After almost four years, COVID-19 has become the newest normal in daily life. While many have adjusted to this change accordingly, data shows that thousands currently incarcerated at the 33 adult institutions managed by the California Department of Corrections and Rehabilitation have been disproportionately affected by the pandemic and its effects.

The California Department of Corrections and Rehabilitation (CDCR) is the law enforcement agency in charge of operating California’s prisons and parole systems. As of 2023, the department is responsible for 33 adult correctional institutions, 13 adult community correctional facilities and 8 juvenile facilities, making it the largest state-run prison system in the United States.

The total population has been consistently above the design capacity. NICOLE XU / DAILY NEXUS

When the COVID-19 pandemic was declared in the United States in March of 2020, the CDCR held about 120,000 inmates and employed about 50,000 staff. Due to an effort to mitigate the spread of COVID-19, the institutions prioritized the release of nonviolent offenders with less than 60 days in their sentence. The number of people admitted to prisons decreased as well, resulting in the lowest state imprisonment level in 30 years. The population dropped from about 120,000 inmates to around 96,000 inmates. 

Yet, CDCR institutions today remain overcrowded and at higher risk for infection. Once COVID-19 protections were removed in 2021, most admissions returned to pre-pandemic levels, making overcrowding a pressing issue once again. 

The combined design capacity of all 34 CDCR institutions is 85,330 inmates, but from January to October of 2023, the institutions have had an average capacity rate of 109.5%. The design capacity represents the maximum number of inmates that can be housed with safety, comfort and hygiene in mind, meaning that some concessions had to be made in these areas when the population rose above 100%. 

Within the cells, there are limited opportunities for the social distancing required to minimize transmission of COVID-19. The standard cell size is anywhere from 25-35 feet, however, in most, if not all cells, there is more than one inmate. This leaves little room for each inmate to be at least 6 feet from the others in their cell, not including the other amenities such as furniture. With overcrowding and consequent lack of distancing, inmates are much more susceptible to any disease and infection.

Coupled with the preexisting conditions that many inmates have, as well as the older demographic of the institutions, inmates are at higher risk than the average Californian to contract COVID-19. 

According to California Correctional Health Care Services (CCHCS), more than 10,000 inmates were treated for hepatitis C in 2018. Approximately 8,000 of California’s inmates are diabetic, 12% of male and 20% of female inmates were asthmatic in 2010 and in 2015, 0.8% of California’s inmates were HIV positive. These rates are almost double that of the general Californian population. These chronic illnesses especially raise the risk of COVID-19 infection because they target or weaken the respiratory and immune systems. 

In order to combat this issue, the CDCR has set a number of guidelines: each facility’s housing units are either categorized into outbreak or open phase. In the open phase, the facility is allowed to function as normal while still observing COVID-19 precautions. The goal is to move from the outbreak to the open phase, or to maintain the open phase. 

According to the CDCR guidelines, in order to move to the open phase, the unit must have no new incarcerated persons outbreak cases in 14 days. If a housing unit experiences an outbreak, they then revert back to the outbreak phase. Under these guidelines, an outbreak is defined as three or more epidemiologically-linked cases of COVID-19 among incarcerated persons in a period of 14 days. Currently, in the overall CDCR population, there are 14 housing units that are in the outbreak phase and 840 that are in the open phase.

Note the logarithmic scale of the # of inmates tested. NICOLE XU / DAILY NEXUS

At the height of the pandemic, the CDCR and CCHCS had stricter guidelines in place. However, with the continuous drop in COVID-19 cases in all institutions in recent years and the high vaccination rates among the population throughout the state’s prisons, the reopening guidelines have been updated and loosened, according to the CDCR’s COVID-19 timeline. Routine surveillance and exposure testing have become voluntary, but all of the institutions continue to test inmates daily, with some prisons testing their entire population in one day. 

Despite significant progress having been made in reducing inmate populations as well as implementing health guidelines, institutionalized individuals remain at higher risk for infectious diseases compared to the rest of the population. Unfortunately, the inherent nature of correctional facilities has proven it difficult to mitigate these issues completely. Problems like this have existed prior to COVID-19, and will likely persist for years to come. Nevertheless, moving forward, the CDCR’s experience with the COVID-19 pandemic may serve as a valuable lesson in using policy to address public health emergencies at correctional institutions around the world.

A version of this article appeared on p. 9 of the Jan 18, 2024 print edition of the Daily Nexus.