Speaker 1: From Pushkin Industries. This is Deep Background, the show where
Speaker 1: we explore the stories behind the stories in the news.
Speaker 1: I'm Noah Feldman. We're all in the process of doing
Speaker 1: our best to social distance to stop the spread of coronavirus.
Speaker 1: And for most of us, and probably it should be
Speaker 1: for all of us, that basically means self imposed isolation
Speaker 1: of a certain degree. But there are many people in
Speaker 1: the United States whose isolation is involuntary, and that is
Speaker 1: people who are incarcerated in jails, in prisons, or in
Speaker 1: immigration detention centers run by ICE. Prisoners have already tested
Speaker 1: positive for coronavirus in New York, in Georgia and other
Speaker 1: states as well. That's going to continue, and officials are
Speaker 1: scrambling to figure out how to stop the spread inside
Speaker 1: of institutions, prisons, in jails. To discuss this situation, I
Speaker 1: spoke to doctor Homer Vendors. Until recently he was the
Speaker 1: chief medical officer of the New York City Correctional Health Services.
Speaker 1: Now he's president of an organization called Community Oriented Correctional
Speaker 1: Health Services, which is a nonprofit that builds partnerships between
Speaker 1: jails and community healthcare providers. He has a new book
Speaker 1: called Life and death in Rikers Island, which is precisely
Speaker 1: about the health risks of incarceration. And he was involved
Speaker 1: in two thousand and nine in New York City's efforts
Speaker 1: to deal with the H one N one virus when
Speaker 1: it was spreading inside of Riker's Island. In short, doctor
Speaker 1: Vners is really the perfect person to speak to about
Speaker 1: this problem. We spoke on Monday morning, Homer. As of
Speaker 1: this morning, New York City Corrections, where you used to
Speaker 1: be the director of health for the entire system, is
Speaker 1: reporting thirty eight cases of corona among either inmates or
Speaker 1: prison staff. For jail staff, How worried should we be
Speaker 1: about that number? I think that that number should cause alarm.
Speaker 1: That should make us think about not just what's happening
Speaker 1: to people who are detained in the New York City
Speaker 1: jails and the people who work there, but every single
Speaker 1: one of the five thousand jails and prisons and ice
Speaker 1: detention centers across the country. I think this is a
Speaker 1: very small foreshadowing of things to come and implications for
Speaker 1: the survival. The welfare of the people who are in
Speaker 1: these places, who work in these places, is really in peril.
Speaker 1: And this is just the first of what I fear
Speaker 1: will be many many more headlines and reports like this
Speaker 1: around the country, many of the places, by the way,
Speaker 1: that have far fewer health resources, far less access from
Speaker 1: the press from outside eyes. So I think this is
Speaker 1: the beginning of what we've been worrying about is going
Speaker 1: to be a significant feature of this outbreak. A lot
Speaker 1: of us have a visual image of what it's actually
Speaker 1: like inside a jail or a prison only from television,
Speaker 1: and in fact, mostly from fictional television. Would you explain
Speaker 1: a little bit to us about how conditions, for example,
Speaker 1: in a big city jail like Rikers, are especially conducive
Speaker 1: to the transmission of infectious disease. Yeah. I think that
Speaker 1: there are some features of jails that we might generally
Speaker 1: understand that really contribute to the transmission of communicable diseases.
Speaker 1: So the fact that there are lots of people in
Speaker 1: very small spaces, and those people are jammed into housing
Speaker 1: areas that whether they're a dorm or comprised of cells,
Speaker 1: it's still lots of people in a small space, sharing
Speaker 1: congregate bathrooms and sinks. People to go from one part
Speaker 1: of the jail to the other have to go through
Speaker 1: hallways and go through these things called sally ports or
Speaker 1: control hubs, where they're all jammed in and you have
Speaker 1: a gate that closes behind you before a gate can
Speaker 1: open in front of you. There's intake areas where people
Speaker 1: come in, especially in county jails that have such a
Speaker 1: high churn. You know, half the people are gone by
Speaker 1: day ten or fifteen, so they're constantly filling up with
Speaker 1: newly arrested and detained people. Those folks are coming in
Speaker 1: through these intake pens that are very teeming with people,
Speaker 1: just scores of people in small spaces, nowhere to sit,
Speaker 1: laying on the floor, and that's all the physical plant.
