Derrick Johnson had a makeshift mask.
He had the spray bottle of bleach and extra soap that corrections officers provided.
But he still spent every day crammed in a unit with 63 other men in a Florida prison, crowding into hallways on their way to meals and sleeping only feet away from one another at night.
As the coronavirus ravaged the Everglades Correctional Institution, Johnson was surrounded by coughing and requests for Tylenol.
“Prison is not built to compete with a pandemic,” said Johnson, who was released in December.
The pandemic forced prisons to adapt. Bu now, as new cases are declining and restrictions are being loosened, there’s little evidence to suggest that enough substantive changes have been made to handle future waves of infection, an investigation by The Marshall Project and The Associated Press has found.
The two news organizations — which tracked the spread of COVID-19 through prisons nationwide, counting more than a half million people living and working in prisons who got sick from the coronavirus — found that, with crowded conditions, substandard medical care and constantly shifting populations, prisons were ill-equipped to handle the highly contagious virus. Nationwide, it killed nearly 3,000 prisoners and staff.
Corrections systems responded with inconsistent policies, struggling to contain the virus. At the peak of the pandemic peak in mid-December, more than 25,000 prisoners tested positive in a single week.
In recent months, infections behind bars nationwide have slowed to a few hundred new cases each week, and many prisons have eased restrictions for mask-wearing, visitors and other movement in and out, going back to business as usual.
But it’s still a critical moment, with new coronavirus cases low but the threat of infection looming as new variants spread, said Dr. David Sears, an infectious-disease specialist and correctional health consultant.
“The medical community, prison leadership and society at large have learned so much about COVID in a short period of time,” Sears said. “We need to take these lessons and make sure that the things we’ve learned after a lot of real human suffering are not in vain.”
According to the data collected by The Marshall Project and Associated Press, about three in 10 people in state and federal prisons were infected with the virus. But correctional health experts widely agree that’s an undercount.
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“A great many of the people who ever had COVID, they were never tested,” said Dr. Homer Venters, a former chief medical officer of the New York City jail system who inspected health conditions in prisons around the country over the past year. “In most prisons, it ran through these places like wildfire.”
One man housed at a low-security federal prison compared the Bureau of Prisons’ public data to what he was seeing inside. At least half of his unit fell ill, he said, but the bureau’s data didn’t reflect that.
“For the first year of the COVID, they never tested anybody in my institution unless they had a fever,” the man said in a call from prison. “The easiest way to not have a positive at your institution is to not test anybody.”
In the pandemic’s early days, testing within the Bureau of Prisons was limited, and staff members at some prisons were told there was no need to test inmates; they should just assume everyone had the coronavirus. The Justice Department’s inspector general found that, at some facilities, inmates who tested positive were left in their housing units for days without being isolated.
The Bureau of Prisons said it follows guidance from the federal Centers for Disease Control and Prevention and that inmates who are symptomatic or test positive are placed in medical isolation until they recover.
Even when state and federal prisons conducted tests, they still allowed prisoners who tested positive to come in contact with others.
Texas prison officials transferred more than 100 infected prisoners in East Texas to prisons outside Houston in the first months of the pandemic. Officials said the move would bring the men closer to medical resources. A few days after a group of the sick arrived to his unit, Jason Duncan fell ill.
“The unit nurse came around to take temperatures, mine was checked at 102,” he wrote in a letter at the time. A few hours after having his temperature taken, he fainted. “When I came to, my body was so hot I could not stand at all. I could not breathe, it felt like the life was being [sucked] out of me.”
Eventually, he ended up in a hospital “hooked up to a breathing machine.” Finally, he got a COVID-19 test. “I was given no medication at all,” he wrote, saying he was sent back to the prison, housed in the wing with the sick prisoners who’d been transferred in.