1 00:00:19,636 --> 00:00:23,196 Speaker 1: From Pushkin Industries. This is Deep Background, the show where 2 00:00:23,196 --> 00:00:26,076 Speaker 1: we explore the stories behind the stories in the news. 3 00:00:26,556 --> 00:00:30,156 Speaker 1: I'm Noah Feldman. We're all in the process of doing 4 00:00:30,196 --> 00:00:34,836 Speaker 1: our best to social distance to stop the spread of coronavirus. 5 00:00:34,876 --> 00:00:37,316 Speaker 1: And for most of us, and probably it should be 6 00:00:37,316 --> 00:00:41,436 Speaker 1: for all of us, that basically means self imposed isolation 7 00:00:41,596 --> 00:00:44,436 Speaker 1: of a certain degree. But there are many people in 8 00:00:44,476 --> 00:00:48,756 Speaker 1: the United States whose isolation is involuntary, and that is 9 00:00:48,916 --> 00:00:52,356 Speaker 1: people who are incarcerated in jails, in prisons, or in 10 00:00:52,436 --> 00:00:57,356 Speaker 1: immigration detention centers run by ICE. Prisoners have already tested 11 00:00:57,396 --> 00:01:00,516 Speaker 1: positive for coronavirus in New York, in Georgia and other 12 00:01:00,596 --> 00:01:03,796 Speaker 1: states as well. That's going to continue, and officials are 13 00:01:03,796 --> 00:01:07,516 Speaker 1: scrambling to figure out how to stop the spread inside 14 00:01:07,756 --> 00:01:12,956 Speaker 1: of institutions, prisons, in jails. To discuss this situation, I 15 00:01:13,036 --> 00:01:16,916 Speaker 1: spoke to doctor Homer Vendors. Until recently he was the 16 00:01:16,996 --> 00:01:20,396 Speaker 1: chief medical officer of the New York City Correctional Health Services. 17 00:01:20,996 --> 00:01:24,876 Speaker 1: Now he's president of an organization called Community Oriented Correctional 18 00:01:24,916 --> 00:01:28,476 Speaker 1: Health Services, which is a nonprofit that builds partnerships between 19 00:01:28,556 --> 00:01:31,756 Speaker 1: jails and community healthcare providers. He has a new book 20 00:01:31,876 --> 00:01:34,996 Speaker 1: called Life and death in Rikers Island, which is precisely 21 00:01:35,036 --> 00:01:38,276 Speaker 1: about the health risks of incarceration. And he was involved 22 00:01:38,276 --> 00:01:41,316 Speaker 1: in two thousand and nine in New York City's efforts 23 00:01:41,316 --> 00:01:43,676 Speaker 1: to deal with the H one N one virus when 24 00:01:43,676 --> 00:01:47,836 Speaker 1: it was spreading inside of Riker's Island. In short, doctor 25 00:01:47,916 --> 00:01:50,676 Speaker 1: Vners is really the perfect person to speak to about 26 00:01:50,716 --> 00:01:55,676 Speaker 1: this problem. We spoke on Monday morning, Homer. As of 27 00:01:55,716 --> 00:01:59,396 Speaker 1: this morning, New York City Corrections, where you used to 28 00:01:59,516 --> 00:02:02,676 Speaker 1: be the director of health for the entire system, is 29 00:02:02,716 --> 00:02:08,276 Speaker 1: reporting thirty eight cases of corona among either inmates or 30 00:02:08,436 --> 00:02:12,076 Speaker 1: prison staff. For jail staff, How worried should we be 31 00:02:12,116 --> 00:02:17,796 Speaker 1: about that number? I think that that number should cause alarm. 32 00:02:18,036 --> 00:02:22,036 Speaker 1: That should make us think about not just what's happening 33 00:02:22,036 --> 00:02:24,716 Speaker 1: to people who are detained in the New York City 34 00:02:24,756 --> 00:02:27,956 Speaker 1: jails and the people who work there, but every single 35 00:02:28,276 --> 00:02:31,596 Speaker 1: one of the five thousand jails and prisons and ice 36 00:02:31,636 --> 00:02:33,716 Speaker 1: detention centers across the country. I think this is a 37 00:02:34,516 --> 00:02:38,876 Speaker 1: very small foreshadowing of things to come and implications for 38 00:02:38,916 --> 00:02:41,396 Speaker 1: the survival. The welfare of the people who are in 39 00:02:41,436 --> 00:02:45,396 Speaker 1: these places, who work in these places, is really in peril. 40 00:02:45,636 --> 00:02:47,836 Speaker 1: And this is just the first of what I fear 41 00:02:47,876 --> 00:02:51,436 Speaker 1: will be many many more headlines and reports like this 42 00:02:51,636 --> 00:02:54,436 Speaker 1: around the country, many of the places, by the way, 43 00:02:54,556 --> 00:02:58,876 Speaker 1: that have far fewer health resources, far less access from 44 00:02:58,916 --> 00:03:01,676 Speaker 1: the press from outside eyes. So I think this is 45 00:03:01,716 --> 00:03:04,516 Speaker 1: the beginning of what we've been worrying about is going 46 00:03:04,556 --> 00:03:08,116 Speaker 1: to be a significant feature of this outbreak. A lot 47 00:03:08,156 --> 00:03:10,876 Speaker 1: of us have a visual image of what it's actually 48 00:03:10,916 --> 00:03:14,316 Speaker 1: like inside a jail or a prison only from television, 49 00:03:14,316 --> 00:03:18,196 Speaker 1: and in fact, mostly from fictional television. Would you explain 50 00:03:18,236 --> 00:03:20,436 Speaker 1: a little bit to us about how conditions, for example, 51 00:03:20,596 --> 00:03:24,836 Speaker 1: in a big city jail like Rikers, are especially conducive 52 00:03:24,876 --> 00:03:28,116 Speaker 1: to the transmission of infectious disease. Yeah. I think that 53 00:03:28,156 --> 00:03:31,996 Speaker 1: there are some features of jails that we might generally 54 00:03:32,076 --> 00:03:35,796 Speaker 1: understand that really contribute to the transmission of communicable diseases. 