Speaker 1: Then if you add in the fact that most of
Speaker 1: these places are filthy, they have incredibly bad sanitation. You
Speaker 1: have garbage, food trays, other types of trash built up
Speaker 1: all over the place. They really promote the spread of
Speaker 1: communicable diseases during normal times and during outbreak response. The
Speaker 1: way that they're built and designed and run promotes the
Speaker 1: spread of disease. One reaction that I had when first
Speaker 1: thinking about incarcerated population is that the lockdown, which is
Speaker 1: sometimes the word that we use colloquially to describe what's
Speaker 1: happening to everybody else. I mean, I know that Governor Quoma,
Speaker 1: New York wants to call it a pause. In California,
Speaker 1: they call it a stay in place where, or another
Speaker 1: sub called a shelter in place. But lockdown is still
Speaker 1: the vernacular phrase that comes from prison. I mean, that's
Speaker 1: a prison metaphor, and that might create the impression in
Speaker 1: somebody's mind. I think it did it. At my first
Speaker 1: uneducated thought before I started reading what you were writing
Speaker 1: about this that actually prisons might be manageable because you
Speaker 1: actually do have the capacity to control the movement of prisoners.
Speaker 1: But on closer examination of what you've been saying, that
Speaker 1: seems completely misguided. And I wonder if you would just
Speaker 1: say a word about that, because I think I might
Speaker 1: not be the only person who has that instinct. Yeah,
Speaker 1: I think that you know, prisons and jails are built
Speaker 1: for punishment and security control of people of humans. I
Speaker 1: think that we all have this desire to stop the
Speaker 1: movement of this virus through our society, and there's a
Speaker 1: lot of really important measures that we're all engaged in
Speaker 1: to try and do that. The problem in prisons and
Speaker 1: jails and in correctional spaces is that lockdown generally means
Speaker 1: putting people into locked cells. Often sometimes dorms, but often
Speaker 1: we use it. It's used of cells, locking people into
Speaker 1: cells and then keeping them there and then only bringing
Speaker 1: them out for certain circumstances. And the idea is that
Speaker 1: the problem will stay in the cell and so in
Speaker 1: this circumstance, and what I would say is inappropriate use
Speaker 1: of lockdowns as the primary response to coronavirus. The notion
Speaker 1: would be that if you lock everybody into cells, then
Speaker 1: the virus either won't get in or if it's in
Speaker 1: the cell, it won't get out and it won't move
Speaker 1: around the facility. That is erroneous for a number of reasons.
Speaker 1: First of all, people who are locked down are being punished.
Speaker 1: Whatever you say is the reason for it. When you
Speaker 1: go get locked into a cell, when you're going into solitary,
Speaker 1: it causes a lot of stress. People don't like it.
Speaker 1: It is associated with suicide and self harm, and so
Speaker 1: people don't want to go into those cells. Then to
Speaker 1: institute a lockdown that means that you'll, all a sudden,
Speaker 1: are going to ask your correctional staff to put their
Speaker 1: hands on a lot of people, to have a lot
Speaker 1: more physical contact with people. Sometimes us as a force
Speaker 1: that get them into these cells, and then every time
Speaker 1: they come out of those cells for a shower, if
Speaker 1: they come out to go to the medical unit, if
Speaker 1: they come out for any other reason, you're often then
Speaker 1: in this position of having to have two escort officers
Speaker 1: handcuff them, escort them physically. All of that is just
Speaker 1: really escalating the amount of physical contact between humans in
Speaker 1: these facilities. The other real core problem with this is
Speaker 1: that when people get sick, and we know they're getting sick,
Speaker 1: when they're locked in a cell, you don't see that.
