Lack of COVID-19 testing in California jails sets up ‘perfect storm’ for outbreak, experts warn

Just 4 percent of inmates in California’s largest jails are known to have been tested for COVID-19, despite a drumbeat of warnings about the potential for outbreaks in facilities where people are confined in tight spaces, a Sacramento Bee review has found.

Roughly 1,600 tests for the new coronavirus have been administered in jails located in the 15 California counties experiencing the highest number of infections, according to county-reported data and responses from sheriffs offices and local health departments contacted this week by The Bee. More than one-third of those tests — 667 — have come back positive.

It’s unclear how representative that one-third positive test rate is for the whole California jail population, though. That’s because information about testing in jails is scattershot, with some counties choosing to publish daily updates and others providing little or nothing at all. California’s jail oversight group, the Board of State and Community Corrections, doesn’t collect or share information about how the new coronavirus is spreading.

Experts say the combination of lagging testing and reporting gaps is masking cases of the disease, which could quickly spiral inside jail walls and out as inmates are released back into the community and jail employees come and go daily.

“There’s never been a greater need for oversight,” said Michele Deitch, a jails and prisons expert who teaches at the University of Texas at Austin’s School of Law and Lyndon B. Johnson School of Public Affairs. “We have to find other ways to enhance transparency about what’s going on behind the walls, and one of the best ways to do that is through data.

“That’s good government 101.”

The Bee reviewed data for the 15 counties with the highest COVID-19 case counts, based on reporting by the California Department of Public Health. Facilities in those counties account for 80 percent of all California’s roughly 51,000 county jail inmates.

Sheriffs say they have released more than 4,500 county jail inmates because of the coronavirus emergency, according to state data, in an effort to stem the spread and provide more room in jails for social distancing.

Los Angeles County, which has seen the highest concentration of COVID-19 cases in the state, also accounts for the vast majority of people who have been tested. About 500 inmates in the 12,000-person jail have been tested, with 248 coming back positive, the county sheriff’s office reported in its daily COVID-19 tracking update.

The public health department in Riverside County, where at least two people in custody have died after contracting the disease, reported online that 157 inmates had tested positive.

But that county does not report how many tests were negative or how many people in total received a test. The health department deferred to the sheriff’s office for specific testing information. A sheriff’s spokeswoman said they “do not currently give out how many inmates have been tested.”

“We have a sort of perfect storm here,” said Aaron Littman, a clinical teaching fellow at UCLA School of Law who is studying the new coronavirus’s spread in jails and prisons. “The hardest-hit places are also the hardest to learn about.”

“Even with additional free soap and masks and quarantining procedures, it’s effectively impossible to control COVID-19 outbreaks in densely populated congregate living facilities,” Littman added.

Lack of data about jail infections

County sheriffs who run the jails, and public health departments that collect testing information, rarely publish comprehensive results. The hodgepodge of available data varies across county lines, making it all-but-impossible to have a comprehensive picture of the scope of ongoing outbreaks.

That, in turn, means the public won’t know if counties and the state are focusing enough attention and money on slowing the spread inside the jails and beyond.

The Sacramento County Sheriff’s Office does not publish COVID-19 testing information at all. After a nearly weeklong delay responding to an email from The Bee, a spokeswoman said the county had tested 226 inmates. It reported no positive cases among the 2,400 inmates until Thursday, when officials said a female inmate in the county’s Mail Jail had tested positive. The inmate was put in isolation and later released.

Fresno County likewise does not publish the information but said it had one positive case after performing 20 tests — enough for less than 1 percent of the jail population.

Kern County’s public health department spokeswoman said they would not release the information about COVID-19 tests in jail because it was “not permitted” because of “privacy rules.” A sheriff’s spokesman did not know the status of testing inside the facilities, which hold about 1,500 people.

“The consistency,” Littman said, “is in the lack of transparency.”

Jails and prisons in the U.S. have repeatedly become hotspots for COVID-19 outbreaks, accounting for several of the largest outbreaks in the country.

There have been at least 32,000 infections and 332 deaths in the country’s state and federal prisons, according to data from The New York Times. While the deadliest outbreaks have been in nursing homes, six of the 10 largest outbreaks of positive cases are in prisons or jails.

Researchers with the U.S. Centers for Disease Control and Prevention said in a report this week there were COVID-19 cases among inmates and staff in at least 420 facilities.

That number is likely an undercount, though, because not all health departments responded. Nearly half of the facilities reported cases among staff but not people in custody, suggesting there is not enough testing being done of people in custody.

“Prompt identification of persons with COVID-19 and consistent application of prevention measures within correctional and detention facilities are critical to protecting incarcerated or detained persons, staff members, and the communities to which they return,” the CDC said.

California’s public health department agrees. Last month, it recommended that counties prioritize testing people in congregate settings, including jails and prisons.

“As testing capacity increases, testing should expand accordingly,” the state said.

Constant churn in and out of jails

Limited testing has plagued other congregate care settings for months. Nursing homes and assisted-living facilities have experienced more than 40 percent of the deaths in California from COVID-19, but many facilities still have limited access to tests.

Local jails pose a particular risk because of the constant churn of people being booked and released from custody. Many have existing health conditions that could leave them especially susceptible to illness, and others might not show symptoms at all but could still transmit the new coronavirus.

County jails have changed their intake procedures. Employees in many jails take new inmates’ temperatures and ask a list of health and exposure-related questions before booking them. San Francisco tests newly-arrested people for COVID-19 before they enter the jail intake and release center. A spokeswoman would not say how many people in total had been tested at the jail and instead said a reporter would need to file a formal Public Records Act request with the county.

County jails nationally that conduct robust in-custody testing are finding widespread infection.

In Houston, the Harris County Jail reported testing more than 1,100 people. More than half came back positive. Hundreds of additional tests are being conducted at the jail in Bexar County, Texas, where about 300 inmates have tested positive — including about 75 percent that show no symptoms and likely fueled the rapid spread.

The Texas Commission on Jail Standards publishes updates about the number of county inmates, as well as jail staff, who test positive for COVID-19. California’s equivalent body, the Board of State and Community Corrections, said last month it did not plan to collect that information.

A high proportion of infected people not becoming seriously ill is no doubt a good thing, said Deitch, the jails expert. But if mass testing in jails reveals higher rates of infection, that means the virus could quickly spread beyond the jail.

“We’ve got to be very careful about drawing an imaginary line between what happens in custody settings and what happens in the community,” Deitch said. “If we can’t get the outbreaks under control in the jails and the prisons, we’re not going to stop the spread.”