55 00:03:35,796 --> 00:03:37,636 Speaker 1: So the fact that there are lots of people in 56 00:03:37,796 --> 00:03:41,316 Speaker 1: very small spaces, and those people are jammed into housing 57 00:03:41,396 --> 00:03:44,556 Speaker 1: areas that whether they're a dorm or comprised of cells, 58 00:03:44,556 --> 00:03:47,156 Speaker 1: it's still lots of people in a small space, sharing 59 00:03:47,556 --> 00:03:52,116 Speaker 1: congregate bathrooms and sinks. People to go from one part 60 00:03:52,116 --> 00:03:53,556 Speaker 1: of the jail to the other have to go through 61 00:03:53,636 --> 00:03:56,476 Speaker 1: hallways and go through these things called sally ports or 62 00:03:56,516 --> 00:03:59,036 Speaker 1: control hubs, where they're all jammed in and you have 63 00:03:59,076 --> 00:04:01,436 Speaker 1: a gate that closes behind you before a gate can 64 00:04:01,476 --> 00:04:04,796 Speaker 1: open in front of you. There's intake areas where people 65 00:04:04,796 --> 00:04:06,956 Speaker 1: come in, especially in county jails that have such a 66 00:04:07,036 --> 00:04:09,316 Speaker 1: high churn. You know, half the people are gone by 67 00:04:09,356 --> 00:04:13,076 Speaker 1: day ten or fifteen, so they're constantly filling up with 68 00:04:13,116 --> 00:04:16,636 Speaker 1: newly arrested and detained people. Those folks are coming in 69 00:04:16,636 --> 00:04:20,876 Speaker 1: through these intake pens that are very teeming with people, 70 00:04:20,956 --> 00:04:23,716 Speaker 1: just scores of people in small spaces, nowhere to sit, 71 00:04:23,836 --> 00:04:26,516 Speaker 1: laying on the floor, and that's all the physical plant. 72 00:04:26,516 --> 00:04:29,076 Speaker 1: Then if you add in the fact that most of 73 00:04:29,076 --> 00:04:33,956 Speaker 1: these places are filthy, they have incredibly bad sanitation. You 74 00:04:34,036 --> 00:04:38,276 Speaker 1: have garbage, food trays, other types of trash built up 75 00:04:38,396 --> 00:04:41,836 Speaker 1: all over the place. They really promote the spread of 76 00:04:41,876 --> 00:04:48,556 Speaker 1: communicable diseases during normal times and during outbreak response. The 77 00:04:48,596 --> 00:04:52,436 Speaker 1: way that they're built and designed and run promotes the 78 00:04:52,476 --> 00:04:55,556 Speaker 1: spread of disease. One reaction that I had when first 79 00:04:55,556 --> 00:04:59,836 Speaker 1: thinking about incarcerated population is that the lockdown, which is 80 00:04:59,876 --> 00:05:02,076 Speaker 1: sometimes the word that we use colloquially to describe what's 81 00:05:02,076 --> 00:05:04,796 Speaker 1: happening to everybody else. I mean, I know that Governor Quoma, 82 00:05:04,836 --> 00:05:07,556 Speaker 1: New York wants to call it a pause. In California, 83 00:05:07,596 --> 00:05:09,396 Speaker 1: they call it a stay in place where, or another 84 00:05:09,396 --> 00:05:11,516 Speaker 1: sub called a shelter in place. But lockdown is still 85 00:05:11,836 --> 00:05:14,836 Speaker 1: the vernacular phrase that comes from prison. I mean, that's 86 00:05:14,836 --> 00:05:18,876 Speaker 1: a prison metaphor, and that might create the impression in 87 00:05:18,916 --> 00:05:20,996 Speaker 1: somebody's mind. I think it did it. At my first 88 00:05:21,236 --> 00:05:23,516 Speaker 1: uneducated thought before I started reading what you were writing 89 00:05:23,556 --> 00:05:26,676 Speaker 1: about this that actually prisons might be manageable because you 90 00:05:26,716 --> 00:05:30,356 Speaker 1: actually do have the capacity to control the movement of prisoners. 91 00:05:30,396 --> 00:05:32,556 Speaker 1: But on closer examination of what you've been saying, that 92 00:05:32,556 --> 00:05:35,076 Speaker 1: seems completely misguided. And I wonder if you would just 93 00:05:35,076 --> 00:05:36,596 Speaker 1: say a word about that, because I think I might 94 00:05:36,596 --> 00:05:38,276 Speaker 1: not be the only person who has that instinct. Yeah, 95 00:05:38,276 --> 00:05:41,396 Speaker 1: I think that you know, prisons and jails are built 96 00:05:41,436 --> 00:05:46,076 Speaker 1: for punishment and security control of people of humans. I 97 00:05:46,116 --> 00:05:48,676 Speaker 1: think that we all have this desire to stop the 98 00:05:48,756 --> 00:05:51,036 Speaker 1: movement of this virus through our society, and there's a 99 00:05:51,076 --> 00:05:54,396 Speaker 1: lot of really important measures that we're all engaged in 100 00:05:54,436 --> 00:05:57,636 Speaker 1: to try and do that. The problem in prisons and 101 00:05:57,796 --> 00:06:02,156 Speaker 1: jails and in correctional spaces is that lockdown generally means 102 00:06:02,156 --> 00:06:07,516 Speaker 1: putting people into locked cells. Often sometimes dorms, but often 103 00:06:07,596 --> 00:06:10,756 Speaker 1: we use it. It's used of cells, locking people into 104 00:06:10,756 --> 00:06:13,436 Speaker 1: cells and then keeping them there and then only bringing 105 00:06:13,436 --> 00:06:15,916 Speaker 1: them out for certain circumstances. And the idea is that 106 00:06:16,156 --> 00:06:19,196 Speaker 1: the problem will stay in the cell and so in 107 00:06:19,236 --> 00:06:22,756 Speaker 1: this circumstance, and what I would say is inappropriate use 108 00:06:22,796 --> 00:06:26,676 Speaker 1: of lockdowns as the primary response to coronavirus. The notion 109 00:06:26,756 --> 00:06:29,516 Speaker 1: would be that if you lock everybody into cells, then 110 00:06:29,836 --> 00:06:31,716 Speaker 1: the virus either won't get in or if it's in 111 00:06:31,756 --> 00:06:33,476 Speaker 1: the cell, it won't get out and it won't move 112 00:06:33,516 --> 00:06:37,876 Speaker 1: around the facility. That is erroneous for a number of reasons. 113 00:06:37,916 --> 00:06:41,236 Speaker 1: First of all, people who are locked down are being punished. 