San Quentin Prison Was Free of the Virus. One Decision Fueled an Outbreak. - The New York Times

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The virus arrived in San Quentin after busloads of prisoners were transferred from another facility where infections were rising. What happened is a warning for the nation’s prisons, experts say.

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June 30, 2020Updated 4:45 p.m. ET

The coughing and complaints of sickness began as a procession of busloads of prisoners made its way late last month from a Southern California prison to San Quentin, California’s oldest and most widely known prison, perched on a bluff overlooking San Francisco Bay, not far from the Golden Gate Bridge.

The inmates were being moved to San Quentin as part of a plan to halt the spread of the coronavirus by reducing the number of inmates at the California Institution for Men in Chino, where nine inmates had died and nearly 700 had been infected.

At the time, there were no inmates known to have had the virus at San Quentin.

Within days, some of the 121 prisoners from the buses introduced the virus at San Quentin, public health officials say. More than 1,000 of the 3,700 prisoners have since been infected at San Quentin, the foreboding structure surrounded by barbed wire fences and dotted with guard towers that was once famously home to inmates including Charles Manson; Sirhan Sirhan, who assassinated Robert F. Kennedy; and George Jackson, an inmate who wrote “Soledad Brother,” a series of letters from prison.

The transfer of inmates — an effort intended to slow the virus, which instead apparently created a new outbreak — has been denounced by health officials and a state lawmaker as a public health failure. How San Quentin went from being a prison that had held off the virus for months to a place inundated with sick inmates represents a cautionary tale for the nation’s prison system amid the pandemic.

“What happened — what’s happening — it can really happen anywhere, particularly in an overcrowded prison, which unfortunately is the norm,” said Dr. David Sears, a physician and professor of medicine at the University of California, San Francisco, who toured San Quentin on June 13 and warned state officials about the emerging crisis. “San Quentin’s not the first prison to have a large outbreak, and unfortunately it won’t be the last.”

Days into the outbreak, the prison has grown increasingly chaotic, inmates and others say. Some among San Quentin’s death row inmates, in a secluded part of the prison, are infected, according to advocates for inmates. A number of older prisoners have hung handwritten signs outside their cells that read “Immune Compromised” so that guards will wear masks around them. Other inmates refuse to leave their cells out of fear of catching the virus, according to an inmate, and in recent days, guards have been heard screaming over their radios, “Man down!” after sickened inmates were unable to stand up.

The conversation has been dominated by talk of death.

“I don’t want to see them die,” Rahsaan Thomas, a 49-year-old inmate said of some of the older prisoners in a telephone interview. “I don’t know if I’m tough enough to survive Covid.”

The California Department of Corrections and Rehabilitation said in a statement that it was very concerned about the surge in infections in San Quentin, adding that prison workers had increased testing among inmates and had limited the number of transfers between prisons.

“Public safety is our top priority, as is the health of our community,” said Dana Simas, a spokeswoman for the agency. Workers had begun to build “air-conditioned tent structures” at the San Quentin prison, she said, as officials work to determine the best use of spaces for housing and medical triage.

Broadly, Ms. Simas said that California officials were confident that they could halt the spread of the virus given that the prison system had longstanding plans for managing other outbreaks of influenza, norovirus, measles and mumps.

A hearing is scheduled on Wednesday in the State Senate, where lawmakers say they have become alarmed about the outbreak and what they describe as a haphazard response by prison officials.

Across the United States, the number of prison and jail inmates known to be infected has doubled during the past month to more than 80,000, according to a New York Times database. Prison deaths tied to the coronavirus have also risen significantly, by nearly 30 percent since mid-May. Nine of the 10 largest known clusters of the virus in the United States are inside correctional institutions, The Times’s data shows.

In California prisons, the number of cases has risen by nearly 200 percent and deaths by 144 percent during the past month.

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Public health officials in California and elsewhere have been bracing for months for what they say was inevitable — the spreading of the coronavirus in correctional facilities, which possess unique vulnerabilities.

Most jails and prisons were designed to focus on security. Ventilation is often poor and access to health care is inconsistent. Prison health care in California has historically been so substandard that health services are administered by a federal receiver.