Speaker 1: Correctional officers coming by every fifteen minutes or thirty minutes
Speaker 1: to peek through a dimly illuminated vision panel or window
Speaker 1: in a cell door is not the way that you
Speaker 1: keep an eye on people that you're worried about getting
Speaker 1: sick or dying. So the lockdown as a public health
Speaker 1: response is not appropriate as the primary measure, and in
Speaker 1: many ways it can actually increase the flow of the
Speaker 1: virus into and out of a facility. Obviously, the most
Speaker 1: immediate ethical worry that I think we all need to
Speaker 1: have with respect to incarcerated people is that it shouldn't
Speaker 1: be the case that if someone is being locked up.
Speaker 1: They're being essentially put in a situation like being put
Speaker 1: on a cruise ship, but involuntarily and with much worse conditions,
Speaker 1: which is likely to significantly increase their chance of getting
Speaker 1: sick and dying. But I assume there's also a concern
Speaker 1: for the general public associated with enabling a coronavirus to
Speaker 1: spread rapidly within jails and prisons, partly because corrections officers
Speaker 1: are coming and going and so it will spread into
Speaker 1: the general population. Partly because of resource allocation issues, because
Speaker 1: if you get a big outbreak, a lot of resources
Speaker 1: are inevitably going to be called on, even if they
Speaker 1: were not distributed in a fair way. What do you
Speaker 1: see as the main concern for the general public here?
Speaker 1: I mean putting aside the very pressing ethical concern that
Speaker 1: we shouldn't be arresting people from minor offenses and then
Speaker 1: putting them into place where they have a better chance
Speaker 1: of catching a disease and dying. Yeah, I think the
Speaker 1: simplest way I could put it is that correctional settings, prisons, jails,
Speaker 1: and ice decession centers are going to drive this piademic
Speaker 1: curve straight up. So we hear about trying to flatten
Speaker 1: that curve about trying to relieve the strain and stress
Speaker 1: on our health system by social distancing and taking all
Speaker 1: these other measures and really extreme important measures that are
Speaker 1: being implemented today. What happens behind bars is going to
Speaker 1: drive that epidemic curve in exactly the opposite direction of
Speaker 1: what we're working towards, and so they will quickly become reservoirs.
Speaker 1: And they probably are already, but certainly as we make
Speaker 1: gains in the rest of the community, these places will
Speaker 1: become critical reservoirs for infection. They're going to continue to
Speaker 1: cycle infection out of these places in and out as
Speaker 1: staff go in and out, and to some extent the
Speaker 1: people who are held there. But you know, there's many
Speaker 1: more people coming and going every day who are staff
Speaker 1: members than there are arriving as newly arrived people in
Speaker 1: a prisoner jail. So these places, as reservoirs of infection,
Speaker 1: as congregate settings where the spread of the infection cannot
Speaker 1: really be controlled, stand to dramatically escalate the epidemic curve
Speaker 1: that we're working so hard to bring down. Homer, you
Speaker 1: mentioned crucially that prisons and jails are probably already at
Speaker 1: least in New York City becoming reservoirs of coronavirus. That
Speaker 1: leads us to the really pressing question of what we
Speaker 1: should be doing and how we should be doing it
Speaker 1: with respect to releasing people. And I want to start
Speaker 1: with just asking a question of you when you wear
Speaker 1: your epidemiologist hat. And that is given that we know
Speaker 1: now that there are presumably lots of cases, including asymptomatic cases,
Speaker 1: in jails and prisons, if we open those doors, is
Speaker 1: that going to be adding a new vector of rapid
Speaker 1: spread to the general population. And if so, is that
Speaker 1: nevertheless the right thing to do in terms of the
Speaker 1: overall cost benefit of fighting the disease. Well, I think
Speaker 1: where we're at now is that when coronavirus arrives in
Speaker 1: a community, it's part of the community is the jail
Speaker 1: or prison or is attention center, and it's going to