114 00:06:41,516 --> 00:06:43,516 Speaker 1: Whatever you say is the reason for it. When you 115 00:06:43,556 --> 00:06:46,036 Speaker 1: go get locked into a cell, when you're going into solitary, 116 00:06:46,436 --> 00:06:48,876 Speaker 1: it causes a lot of stress. People don't like it. 117 00:06:48,876 --> 00:06:51,636 Speaker 1: It is associated with suicide and self harm, and so 118 00:06:51,676 --> 00:06:54,756 Speaker 1: people don't want to go into those cells. Then to 119 00:06:54,956 --> 00:06:57,676 Speaker 1: institute a lockdown that means that you'll, all a sudden, 120 00:06:57,716 --> 00:07:00,316 Speaker 1: are going to ask your correctional staff to put their 121 00:07:00,316 --> 00:07:01,836 Speaker 1: hands on a lot of people, to have a lot 122 00:07:01,876 --> 00:07:06,676 Speaker 1: more physical contact with people. Sometimes us as a force 123 00:07:07,076 --> 00:07:09,436 Speaker 1: that get them into these cells, and then every time 124 00:07:09,476 --> 00:07:12,236 Speaker 1: they come out of those cells for a shower, if 125 00:07:12,276 --> 00:07:13,876 Speaker 1: they come out to go to the medical unit, if 126 00:07:13,916 --> 00:07:16,116 Speaker 1: they come out for any other reason, you're often then 127 00:07:16,156 --> 00:07:19,556 Speaker 1: in this position of having to have two escort officers 128 00:07:19,716 --> 00:07:23,316 Speaker 1: handcuff them, escort them physically. All of that is just 129 00:07:23,756 --> 00:07:27,276 Speaker 1: really escalating the amount of physical contact between humans in 130 00:07:27,316 --> 00:07:30,636 Speaker 1: these facilities. The other real core problem with this is 131 00:07:30,636 --> 00:07:33,196 Speaker 1: that when people get sick, and we know they're getting sick, 132 00:07:33,756 --> 00:07:35,396 Speaker 1: when they're locked in a cell, you don't see that. 133 00:07:35,596 --> 00:07:38,916 Speaker 1: Correctional officers coming by every fifteen minutes or thirty minutes 134 00:07:39,436 --> 00:07:44,596 Speaker 1: to peek through a dimly illuminated vision panel or window 135 00:07:44,636 --> 00:07:46,876 Speaker 1: in a cell door is not the way that you 136 00:07:46,956 --> 00:07:48,756 Speaker 1: keep an eye on people that you're worried about getting 137 00:07:48,796 --> 00:07:52,476 Speaker 1: sick or dying. So the lockdown as a public health 138 00:07:52,476 --> 00:07:57,796 Speaker 1: response is not appropriate as the primary measure, and in 139 00:07:57,836 --> 00:08:01,476 Speaker 1: many ways it can actually increase the flow of the 140 00:08:01,556 --> 00:08:05,676 Speaker 1: virus into and out of a facility. Obviously, the most 141 00:08:05,756 --> 00:08:08,756 Speaker 1: immediate ethical worry that I think we all need to 142 00:08:08,796 --> 00:08:11,636 Speaker 1: have with respect to incarcerated people is that it shouldn't 143 00:08:11,636 --> 00:08:13,516 Speaker 1: be the case that if someone is being locked up. 144 00:08:13,556 --> 00:08:17,676 Speaker 1: They're being essentially put in a situation like being put 145 00:08:17,676 --> 00:08:20,876 Speaker 1: on a cruise ship, but involuntarily and with much worse conditions, 146 00:08:21,076 --> 00:08:24,196 Speaker 1: which is likely to significantly increase their chance of getting 147 00:08:24,196 --> 00:08:27,476 Speaker 1: sick and dying. But I assume there's also a concern 148 00:08:27,556 --> 00:08:32,396 Speaker 1: for the general public associated with enabling a coronavirus to 149 00:08:32,396 --> 00:08:35,996 Speaker 1: spread rapidly within jails and prisons, partly because corrections officers 150 00:08:35,996 --> 00:08:37,516 Speaker 1: are coming and going and so it will spread into 151 00:08:37,556 --> 00:08:41,476 Speaker 1: the general population. Partly because of resource allocation issues, because 152 00:08:41,476 --> 00:08:44,036 Speaker 1: if you get a big outbreak, a lot of resources 153 00:08:44,076 --> 00:08:46,316 Speaker 1: are inevitably going to be called on, even if they 154 00:08:46,316 --> 00:08:49,796 Speaker 1: were not distributed in a fair way. What do you 155 00:08:49,836 --> 00:08:52,876 Speaker 1: see as the main concern for the general public here? 156 00:08:52,916 --> 00:08:55,516 Speaker 1: I mean putting aside the very pressing ethical concern that 157 00:08:55,556 --> 00:08:57,996 Speaker 1: we shouldn't be arresting people from minor offenses and then 158 00:08:58,036 --> 00:08:59,716 Speaker 1: putting them into place where they have a better chance 159 00:08:59,756 --> 00:09:02,676 Speaker 1: of catching a disease and dying. Yeah, I think the 160 00:09:02,756 --> 00:09:06,236 Speaker 1: simplest way I could put it is that correctional settings, prisons, jails, 161 00:09:06,236 --> 00:09:09,436 Speaker 1: and ice decession centers are going to drive this piademic 162 00:09:09,516 --> 00:09:12,876 Speaker 1: curve straight up. So we hear about trying to flatten 163 00:09:12,876 --> 00:09:15,996 Speaker 1: that curve about trying to relieve the strain and stress 164 00:09:16,036 --> 00:09:19,316 Speaker 1: on our health system by social distancing and taking all 165 00:09:19,356 --> 00:09:22,396 Speaker 1: these other measures and really extreme important measures that are 166 00:09:22,396 --> 00:09:26,556 Speaker 1: being implemented today. What happens behind bars is going to 167 00:09:26,636 --> 00:09:29,476 Speaker 1: drive that epidemic curve in exactly the opposite direction of 168 00:09:29,516 --> 00:09:33,396 Speaker 1: what we're working towards, and so they will quickly become reservoirs. 169 00:09:33,396 --> 00:09:37,756 Speaker 1: And they probably are already, but certainly as we make 170 00:09:37,796 --> 00:09:40,516 Speaker 1: gains in the rest of the community, these places will 171 00:09:40,556 --> 00:09:43,996 Speaker 1: become critical reservoirs for infection. They're going to continue to 172 00:09:44,076 --> 00:09:47,716 Speaker 1: cycle infection out of these places in and out as 173 00:09:47,716 --> 00:09:49,916 Speaker 1: staff go in and out, and to some extent the 174 00:09:49,996 --> 00:09:51,956 Speaker 1: people who are held there. But you know, there's many 175 00:09:51,956 --> 00:09:54,836 Speaker 1: more people coming and going every day who are staff 176 00:09:54,876 --> 00:09:58,716 Speaker 1: members than there are arriving as newly arrived people in 177 00:09:58,756 --> 00:10:02,356 Speaker 1: a prisoner jail. So these places, as reservoirs of infection, 178 00:10:02,596 --> 00:10:06,476 Speaker 1: as congregate settings where the spread of the infection cannot 179 00:10:06,476 --> 00:10:12,196 