California prisons have required everyone to wear masks, but social distancing policies and mask-wearing rules among prison guards are nearly impossible to enforce. Longstanding prohibitions on cleaning supplies that contain bleach or alcohol have made it difficult for crowded facilities like San Quentin to meet even basic sanitary standards given that hundreds of inmates share a limited number of toilets, telephones and shower stalls.

Since the pandemic, California has agreed to release as many as 3,500 inmates up to six months early and is considering more early releases, but the prison system remains at 124 percent of capacity, according to state records.

Public health experts said deficiencies were made worse at San Quentin. The prison is dominated by row after row of barred cells. Paint peels from walls, state work orders show, and puddles form after rain showers because the ceilings leak.

The prison opened in 1852, and is at 117 percent of its capacity, according to state data. As many as half of all inmates suffer from health conditions that make them especially vulnerable to the virus.

“There’s no way to address a public health problem when you need to isolate people but your system is bursting at the seams,” said Adamu Chan, a San Quentin inmate.

Dr. Brie Williams, a physician and professor of medicine at the University of California, San Francisco, and director of the university’s Criminal Justice & Health Program, said absent a coronavirus vaccine, prisons were outmatched, despite their plans for managing other sorts of outbreaks.

“The difference with this infection is that with all of those other conditions we were able to essentially, eventually throw money at them in the way of fancy medications,” she said.

Dr. Matt Willis, the top public health official in Marin County, where San Quentin is, said state prison officials had told him they were capable of handling the virus on their own.

The county’s health department was told by state prison leaders “very clearly that this is not part of our jurisdiction,” Dr. Willis said. The corrections system, he said, has a “lot of control over every aspect of their processes” and has not been transparent about their handling of the virus.

Updated June 30, 2020

What are the symptoms of coronavirus?

Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

What’s the best material for a mask?

Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.

Is it harder to exercise while wearing a mask?

A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.

I’ve heard about a treatment called dexamethasone. Does it work?

The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.

What is pandemic paid leave?

The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.

Does asymptomatic transmission of Covid-19 happen?

So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.

What’s the risk of catching coronavirus from a surface?

Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.

How does blood type influence coronavirus?

A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.

How many people have lost their jobs due to coronavirus in the U.S.?

The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.

How can I protect myself while flying?

If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)

What should I do if I feel sick?

If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.


“It may work in certain settings,” he added, “but when you have a complex disaster that’s moving quickly, I think we’re finding that the process is just not matching our needs.”

San Quentin’s crisis began with a handful of decisions that were made as officials were trying to quell the outbreak in Chino, interviews with inmates, correctional officers, elected officials and health experts show.

On May 30, the inmates from Chino boarded buses for San Quentin after being told they were being transferred to reduce overcrowding, which would protect vulnerable inmates at the prison they were leaving, the California Institution for Men.

Each of the 121 inmates who boarded the buses had been tested at various points over the previous several months, but few — if any — had been tested during the previous three weeks, prison officials have acknowledged.

Arriving at San Quentin, prisoners’ temperatures were taken and they were placed in a holding area, but no Covid-19 tests were given.

For days, the men used the same showers and ate in the same dining hall as other San Quentin inmates.

It took only days, data from the prison system shows, for the virus to make its way through the prison, where hundreds of inmates sleep in bunk beds within a few inches of one another in a crowded dormitory that was once a gymnasium. In other parts of the prison, men are paired inside 4-by-9 foot cells.

Over the past week, the prison has conducted mass testing. So far, more than half the inmates tested have seen positive results, state data shows.

The virus has spread so rapidly and there is so little unoccupied space left at the sprawling prison that some infected inmates have been placed in small isolation cells where, in normal times, death row inmates are sent for punishment.

Marion Wickerd got a call last week from her husband Tommy Wickerd, 53, an inmate in San Quentin.

“He said, ‘People are dropping right and left in front of me, but I’m OK,” Ms. Wickerd said.

A few hours later, though, he called back. He had tested positive. She said she had not spoken to him in several days.

“All I know is that my husband is not dead because no one has called to tell me that,” she said. “Worried? You bet. Scared? You bet.”

Reporting was contributed by Brendon Derr, Danya Issawi, Ann Hinga Klein, Savannah Redl and Maura Turcotte.

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