Speaker 1: arrive there. So places where we likely have a significant
Speaker 1: number of people who are asymptomatic, who are kind of
Speaker 1: brewing early infections. It's no different inside the jail than
Speaker 1: outside the jail. Now, in the coming weeks, we will
Speaker 1: have spread inside those facilities that you may be more
Speaker 1: accelerated than outside. But one of My primary concerns is
Speaker 1: that unlike the community, where we're going to have some
Speaker 1: family or ability some other we have capacity to see
Speaker 1: who's getting sick and who needs hospital level care. We're
Speaker 1: going to miss that behind bars. When H one N
Speaker 1: one hit, everybody who was symptomatic was tested in the
Speaker 1: New York City jails, and so sometimes the press and
Speaker 1: people on the outside would erroneously think that this was
Speaker 1: a riker's outbreak of H one N one. But we
Speaker 1: everybody who was symptomatic was in a housing area, and
Speaker 1: these weren't cells, they were dorms, but they were in
Speaker 1: housing areas where they couldn't move in and out. But
Speaker 1: also we would give them a test and then if
Speaker 1: they were symptoms attic, they'd go to the same place
Speaker 1: that the coronavirus patients are going today, the West Facility
Speaker 1: of Communicable Disease Unit. But people thought, because I think
Speaker 1: it was like two and a half percent of the
Speaker 1: people coming into the who it came into the jails
Speaker 1: during that time tested positive, they thought, boy, this is
Speaker 1: a riker's problem. It wasn't. It's a community problem. We
Speaker 1: just happened to be very aggressive about testing because we
Speaker 1: did not want to miss a single case. I think
Speaker 1: that the way to characterize what's happening behind bars is
Speaker 1: if it's in the community, it's part of the community's
Speaker 1: the jail or prison, and so I don't believe that,
Speaker 1: at least today, there's an epidemiologic reason to say releasing
Speaker 1: people is going to contribute to the infection. And I
Speaker 1: think that right now we've turned a corner in this country,
Speaker 1: which is our primary focus is on preventing death, and
Speaker 1: to do that, we have to get people out of
Speaker 1: these places. We'll be back in just a moment. There
Speaker 1: are voices, including yours, increasingly calling for release of certainly
Speaker 1: people who are jailed awaiting trial, and even of inmates
Speaker 1: who've already been convicted or guilty to crimes. Do you
Speaker 1: have a view about how that should be done, how
Speaker 1: should that be triage. I think that we'll need different
Speaker 1: strategies for county jails, for state and federal prisons, and
Speaker 1: for ice detention centers. Some of these places, like ice detention,
Speaker 1: there's not really nobody is even making a public safety
Speaker 1: argument for why people should be detained, and so you
Speaker 1: could categorically just administratively, it seems to let people out
Speaker 1: county jails have one set of pathways, which involved looking
Speaker 1: at people in the nature of their charges and figuring
Speaker 1: out how they can get people out certainly before there
Speaker 1: so they can just show up to trial. And that's
Speaker 1: and that's different than you know, when I've talked to
Speaker 1: state prison administrators in the last couple of weeks, that's
Speaker 1: a very tough off road. There are people who are
Speaker 1: on the pathway to prison release, and so those pathways
Speaker 1: can be accelerated. There are in most states prison furlough
Speaker 1: processes that can be enacted, But the state prisons I'm
Speaker 1: terribly worried about because you have just huge numbers of people.
Speaker 1: I was talking with somebody from a state prison system
Speaker 1: yesterday where the overall capacity of the state prison is
Speaker 1: at one hundred and seventy five percent of what they
Speaker 1: should have, and so incredibly densely populated places where there's
Speaker 1: really very little prospect of getting people out. And so
Speaker 1: as I think about what we need to do to
Speaker 1: react besides release, part of it is it will contemplate
Speaker 1: strategies that are different for these different types of settings.