Speaker 1: really be controlled, stand to dramatically escalate the epidemic curve 180 00:10:12,236 --> 00:10:14,836 Speaker 1: that we're working so hard to bring down. Homer, you 181 00:10:14,876 --> 00:10:19,836 Speaker 1: mentioned crucially that prisons and jails are probably already at 182 00:10:19,916 --> 00:10:24,676 Speaker 1: least in New York City becoming reservoirs of coronavirus. That 183 00:10:24,756 --> 00:10:27,796 Speaker 1: leads us to the really pressing question of what we 184 00:10:27,836 --> 00:10:30,036 Speaker 1: should be doing and how we should be doing it 185 00:10:30,116 --> 00:10:33,356 Speaker 1: with respect to releasing people. And I want to start 186 00:10:33,396 --> 00:10:35,676 Speaker 1: with just asking a question of you when you wear 187 00:10:35,716 --> 00:10:39,276 Speaker 1: your epidemiologist hat. And that is given that we know 188 00:10:39,396 --> 00:10:43,596 Speaker 1: now that there are presumably lots of cases, including asymptomatic cases, 189 00:10:44,236 --> 00:10:48,116 Speaker 1: in jails and prisons, if we open those doors, is 190 00:10:48,116 --> 00:10:50,676 Speaker 1: that going to be adding a new vector of rapid 191 00:10:50,756 --> 00:10:53,876 Speaker 1: spread to the general population. And if so, is that 192 00:10:53,996 --> 00:10:55,756 Speaker 1: nevertheless the right thing to do in terms of the 193 00:10:55,796 --> 00:10:59,036 Speaker 1: overall cost benefit of fighting the disease. Well, I think 194 00:10:59,076 --> 00:11:03,516 Speaker 1: where we're at now is that when coronavirus arrives in 195 00:11:03,556 --> 00:11:06,796 Speaker 1: a community, it's part of the community is the jail 196 00:11:06,916 --> 00:11:09,156 Speaker 1: or prison or is attention center, and it's going to 197 00:11:09,276 --> 00:11:14,596 Speaker 1: arrive there. So places where we likely have a significant 198 00:11:14,676 --> 00:11:17,636 Speaker 1: number of people who are asymptomatic, who are kind of 199 00:11:17,636 --> 00:11:21,236 Speaker 1: brewing early infections. It's no different inside the jail than 200 00:11:21,276 --> 00:11:23,476 Speaker 1: outside the jail. Now, in the coming weeks, we will 201 00:11:23,556 --> 00:11:27,756 Speaker 1: have spread inside those facilities that you may be more 202 00:11:27,796 --> 00:11:32,596 Speaker 1: accelerated than outside. But one of My primary concerns is 203 00:11:32,636 --> 00:11:35,036 Speaker 1: that unlike the community, where we're going to have some 204 00:11:35,436 --> 00:11:38,956 Speaker 1: family or ability some other we have capacity to see 205 00:11:38,996 --> 00:11:41,996 Speaker 1: who's getting sick and who needs hospital level care. We're 206 00:11:41,996 --> 00:11:44,876 Speaker 1: going to miss that behind bars. When H one N 207 00:11:44,916 --> 00:11:48,036 Speaker 1: one hit, everybody who was symptomatic was tested in the 208 00:11:48,076 --> 00:11:52,196 Speaker 1: New York City jails, and so sometimes the press and 209 00:11:52,276 --> 00:11:55,396 Speaker 1: people on the outside would erroneously think that this was 210 00:11:55,436 --> 00:11:58,116 Speaker 1: a riker's outbreak of H one N one. But we 211 00:11:58,316 --> 00:12:01,276 Speaker 1: everybody who was symptomatic was in a housing area, and 212 00:12:01,316 --> 00:12:03,476 Speaker 1: these weren't cells, they were dorms, but they were in 213 00:12:03,516 --> 00:12:05,676 Speaker 1: housing areas where they couldn't move in and out. But 214 00:12:05,716 --> 00:12:07,756 Speaker 1: also we would give them a test and then if 215 00:12:07,756 --> 00:12:10,236 Speaker 1: they were symptoms attic, they'd go to the same place 216 00:12:10,276 --> 00:12:13,156 Speaker 1: that the coronavirus patients are going today, the West Facility 217 00:12:13,156 --> 00:12:17,036 Speaker 1: of Communicable Disease Unit. But people thought, because I think 218 00:12:17,076 --> 00:12:18,956 Speaker 1: it was like two and a half percent of the 219 00:12:18,996 --> 00:12:21,196 Speaker 1: people coming into the who it came into the jails 220 00:12:21,236 --> 00:12:23,996 Speaker 1: during that time tested positive, they thought, boy, this is 221 00:12:24,036 --> 00:12:26,676 Speaker 1: a riker's problem. It wasn't. It's a community problem. We 222 00:12:26,796 --> 00:12:29,196 Speaker 1: just happened to be very aggressive about testing because we 223 00:12:29,196 --> 00:12:32,156 Speaker 1: did not want to miss a single case. I think 224 00:12:32,196 --> 00:12:35,516 Speaker 1: that the way to characterize what's happening behind bars is 225 00:12:35,996 --> 00:12:38,836 Speaker 1: if it's in the community, it's part of the community's 226 00:12:38,836 --> 00:12:43,196 Speaker 1: the jail or prison, and so I don't believe that, 227 00:12:43,636 --> 00:12:48,596 Speaker 1: at least today, there's an epidemiologic reason to say releasing 228 00:12:48,636 --> 00:12:51,356 Speaker 1: people is going to contribute to the infection. And I 229 00:12:51,396 --> 00:12:54,276 Speaker 1: think that right now we've turned a corner in this country, 230 00:12:54,276 --> 00:12:58,996 Speaker 1: which is our primary focus is on preventing death, and 231 00:12:59,076 --> 00:13:00,636 Speaker 1: to do that, we have to get people out of 232 00:13:00,636 --> 00:13:13,716 Speaker 1: these places. We'll be back in just a moment. There 233 00:13:13,716 --> 00:13:19,796 Speaker 1: are voices, including yours, increasingly calling for release of certainly 234 00:13:19,916 --> 00:13:23,756 Speaker 1: people who are jailed awaiting trial, and even of inmates 235 00:13:23,796 --> 00:13:27,356 Speaker 1: who've already been convicted or guilty to crimes. Do you 236 00:13:27,396 --> 00:13:29,196 Speaker 1: have a view about how that should be done, how 237 00:13:29,236 --> 00:13:32,556 Speaker 1: should that be triage. I think that we'll need different 238 00:13:32,556 --> 00:13:36,156 Speaker 1: strategies for county jails, for state and federal prisons, and 239 00:13:36,196 --> 00:13:39,836 Speaker 1: for ice detention centers. Some of these places, like ice detention, 240 00:13:40,196 --> 00:13:43,596 Speaker 1: there's not really nobody is even making a public safety 241 00:13:43,636 --> 00:13:45,876 Speaker 1: argument for why people should be detained, and so you 242 00:13:45,916 --> 00:13:49,276 Speaker 1: could categorically just administratively, it seems to let people out 243 00:13:49,756 --> 00:13:54,076 Speaker 1: county jails have one set of pathways, which involved looking 244 00:13:54,076 --> 00:13:56,276 Speaker 1: at people in the nature of their charges and figuring 245 00:13:56,276 --> 00:13:59,676 Speaker 1: out how they can get people out certainly before there 246 00:13:59,756 --> 00:14:01,716 Speaker 1: so they can just show up to trial. And that's 247 00:14:02,196 --> 00:14:04,596 Speaker 1: and that's different than you know, when I've talked to 248 00:14:04,636 --> 00:14:08,476 Speaker 1: state prison administrators in the last couple of weeks, that's 249 00:14:08,476 --> 00:14:11,796 Speaker 1: a very tough off road. There are people who are 250 00:14:11,796 --> 00:14:14,436 Speaker 1: on the pathway to prison release, and so those pathways 251 00:14:14,436 --> 00:14:18,356 Speaker 1: can be accelerated. There are in most states prison furlough 252 00:14:18,636 --> 00:14:23,156 Speaker 1: processes that can be enacted, But the state prisons I'm 253 00:14:23,316 --> 00:14:26,836 Speaker 1: terribly worried about because you have just huge numbers of people. 254 00:14:27,396 --> 00:14:29,756 Speaker 1: I was talking with somebody from a state prison system 255 00:14:29,836 --> 00:14:33,516 Speaker 1: yesterday where the overall capacity of the state prison is 256 00:14:33,556 --> 00:14:35,996 Speaker 1: at one hundred and seventy five percent of what they 257 00:14:36,036 --> 00:14:40,436 Speaker 1: should have, and so incredibly densely populated places where there's 258 00:14:40,476 --> 00:14:43,956 Speaker 1: really very little prospect of getting people out. And so 259 00:14:44,476 --> 00:14:47,276 Speaker 1: as I think about what we need to do to 260 00:14:47,356 --> 00:14:50,956 Speaker 1: react besides release, part of it is it will contemplate 261 00:14:50,996 --> 00:14:54,476 Speaker 1: strategies that are different for these different types of settings. 262 00:14:55,316 --> 00:14:57,996 Speaker 1: That seems very sensible, but I just you know, there 263 00:14:58,076 --> 00:14:59,916 Speaker 1: is a substantial risk I think that none of that 264 00:14:59,956 --> 00:15:02,516 Speaker 1: could happen fast enough. I mean, so, for example, I 265 00:15:02,556 --> 00:15:06,796 Speaker 1: know some DA's offices around the city, including Brooklyn, have 266 00:15:06,916 --> 00:15:11,476 Speaker 1: called for applications from lawyers for people who are detained 267 00:15:11,516 --> 00:15:13,836 Speaker 1: to say, hey, explain to us why we should go 268 00:15:13,876 --> 00:15:15,956 Speaker 1: to the court and move to have your or agree 269 00:15:15,956 --> 00:15:19,076 Speaker 1: to your emotion to have your client release under these 270 00:15:19,076 --> 00:15:21,876 Speaker 1: conditions and circumstances. I think that's a great response. I 271 00:15:21,996 --> 00:15:24,516 Speaker 1: worry that it can't work at scale. It's not just 272 00:15:24,596 --> 00:15:28,396 Speaker 1: that courts are moving more slowly because of their own 273 00:15:28,436 --> 00:15:32,636 Speaker 1: concerns about Corona's that even under the best of circumstances, 274 00:15:32,676 --> 00:15:35,036 Speaker 1: that's a very individuated way of doing it. And of 275 00:15:35,036 --> 00:15:37,316 Speaker 1: course it seems sensible. Let's make sure, let's weigh, let's 276 00:15:37,356 --> 00:15:39,556 Speaker 1: make a judgment about each person. That's what courts are 277 00:15:39,596 --> 00:15:43,196 Speaker 1: good at. But it's not a crisis response approach. Do 278 00:15:43,236 --> 00:15:45,676 Speaker 1: you think there's a plausible argument to say, for example, 279 00:15:45,716 --> 00:15:50,636 Speaker 1: that all non violent offenders being held in rikers, or 280 00:15:50,676 --> 00:15:53,236 Speaker 1: all non violent offenders over the age of fifty, or 281 00:15:53,476 --> 00:15:55,916 Speaker 1: you know, something of that sort just ought to be 282 00:15:56,236 --> 00:15:58,076 Speaker 1: straight up released. And the reason I ask this is 283 00:15:58,076 --> 00:16:00,556 Speaker 1: not just about getting things right in New York city 284 00:16:00,676 --> 00:16:03,436 Speaker 1: or in the jail slash prison that you know very well. 285 00:16:03,676 --> 00:16:05,516 Speaker 1: It's also that this is going to become a paradigm 286 00:16:05,556 --> 00:16:09,396 Speaker 1: set a presumably for other places in the country, if 287 00:16:09,436 --> 00:16:14,356 Speaker 1: in most likely when we see the same scenario repeated elsewhere. Yeah, 288 00:16:14,436 --> 00:16:18,276 Speaker 1: I think that's an important point that deliberative and piecemeal 289 00:16:18,516 --> 00:16:22,156 Speaker 1: approaches are not always the ones we want to turn 290 00:16:22,196 --> 00:16:24,876 Speaker 1: to in really die our emergencies. I reminded of a 291 00:16:24,876 --> 00:16:27,356 Speaker 1: colleague who once told me that after Katrina in New Orleans, 292 00:16:28,156 --> 00:16:32,396 Speaker 1: what they got was a plan that was developed by 293 00:16:32,436 --> 00:16:34,636 Speaker 1: an Internet And I can say this as an Internet, 294 00:16:34,676 --> 00:16:36,476 Speaker 1: but what they needed was a plan developed by an 295 00:16:36,476 --> 00:16:39,716 Speaker 1: emergency medicine doc. And I don't mean that just for 296 00:16:39,756 --> 00:16:41,796 Speaker 1: the medical part, and so I think that's right. I 297 00:16:41,796 --> 00:16:44,836 Speaker 1: think one of the things I'm calling for in terms 298 00:16:44,836 --> 00:16:48,116 Speaker 1: of what we should do besides release