The Pandemic Behind Bars

Colorado’s vaccine distribution plan does not prioritize people who are incarcerated or detained. But new analysis from the Colorado Health Institute (CHI) shows that COVID-19 has spread through Colorado’s prisons, jails, and other correctional and detention facilities at an alarming rate.

Outbreaks at prisons, jails, and other correctional and detention facilities account for 1 in every 24 cases of COVID-19 in Colorado since the start of the pandemic, and 15 of the 20 largest outbreaks in the state have occurred in prisons and jails.

Please note that CHI’s analysis is based in large part on COVID-19 outbreak data published by the Colorado Department of Public Health and Environment (CDPHE) on January 20, 2021, and COVID-19 case data published by the Federal Bureau of Prisons on January 22, 2021. Unless otherwise noted, it does not include additional data on COVID-19 cases collected by other entities, nor does it capture changes in case numbers since the dates noted above. More information on sources is available at the end of this report.

Colorado’s Vaccine Distribution Plan

In accordance with federal guidance, Colorado’s vaccine distribution plan begins with health care workers who work closely with COVID-19 patients, as well as staff and residents of long-term care facilities such as nursing homes and assisted living facilities, where the spread of the virus has been particularly devastating. Next, in what the state calls “Phase 1B,” are Coloradans 70 and older, other health care workers, and first responders, followed by frontline essential workers, essential government officials, and frontline journalists. Phase 2 includes people ages 60-69, people with medical conditions that put them at higher risk, other essential workers and government officials, and adults who received a placebo during a COVID-19 vaccine clinical trial. Last, in Phase 3, is the general public — people over 16 not identified in any of the earlier priority groups.

But the state’s vaccine distribution plan has not always looked this way.

A previous version of the plan, shared by the state in October, included a priority population no longer mentioned in the current plan: people who are incarcerated.

Previously, people in “congregate housing,” including incarcerated people, were placed at the beginning of Phase 2, after Colorado’s “critical workforce” and residents of long-term care facilities, but ahead of older adults, people with medical conditions, and the general public.

But after a guest editorial in The Denver Post blasted Gov. Jared Polis for prioritizing incarcerated people over older adults, the governor pivoted. At a press conference two days later, in early December, a reporter asked Polis about the prioritization of incarcerated people, referencing the editorial specifically. Polis replied, “There’s no way [the vaccine is] going to go to prisoners before it goes to the people who haven’t committed any crime,” adding that the proposed distribution plan would be amended. His office later clarified that “inmate status will not make a difference in terms of timing of receipt of the vaccine,” and that inmates who fell into a priority group, such as people over 70 or people with a high-risk medical condition, would be eligible to receive the vaccine at the same time as others in that category.

Colorado’s vaccine distribution plan has since been adjusted. Under the revised plan, people who work in correctional facilities are slated to receive their vaccines as part of Phase 1B, just as they were before. Any mention of the people held in those correctional facilities, however, has disappeared from the list altogether.

The Spread of COVID-19 in Colorado’s Correctional and Detention Systems

The spread of COVID-19 through Colorado’s correctional and detention facilities has been both profound and far-reaching, according to COVID-19 outbreak data published by the Colorado Department of Public Health and Environment (CDPHE) (supplemented here by data from the Federal Bureau of Prisons).

Since the start of the pandemic, over 16,000 cases have been reported at Colorado prisons, jails, or other correctional and detention facilities.

For comparison, that’s about 6,000 fewer cases than have been reported at long-term care facilities for older adults (22,620). It’s also more than the number of cases reported in other health care settings (2,345); child care centers, schools, colleges, and universities (9,369); and office spaces (1,632) combined. (See figure below.)

Vaccination plans have prioritized older adults and people with underlying health conditions because they are more vulnerable to severe illness, and mortality rates in long-term care facilities and other health care settings are extraordinarily high — higher than in prisons and jails. But national studies indicate that mortality rates among incarcerated people are significantly higher than those of the general public. And regardless of the circumstances leading up to one’s incarceration or detention, exposure to a life-threatening illness (with the potential for long-term health effects) is not part of their prison sentence or terms of detention.

This is a national problem. The Marshall Project estimates that one in five people incarcerated in state and federal prisons in the United States has tested positive — a rate four times higher than the general population.

According to the Centers for Disease Control and Prevention (CDC), outbreaks in settings such as prisons and jails are uniquely difficult to control due to “the inability to physically distance, limited space for isolation or quarantine, and limited testing and personal protective equipment resources.”  

The CDC also notes that people in correctional and detention facilities “may also be older or have high-risk medical conditions that place them at higher risk of experiencing severe COVID-19.” According to the Colorado Department of Corrections, 30% of people incarcerated in Colorado state prisons have “medical needs,” 35% have “mental health needs,” and 7% are over 60.

COVID-19 in correctional and detention facilities also presents a threat to the general public. Correctional staff, attorneys, and medical providers who work in these settings not only risk carrying the virus into their place of work, they also risk bringing the virus home to their families and the greater community. Additionally, inmates and detainees have limited ability to quarantine before release, which can further contribute to the transmission of COVID-19 into the surrounding community. Jail and prison walls are permeable — hundreds of people are released from Colorado jails and prisons every day. As a result, outbreaks inside these facilities contribute to outbreaks in the greater community — and vice versa.

Given these challenges, the CDC recommends vaccinating incarcerated and detained people at the same time as correctional staff.

Of the 16,177 cases reported at Colorado correctional and detention facilities, 2,330 have been among staff and 13,827 have been among people who are incarcerated, detained, or otherwise residing in correctional settings.

In total, there have been 32 recorded deaths. Of the 32 people who died, 31 were considered “residents” of a correctional or detention facility.

COVID-19 has spread to nearly every corner of the state’s detention and corrections apparatus, including state prisons, federal prisons, the U.S. Immigration and Customs Enforcement (ICE) detention facility in Aurora, and city and county jails.

The extent of the spread in each of these settings is described in further detail below.

State and Federal Prisons

There are 21 state prisons in Colorado (19 state-run prisons and two private prisons). As of this month, 20 of the 21 state prisons have reported outbreaks. The only prison that has not reported any cases of COVID-19 is the smallest in the state — Colorado Correctional Center in Golden houses 81 inmates.

Colorado is also home to two federal prison complexes, one in Englewood and one in Florence. They collectively span four federal prison facilities — all four of which have reported outbreaks.

In total, there have been 9,418 reported cases of COVID-19 among people in Colorado’s state and federal prisons. As of this writing, there are 16,902 people held in state and federal prisons in Colorado. It’s difficult to say exactly how many people who are currently incarcerated have contracted COVID-19, since the prison population changes as people are admitted and released. But it’s safe to say that for every 1,000 prisoners in Colorado, 557 incarcerated people have been reported as COVID-positive.