Speaker 1: That seems very sensible, but I just you know, there
Speaker 1: is a substantial risk I think that none of that
Speaker 1: could happen fast enough. I mean, so, for example, I
Speaker 1: know some DA's offices around the city, including Brooklyn, have
Speaker 1: called for applications from lawyers for people who are detained
Speaker 1: to say, hey, explain to us why we should go
Speaker 1: to the court and move to have your or agree
Speaker 1: to your emotion to have your client release under these
Speaker 1: conditions and circumstances. I think that's a great response. I
Speaker 1: worry that it can't work at scale. It's not just
Speaker 1: that courts are moving more slowly because of their own
Speaker 1: concerns about Corona's that even under the best of circumstances,
Speaker 1: that's a very individuated way of doing it. And of
Speaker 1: course it seems sensible. Let's make sure, let's weigh, let's
Speaker 1: make a judgment about each person. That's what courts are
Speaker 1: good at. But it's not a crisis response approach. Do
Speaker 1: you think there's a plausible argument to say, for example,
Speaker 1: that all non violent offenders being held in rikers, or
Speaker 1: all non violent offenders over the age of fifty, or
Speaker 1: you know, something of that sort just ought to be
Speaker 1: straight up released. And the reason I ask this is
Speaker 1: not just about getting things right in New York city
Speaker 1: or in the jail slash prison that you know very well.
Speaker 1: It's also that this is going to become a paradigm
Speaker 1: set a presumably for other places in the country, if
Speaker 1: in most likely when we see the same scenario repeated elsewhere. Yeah,
Speaker 1: I think that's an important point that deliberative and piecemeal
Speaker 1: approaches are not always the ones we want to turn
Speaker 1: to in really die our emergencies. I reminded of a
Speaker 1: colleague who once told me that after Katrina in New Orleans,
Speaker 1: what they got was a plan that was developed by
Speaker 1: an Internet And I can say this as an Internet,
Speaker 1: but what they needed was a plan developed by an
Speaker 1: emergency medicine doc. And I don't mean that just for
Speaker 1: the medical part, and so I think that's right. I
Speaker 1: think one of the things I'm calling for in terms
Speaker 1: of what we should do besides release with keeping releases,
Speaker 1: the number one objective is every state must appoint or
Speaker 1: identify a correctional health coordinator who can manage this process,
Speaker 1: and the CDC needs to also, and so does HHS.
Speaker 1: We need state level and federal level people who have
Speaker 1: been identified to coordinate what's happening with the health aspects
Speaker 1: of corrections and to tend spaces around the country because
Speaker 1: we have five thousand of these places. If you sit
Speaker 1: as a commissioner of health or the person who's running
Speaker 1: your state's COVID emergency response, you look across this array
Speaker 1: of places you probably don't even know much about. You
Speaker 1: have county jails in all your counties, mostly, you have
Speaker 1: state prisons, and then you have ice detension centers, some
Speaker 1: of which are run by for profit companies. And so
Speaker 1: we need just like we're taking seriously what's happening in
Speaker 1: long term care facilities, assisted living, in nursing home settings,
Speaker 1: we need to identify one person in every state that's
Speaker 1: going to take on this task because we don't even
Speaker 1: have data today. Nobody could tell you how many patients
Speaker 1: inside county jails, state and federal prisons, and ice detention
Speaker 1: centers have symptoms today, how many are needing a test.
Speaker 1: And one of the critical concerns I have is we
Speaker 1: do not have pathways to hospital level care for most
Speaker 1: of these patients. Most of these patients who get sick,
Speaker 1: the traditional method of getting them into a hospital is
Speaker 1: to send them with two armed correctional officers to go
Speaker 1: to a local hospital. It's a process that for people
Speaker 1: who have seen it, like everybody who works in emergency
Speaker 1: rooms and people who work in corrections know this. It
Speaker 1: takes a ton of resources because you're sending two officers
Speaker 1: who are going to stay with this person twenty four
Speaker 1: to seven. They take up a ton of space in
Speaker 1: an emergency room. Emergency rooms that are incredibly over stretch
Speaker 1: right now in terms of their staffing and their space.