with keeping releases, 299 00:16:48,156 --> 00:16:52,836 Speaker 1: the number one objective is every state must appoint or 300 00:16:52,916 --> 00:16:56,556 Speaker 1: identify a correctional health coordinator who can manage this process, 301 00:16:56,716 --> 00:16:59,596 Speaker 1: and the CDC needs to also, and so does HHS. 302 00:16:59,676 --> 00:17:02,436 Speaker 1: We need state level and federal level people who have 303 00:17:02,516 --> 00:17:07,956 Speaker 1: been identified to coordinate what's happening with the health aspects 304 00:17:07,996 --> 00:17:11,036 Speaker 1: of corrections and to tend spaces around the country because 305 00:17:11,036 --> 00:17:13,116 Speaker 1: we have five thousand of these places. If you sit 306 00:17:13,716 --> 00:17:16,036 Speaker 1: as a commissioner of health or the person who's running 307 00:17:16,076 --> 00:17:20,596 Speaker 1: your state's COVID emergency response, you look across this array 308 00:17:20,676 --> 00:17:23,076 Speaker 1: of places you probably don't even know much about. You 309 00:17:23,116 --> 00:17:26,276 Speaker 1: have county jails in all your counties, mostly, you have 310 00:17:26,316 --> 00:17:29,076 Speaker 1: state prisons, and then you have ice detension centers, some 311 00:17:29,116 --> 00:17:31,956 Speaker 1: of which are run by for profit companies. And so 312 00:17:32,756 --> 00:17:35,556 Speaker 1: we need just like we're taking seriously what's happening in 313 00:17:35,596 --> 00:17:39,436 Speaker 1: long term care facilities, assisted living, in nursing home settings, 314 00:17:39,676 --> 00:17:42,116 Speaker 1: we need to identify one person in every state that's 315 00:17:42,156 --> 00:17:43,876 Speaker 1: going to take on this task because we don't even 316 00:17:43,876 --> 00:17:47,196 Speaker 1: have data today. Nobody could tell you how many patients 317 00:17:47,476 --> 00:17:50,716 Speaker 1: inside county jails, state and federal prisons, and ice detention 318 00:17:50,876 --> 00:17:54,316 Speaker 1: centers have symptoms today, how many are needing a test. 319 00:17:54,916 --> 00:17:57,676 Speaker 1: And one of the critical concerns I have is we 320 00:17:57,756 --> 00:18:00,476 Speaker 1: do not have pathways to hospital level care for most 321 00:18:00,516 --> 00:18:03,076 Speaker 1: of these patients. Most of these patients who get sick, 322 00:18:03,676 --> 00:18:05,956 Speaker 1: the traditional method of getting them into a hospital is 323 00:18:05,996 --> 00:18:09,156 Speaker 1: to send them with two armed correctional officers to go 324 00:18:09,196 --> 00:18:12,036 Speaker 1: to a local hospital. It's a process that for people 325 00:18:12,076 --> 00:18:14,676 Speaker 1: who have seen it, like everybody who works in emergency 326 00:18:14,756 --> 00:18:17,516 Speaker 1: rooms and people who work in corrections know this. It 327 00:18:17,596 --> 00:18:21,076 Speaker 1: takes a ton of resources because you're sending two officers 328 00:18:21,196 --> 00:18:22,996 Speaker 1: who are going to stay with this person twenty four 329 00:18:22,996 --> 00:18:25,076 Speaker 1: to seven. They take up a ton of space in 330 00:18:25,116 --> 00:18:28,676 Speaker 1: an emergency room. Emergency rooms that are incredibly over stretch 331 00:18:28,756 --> 00:18:31,356 Speaker 1: right now in terms of their staffing and their space. 332 00:18:31,916 --> 00:18:35,036 Speaker 1: And so if we get five or ten or fifteen 333 00:18:35,116 --> 00:18:38,956 Speaker 1: people from one facility going to the hospital, there just 334 00:18:38,996 --> 00:18:41,956 Speaker 1: won't be CEOs correctional officers to go with them. They're 335 00:18:41,996 --> 00:18:44,596 Speaker 1: going to have fewer staff because they'll be sick. We 336 00:18:44,676 --> 00:18:47,316 Speaker 1: won't have a magical new resource for them to go 337 00:18:47,396 --> 00:18:51,316 Speaker 1: to to get this care. And my experience in investigating 338 00:18:51,316 --> 00:18:54,356 Speaker 1: deaths all over the country is that these patients are 339 00:18:54,396 --> 00:18:56,716 Speaker 1: patients who are behind bars today, are the ones that 340 00:18:56,756 --> 00:18:58,196 Speaker 1: go to the back of the line when it comes 341 00:18:58,196 --> 00:19:01,556 Speaker 1: to access to hospital level care. And so part of 342 00:19:01,556 --> 00:19:06,036 Speaker 1: the priority has to be we create explicit passways for 343 00:19:06,316 --> 00:19:09,756 Speaker 1: access to hospital level care when we had toify patients 344 00:19:09,756 --> 00:19:13,356 Speaker 1: that need it in the real world. I don't think 345 00:19:13,556 --> 00:19:15,836 Speaker 1: you'll see that happening. I mean, I think it's maybe 346 00:19:15,876 --> 00:19:18,916 Speaker 1: ten or fifteen patients. You could conceive of a system saying, well, 347 00:19:18,916 --> 00:19:21,356 Speaker 1: we're going to send two correctional officers, but at some point, 348 00:19:21,396 --> 00:19:22,876 Speaker 1: either they're going to have to stop doing that and 349 00:19:22,956 --> 00:19:27,836 Speaker 1: shoulder the risk of escape, or alternatively, simply not send 350 00:19:27,876 --> 00:19:32,956 Speaker 1: people who are incarcerated to hospitals. And if that happens, 351 00:19:33,796 --> 00:19:37,236 Speaker 1: what will happen within the jails and the prisons. Well, 352 00:19:37,276 --> 00:19:39,556 Speaker 1: if those are the only two options, then yes, people 353 00:19:39,596 --> 00:19:42,476 Speaker 1: will die preventable death because people will be held in 354 00:19:42,516 --> 00:19:45,156 Speaker 1: correctional facilities where staff will to try and take care 355 00:19:45,156 --> 00:19:47,716 Speaker 1: of them for too long. They'll get well passed their 356 00:19:47,796 --> 00:19:52,276 Speaker 1: level of clinical competence and equipment and infection control capacity. 