisons up until this point.”
Yet testing has been limited. During the pandemic, a total of 389 COVID-19 tests have been administered to state prison inmates, according to the Corrections Department website.
Vermont has done more testing. With an in-state prison and correctional facility population of about 1,400, Vermont prison managers have conducted 2,200 tests that identified 56 cases of COVID-19. Prisoners housed in a privately run Mississippi facility fared much worse: 219 tests found 185 cases.
With less testing, New Hampshire has found far fewer COVID-19 cases in its prisons. Prior to the current surge, only one inmate in the state prison system had been found to have COVID-19. That case showed up on May 26, when a prisoner being transferred from a prison in another state tested positive and was placed in quarantine prior to contact with other New Hampshire inmates. No other cases were tracked back to that case.
Meanwhile, Granite State prison facilities were changed to fight the spread of COVID-19, according to the Corrections Department website. Hand washing stations and barriers were installed, two masks given to each inmate, other personal protective equipment provided to staff, sleeping configurations modified and quarantine areas prepared. Transferred inmates were quarantined, medical copays suspended for COVID-19-related sick calls and visiting by interns, volunteers and others called off.
A total of 44 corrections department members, who live outside the prison, contracted the virus. Most of the cases – 32 – were reported since Nov. 1. On Wednesday, the Corrections Department said there were 24 active cases among staff.
And, for the first time, there were multiple active cases among inmates, all in Concord: 10 in the Secure Psychiatric and Residential Treatment units and two in the adjoining state prison for men, according to the department. None of those individuals were hospitalized, said Paul Raymond, a spokesman for the state’s Joint Information Center on COVID-19.
The uptick in inmate cases followed the recent testing push. On Nov. 17, public health officials conducted “a voluntary testing event … for specific staff” at the men’s prison in Concord, Hanks, the corrections commissioner, said via email. Two days later, “in response to staff COVID-19 positives,” voluntary testing was done for residents of the behavioral health units, she added. “Resident positive cases were identified and those residents were placed in medical isolation,” Hanks wrote. Another round of tests done on Nov. 20 in the reception and diagnosis unit found no positives.
County jails
The pandemic has also challenged the jails in New Hampshire’s 10 counties which house individuals — in normal times, about 1,800 — as they await trial or serve short sentences.
In Laconia, Belknap County Corrections Department Superintendent Adam Cunningham said that COVID-19-related quarantine and isolation measures have taxed his facility. With an original structure built in 1860, a jail able to house up to 144 prisoners now holds 48, while 11 have been sent into custody in Carroll County. The jail is maxed out for “staffing and space, particularly with our facility layout,” he said.
And testing is limited, he added: “We only test when somebody comes in and they’re exhibiting (or reporting) symptoms.”
The Grafton County Corrections Department also limits testing to symptomatic individuals, although in the current surge expanded testing is “not off the table,” said Superintendent Thomas Elliott. With 37 inmates in a facility that can hold 150, space for quarantine and isolation, when needed, is available. But so far the North Haverhill jail has had no positive tests of staff or inmates, Elliott said.
The jail in Rockingham County, which suffered an 11-case outbreak in August, is taking a more aggressive approach to testing, according to Superintendent Jason Henry. The jail, which has a capacity of 400 and a current census of 113, quarantines new arrivals and tests any who remain longer than five days. “We’re doing above and beyond and it’s working,” Henry said.
But COVID-19 still looms, he added: “It’s stressful on staff and it’s stressful on inmates.”
Charlie Buttrey, a Lebanon-based attorney, said that he has a client serving a prison sentence while he awaits an upcoming trial, but COVID-19 limits on visits and interactions with prisoners have affected his representation: “I can’t share with him documents and other evidence that we need to look at together.”
Buttrey said he also has a friend in prison who has small children but hasn’t seen them for more than nine months: “It’s been excruciating.” But Buttrey said he recognizes that prison officials do n’t control the pandemic: “I think the prisons are doing the best they can under the circumstances.”
Rick Jurgens can be reached at rjurgens_2000@yahoo.com or 802-281-6641. These articles are being shared by partners in The Granite State News Collaborative. For more information visit collaborativenh.org.