Speaker 1: And so if we get five or ten or fifteen
Speaker 1: people from one facility going to the hospital, there just
Speaker 1: won't be CEOs correctional officers to go with them. They're
Speaker 1: going to have fewer staff because they'll be sick. We
Speaker 1: won't have a magical new resource for them to go
Speaker 1: to to get this care. And my experience in investigating
Speaker 1: deaths all over the country is that these patients are
Speaker 1: patients who are behind bars today, are the ones that
Speaker 1: go to the back of the line when it comes
Speaker 1: to access to hospital level care. And so part of
Speaker 1: the priority has to be we create explicit passways for
Speaker 1: access to hospital level care when we had toify patients
Speaker 1: that need it in the real world. I don't think
Speaker 1: you'll see that happening. I mean, I think it's maybe
Speaker 1: ten or fifteen patients. You could conceive of a system saying, well,
Speaker 1: we're going to send two correctional officers, but at some point,
Speaker 1: either they're going to have to stop doing that and
Speaker 1: shoulder the risk of escape, or alternatively, simply not send
Speaker 1: people who are incarcerated to hospitals. And if that happens,
Speaker 1: what will happen within the jails and the prisons. Well,
Speaker 1: if those are the only two options, then yes, people
Speaker 1: will die preventable death because people will be held in
Speaker 1: correctional facilities where staff will to try and take care
Speaker 1: of them for too long. They'll get well passed their
Speaker 1: level of clinical competence and equipment and infection control capacity.
Speaker 1: Some of the data indicate thirty or forty percent of
Speaker 1: the people who need kind of a middle level of
Speaker 1: inpatient treatment but not yet I see you treatment. About
Speaker 1: thirty or forty percent of them will need a higher
Speaker 1: level of care. Well, if you're trying to manage the
Speaker 1: middle level inpatient folks in your jail or prison or
Speaker 1: detention center, than when they need that higher level of
Speaker 1: care because they deteriorate, you're not rolling them down the
Speaker 1: hall to the ICU. You're going through a two hour
Speaker 1: transfer process, so they're going to die. There is another option.
Speaker 1: We did this after Sandy to set up secure treatment
Speaker 1: units as part of what's going to be the surge
Speaker 1: in capacity at hospital. So hospitals that are currently building
Speaker 1: sometimes tense, sometimes new opening up wings that have been mothballed,
Speaker 1: setting up new space to handle this incoming flux of
Speaker 1: COVID patients. In that the states that are planning this
Speaker 1: with their hospital partners, they need to explicitly detail and
Speaker 1: plan for care for incarcerated patients. And so sometimes what
Speaker 1: you can do is you can as we did after Sandy,
Speaker 1: We've set up a new unit. We had patients go
Speaker 1: to a couple of dedicated places but when Bell was evacuated.
Speaker 1: But one of the things you need is the capacity
Speaker 1: to set up are units. So you're not relying on
Speaker 1: two correctional officers for every patient. But you can figure
Speaker 1: out how to get a better ratio of correctional officers
Speaker 1: to patients in a unit that's somewhat secured, that meets
Speaker 1: the custodial requirements of the securing authorities. And it may
Speaker 1: be that in some states and some regions you actually
Speaker 1: have multiple correctional administrations, like different sheriffs or sheriffs and
Speaker 1: state prisons cooperating to figure out how can they staff
Speaker 1: up and design these units quickly with the hospitals that
Speaker 1: are surging their capacity. Because these units and this response
Speaker 1: has to involve hospital level care by hospital staff, it's
Speaker 1: not going to work if you're keeping patients out in
Speaker 1: these correctional settings. They're just not going to survive. What's
Speaker 1: the sort of best case scenario you can picture. We've
Speaker 1: spent a lot of time in this pandemic situation talking
Speaker 1: about worst case scenarios, and you've made it pretty clear
Speaker 1: that the worst case scenario is significant number of people
Speaker 1: dying unnecessarily and prisons and jails really contributing to the
Speaker 1: rapid rise of the curve. But what's the best case
Speaker 1: scenario that you can realistically foresee if good recommendations are
Speaker 1: followed well. I think that one of the things that
Speaker 1: could happen relatively quickly is that as states in the
Speaker 1: CDC identify correctional health coordinators, they are going to get
Speaker 1: a quick snapshot of where the outbreak is impacting incarcerated
Speaker 1: patients first. And this won't be uniform, just as you know,
Speaker 1: it really reflects what's happening in the community, and so
Speaker 1: for the next few weeks we're going to have hotspots
Speaker 1: where the problems are evolving. We may in a month
Speaker 1: or two have a much more prevalent problem that is
Speaker 1: more generalized, but for the next month or so, we're
Speaker 1: going to have places Rikers being the first that's being reported.