357 00:19:53,116 --> 00:19:55,636 Speaker 1: Some of the data indicate thirty or forty percent of 358 00:19:55,636 --> 00:19:57,716 Speaker 1: the people who need kind of a middle level of 359 00:19:57,796 --> 00:20:00,956 Speaker 1: inpatient treatment but not yet I see you treatment. About 360 00:20:00,996 --> 00:20:02,876 Speaker 1: thirty or forty percent of them will need a higher 361 00:20:02,956 --> 00:20:05,276 Speaker 1: level of care. Well, if you're trying to manage the 362 00:20:05,476 --> 00:20:09,796 Speaker 1: middle level inpatient folks in your jail or prison or 363 00:20:09,996 --> 00:20:13,116 Speaker 1: detention center, than when they need that higher level of 364 00:20:13,116 --> 00:20:15,756 Speaker 1: care because they deteriorate, you're not rolling them down the 365 00:20:15,756 --> 00:20:17,996 Speaker 1: hall to the ICU. You're going through a two hour 366 00:20:18,036 --> 00:20:21,356 Speaker 1: transfer process, so they're going to die. There is another option. 367 00:20:21,796 --> 00:20:25,636 Speaker 1: We did this after Sandy to set up secure treatment 368 00:20:25,716 --> 00:20:30,356 Speaker 1: units as part of what's going to be the surge 369 00:20:30,436 --> 00:20:34,956 Speaker 1: in capacity at hospital. So hospitals that are currently building 370 00:20:35,796 --> 00:20:39,796 Speaker 1: sometimes tense, sometimes new opening up wings that have been mothballed, 371 00:20:39,956 --> 00:20:44,676 Speaker 1: setting up new space to handle this incoming flux of 372 00:20:44,996 --> 00:20:48,476 Speaker 1: COVID patients. In that the states that are planning this 373 00:20:48,676 --> 00:20:52,356 Speaker 1: with their hospital partners, they need to explicitly detail and 374 00:20:52,476 --> 00:20:56,836 Speaker 1: plan for care for incarcerated patients. And so sometimes what 375 00:20:56,916 --> 00:20:59,156 Speaker 1: you can do is you can as we did after Sandy, 376 00:20:59,156 --> 00:21:01,556 Speaker 1: We've set up a new unit. We had patients go 377 00:21:01,596 --> 00:21:06,036 Speaker 1: to a couple of dedicated places but when Bell was evacuated. 378 00:21:06,076 --> 00:21:08,356 Speaker 1: But one of the things you need is the capacity 379 00:21:08,356 --> 00:21:10,836 Speaker 1: to set up are units. So you're not relying on 380 00:21:11,436 --> 00:21:15,596 Speaker 1: two correctional officers for every patient. But you can figure 381 00:21:15,636 --> 00:21:19,116 Speaker 1: out how to get a better ratio of correctional officers 382 00:21:19,116 --> 00:21:22,476 Speaker 1: to patients in a unit that's somewhat secured, that meets 383 00:21:22,516 --> 00:21:26,156 Speaker 1: the custodial requirements of the securing authorities. And it may 384 00:21:26,196 --> 00:21:28,996 Speaker 1: be that in some states and some regions you actually 385 00:21:28,996 --> 00:21:33,236 Speaker 1: have multiple correctional administrations, like different sheriffs or sheriffs and 386 00:21:33,236 --> 00:21:36,556 Speaker 1: state prisons cooperating to figure out how can they staff 387 00:21:36,636 --> 00:21:39,916 Speaker 1: up and design these units quickly with the hospitals that 388 00:21:39,996 --> 00:21:44,156 Speaker 1: are surging their capacity. Because these units and this response 389 00:21:44,196 --> 00:21:47,836 Speaker 1: has to involve hospital level care by hospital staff, it's 390 00:21:47,876 --> 00:21:50,356 Speaker 1: not going to work if you're keeping patients out in 391 00:21:50,396 --> 00:21:54,556 Speaker 1: these correctional settings. They're just not going to survive. What's 392 00:21:54,596 --> 00:21:57,316 Speaker 1: the sort of best case scenario you can picture. We've 393 00:21:57,316 --> 00:21:59,436 Speaker 1: spent a lot of time in this pandemic situation talking 394 00:21:59,476 --> 00:22:01,356 Speaker 1: about worst case scenarios, and you've made it pretty clear 395 00:22:01,356 --> 00:22:03,796 Speaker 1: that the worst case scenario is significant number of people 396 00:22:03,916 --> 00:22:08,356 Speaker 1: dying unnecessarily and prisons and jails really contributing to the 397 00:22:08,476 --> 00:22:11,156 Speaker 1: rapid rise of the curve. But what's the best case 398 00:22:11,156 --> 00:22:15,356 Speaker 1: scenario that you can realistically foresee if good recommendations are 399 00:22:15,396 --> 00:22:19,436 Speaker 1: followed well. I think that one of the things that 400 00:22:19,556 --> 00:22:22,876 Speaker 1: could happen relatively quickly is that as states in the 401 00:22:22,956 --> 00:22:26,796 Speaker 1: CDC identify correctional health coordinators, they are going to get 402 00:22:26,836 --> 00:22:33,076 Speaker 1: a quick snapshot of where the outbreak is impacting incarcerated 403 00:22:33,156 --> 00:22:36,556 Speaker 1: patients first. And this won't be uniform, just as you know, 404 00:22:36,676 --> 00:22:39,156 Speaker 1: it really reflects what's happening in the community, and so 405 00:22:39,276 --> 00:22:41,996 Speaker 1: for the next few weeks we're going to have hotspots 406 00:22:41,996 --> 00:22:45,236 Speaker 1: where the problems are evolving. We may in a month 407 00:22:45,396 --> 00:22:48,476 Speaker 1: or two have a much more prevalent problem that is 408 00:22:48,756 --> 00:22:51,316 Speaker 1: more generalized, but for the next month or so, we're 409 00:22:51,316 --> 00:22:54,636 Speaker 1: going to have places Rikers being the first that's being reported. 410 00:22:55,076 --> 00:22:58,956 Speaker 1: It's critical for us to appoint these correctional health coordinators 411 00:22:59,076 --> 00:23:01,636 Speaker 1: right now because they need to be the ones that 412 00:23:01,676 --> 00:23:05,316 Speaker 1: are in the room with the governor's staff, with people 413 00:23:05,476 --> 00:23:09,516 Speaker 1: running the overall response, to understand and report to others 414 00:23:09,876 --> 00:23:11,956 Speaker 1: where patients are going to need to be going, and 415 00:23:12,036 --> 00:23:14,436 Speaker 1: how we can build these new units in a way 416 00:23:14,476 --> 00:23:17,476 Speaker 1: that meets the statewide needs. So if you look at 417 00:23:17,476 --> 00:23:21,116 Speaker 1: the footprint of incarceration in every state, one of the 418 00:23:21,156 --> 00:23:23,556 Speaker 1: things that's really terrifying is in a lot of rural 419 00:23:23,636 --> 00:23:29,276 Speaker 1: counties we have large overfilled county jails, we have a 420 00:23:29,316 --> 00:23:32,196 Speaker 1: fair number of prisons, and we have a lot of 421 00:23:32,196 --> 00:23:36,036 Speaker 1: ice dissension centers, all in places where we've lost hospital 422 00:23:36,116 --> 00:23:39,916 Speaker 1: capacity in the last ten or fifteen years. That requires 423 00:23:39,956 --> 00:23:43,076 Speaker 1: a coordination at a state level to understand day to 424 00:23:43,156 --> 00:23:45,916 Speaker 1: day who are the patients that need higher level care 425 00:23:45,916 --> 00:23:48,196 Speaker 1: and where can they go? And I think that that 426 00:23:48,316 --> 00:23:51,316 Speaker 1: kind of it's not just epidemiology. A lot of this 427 00:23:51,396 --> 00:23:54,516 Speaker 1: is also supply chain. How can we get people connected 428 00:23:54,556 --> 00:23:57,516 Speaker 1: to the things they need. That's happening in every pretty 429 00:23:57,556 --> 00:24:00,196 Speaker 1: much every other aspect of society right now. So these 430 00:24:00,196 --> 00:24:03,556 Speaker 1: are not principles or tasks that are foreign to the 431 00:24:03,556 --> 00:24:06,356 Speaker 1: rest of the nation. It's just that these patients and 432 00:24:06,396 --> 00:24:10,236 Speaker 1: their welfare haven't traditionally been incorporated, but they must be 433 00:24:10,316 --> 00:24:14,676 Speaker 1: incorporated now this week to this response if we want 434 00:24:14,716 --> 00:24:17,516 Speaker 1: to save their lives and also help really bring down 435 00:24:17,516 --> 00:24:20,876 Speaker 1: that curve. Homer, I want to thank you not only 436 00:24:20,916 --> 00:24:23,156 Speaker 1: for the important work you're doing in this crisis, but 437 00:24:23,276 --> 00:24:25,676 Speaker 1: for the work that you do all the time to 438 00:24:25,676 --> 00:24:29,556 Speaker 1: try to improve conditions for public health inside of prisons 439 00:24:29,596 --> 00:24:33,596 Speaker 1: and to build partnerships between jails and community healthcare providers. 440 00:24:33,636 --> 00:24:36,836 Speaker 1: That's important even when we're not under conditions of the pandemic, 441 00:24:36,876 --> 00:24:39,916 Speaker 1: and what you're doing now is also obviously great pressing significance. 442 00:24:39,956 --> 00:24:42,116 Speaker 1: Thank you very much for your time. Thank you very much, 443 00:24:42,156 --> 00:24:45,996 Speaker 1: have a good day. Speaking to home reveners makes it 444 00:24:46,156 --> 00:24:49,436 Speaker 1: extremely clear that the problem of coronavirus that we're struggling 445 00:24:49,436 --> 00:24:53,236 Speaker 1: with across the country now is especially acute and worrisome 446 00:24:53,436 --> 00:24:56,916 Speaker 1: when it comes to people who are incarcerated. It's not 447 00:24:56,956 --> 00:24:59,916 Speaker 1: only an ethical issue, it's also a public health issue 448 00:24:59,956 --> 00:25:03,396 Speaker 1: of the most pressing type. He's calling for the appointment 449 00:25:03,436 --> 00:25:06,636 Speaker 1: of coordinators in every state to deal with the problem. 450 00:25:06,756 --> 00:25:09,116 Speaker 1: That seems like a no brainer and should certainly be adopted. 451 00:25:09,116 --> 00:25:11,556 Speaker 1: It's my instinct, however, that we may need to go 452 00:25:11,636 --> 00:25:13,996 Speaker 1: further than that, and I hope that governors across the 453 00:25:13,996 --> 00:25:17,636 Speaker 1: country and prosecutor's offices as well, will look seriously at 454 00:25:17,676 --> 00:25:22,156 Speaker 1: engaging in more systematic analysis of who could safely be released, 455 00:25:22,476 --> 00:25:24,676 Speaker 1: both in order to protect them and to protect the 456 00:25:24,756 --> 00:25:28,556 Speaker 1: general public against the risk of many, many acute cases 457 00:25:28,716 --> 00:25:33,636 Speaker 1: of coronavirus arising among people who are locked up. Almost 458 00:25:33,636 --> 00:25:36,196 Speaker 1: every university that I know of has sent home students 459 00:25:36,196 --> 00:25:40,276 Speaker 1: from its dorms, and prisons in the end bear such 460 00:25:40,276 --> 00:25:43,556 Speaker 1: a close resemblance to dormitory living that the probability of 461 00:25:43,596 --> 00:25:47,836 Speaker 1: spread seems very, very great within them. That's a radical measure, 462 00:25:48,276 --> 00:25:51,596 Speaker 1: but this is an emergency, and an emergency radical measures 463 00:25:51,596 --> 00:25:55,236 Speaker 1: at least need to be considered seriously and evaluated in 464 00:25:55,316 --> 00:25:59,556 Speaker 1: determining whether we should adopt them or not. Deep Background 465 00:25:59,636 --> 00:26:02,396 Speaker 1: is brought to you by Pushkin Industries. Our producer is 466 00:26:02,476 --> 00:26:06,756 Speaker 1: Lydia Gene Caught with research help from Zooeywyn. Mastering is 467 00:26:06,756 --> 00:26:10,756 Speaker 1: by Jason Gambrel and Martin Gonzalez. Our showrunner is Sophie mckibbon. 468 00:26:11,116 --> 00:26:14,356 Speaker 1: Our theme music is composed by Luis gera special thanks 469 00:26:14,356 --> 00:26:18,036 Speaker 1: to the Pushkin Brass, Malcolm Gladwell, Jacob Weisberg, and Mia Lobel. 470 00:26:18,436 --> 00:26:21,316 Speaker 1: I'm Noah Feldman. I also write a regular column for 471 00:26:21,396 --> 00:26:24,396 Speaker 1: Bloomberg Opinion, which you can find at Bloomberg dot com 472 00:26:24,396 --> 00:26:28,716 Speaker 1: slash Feldman. To discover Bloomberg's original slate of podcasts, go 473 00:26:28,796 --> 00:26:32,476 Speaker 1: to Bloomberg dot com slash Podcasts. You can follow me 474 00:26:32,516 --> 00:26:36,516 Speaker 1: on Twitter at Noah R. Feldman. This is Deep Background.