Speaker 1: It's critical for us to appoint these correctional health coordinators
Speaker 1: right now because they need to be the ones that
Speaker 1: are in the room with the governor's staff, with people
Speaker 1: running the overall response, to understand and report to others
Speaker 1: where patients are going to need to be going, and
Speaker 1: how we can build these new units in a way
Speaker 1: that meets the statewide needs. So if you look at
Speaker 1: the footprint of incarceration in every state, one of the
Speaker 1: things that's really terrifying is in a lot of rural
Speaker 1: counties we have large overfilled county jails, we have a
Speaker 1: fair number of prisons, and we have a lot of
Speaker 1: ice dissension centers, all in places where we've lost hospital
Speaker 1: capacity in the last ten or fifteen years. That requires
Speaker 1: a coordination at a state level to understand day to
Speaker 1: day who are the patients that need higher level care
Speaker 1: and where can they go? And I think that that
Speaker 1: kind of it's not just epidemiology. A lot of this
Speaker 1: is also supply chain. How can we get people connected
Speaker 1: to the things they need. That's happening in every pretty
Speaker 1: much every other aspect of society right now. So these
Speaker 1: are not principles or tasks that are foreign to the
Speaker 1: rest of the nation. It's just that these patients and
Speaker 1: their welfare haven't traditionally been incorporated, but they must be
Speaker 1: incorporated now this week to this response if we want
Speaker 1: to save their lives and also help really bring down
Speaker 1: that curve. Homer, I want to thank you not only
Speaker 1: for the important work you're doing in this crisis, but
Speaker 1: for the work that you do all the time to
Speaker 1: try to improve conditions for public health inside of prisons
Speaker 1: and to build partnerships between jails and community healthcare providers.
Speaker 1: That's important even when we're not under conditions of the pandemic,
Speaker 1: and what you're doing now is also obviously great pressing significance.
Speaker 1: Thank you very much for your time. Thank you very much,
Speaker 1: have a good day. Speaking to home reveners makes it
Speaker 1: extremely clear that the problem of coronavirus that we're struggling
Speaker 1: with across the country now is especially acute and worrisome
Speaker 1: when it comes to people who are incarcerated. It's not
Speaker 1: only an ethical issue, it's also a public health issue
Speaker 1: of the most pressing type. He's calling for the appointment
Speaker 1: of coordinators in every state to deal with the problem.
Speaker 1: That seems like a no brainer and should certainly be adopted.
Speaker 1: It's my instinct, however, that we may need to go
Speaker 1: further than that, and I hope that governors across the
Speaker 1: country and prosecutor's offices as well, will look seriously at
Speaker 1: engaging in more systematic analysis of who could safely be released,
Speaker 1: both in order to protect them and to protect the
Speaker 1: general public against the risk of many, many acute cases
Speaker 1: of coronavirus arising among people who are locked up. Almost
Speaker 1: every university that I know of has sent home students
Speaker 1: from its dorms, and prisons in the end bear such
Speaker 1: a close resemblance to dormitory living that the probability of
Speaker 1: spread seems very, very great within them. That's a radical measure,
Speaker 1: but this is an emergency, and an emergency radical measures
Speaker 1: at least need to be considered seriously and evaluated in
Speaker 1: determining whether we should adopt them or not. Deep Background
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