Judge Tigar in Plata: Pleas to Governor to Release on Large Scale “Have Fallen on Deaf Ears”

Today, Judge Tigar held a two-hour case management conference in Plata v. Newsom to discuss the latest developments as described in the joint case management statement. On the agenda were specific issues such as vaccination plan and staff compliance, but in the background loomed the basic problem: the solution to this catastrophe is a mass release but none is forthcoming.

The conference opened with CCHCS Receiver Clark Kelso offering an overview of the vaccination progress and plans. So far, in skilled nursing facilities, they have vaccinated 2300 incarcerated people. In combination with people who recently had COVID, they are approaching 80 percent coverage in these institutions. The good news are that the refusal rate is very low–between 8 and 10 percent–especially compared to previous vaccination campaigns such as flu vaccines. In response to Judge Tigar’s question, Mr. Kelson explained that they will have a full documentation of the refusals.

Judge Tigar’s next questions were an effort to find out how far CDCR/CCHCS were from vaccinating the entire COVID-naive population behind bars, assuming that appropriate vaccine dosage would be available. Kelso explained that the next step is to offer the vaccine to everyone aged 65 and up (2000 people, if you exclude people who have been infected.) After that, the next priority would be people who have not been infected with COVID and have risk scores of 3 and above (CCHCS uses a scale based on CDC risk assessment, where they assign points to preexisting conditions.) Kelso estimated that this group–approximately 5200 people–could be vaccinated in about 7 days. The next scenario would be to tackle 42,000 people–the remaining people in CDCR custody who have not been infected–which would realistically take about 4 weeks. The severe nursing shortage was mentioned, of course.

The problem, as I explained in a previous post, is not buy-in from incarcerated people but from staff. Kelso explained that, so far, they have vaccinated 19,351 staff members, out of which 110 have received the second dose. In the three skilled nursing facilities, staff buy-in is 95% and full vaccination will be completed in a few days. The percentage of compliance among the staff is declining, and even though no one at the hearing provided a breakdown, it was widely assumed (probably with good reason) that the problem is with custody staff rather than with health care professionals.

At that point, Judge Tigar talked about the elephant in the room: the institutional unwillingness to take the obvious best step, which would be releases. “I have sometimes become emotional when discussing this,” he said, referencing the previous hearing, in which he mentioned people who died by name and showed their pictures. He said that he “cajoled and begged the governor to release significant numbers beyond the current numbers so we can avoid unnecessary sickness and death. So far these requests have, again, with all appreciation for the efforts that have been made, fallen on deaf ears. The consequence is now becoming more apparent. COVID has spread more easily than it had to, and we’ll never know for sure, but there is unknown number of people who got sick and died who didn’t have to.” Judge Tigar highlighted the importance of granting people the good time credits they are unable to earn because of the lockdowns, saying that “we’re overincarcerating and doing worse precisely when we were supposed to do later.” He also pointed out that he “[could not] overemphasize the need to release elderly infirm people. There is an alarming increase in deaths” (56 since the previous case management conference) and “we must ensure it does not continue. I take this case personally. I asked CDCR to send me the records of all the inmates from CMF and CHCF who died from COVID since the last CMC. The vast majority were elderly.” Judge Tigar was visibly emotional when describing incarcerated people who have to use commode chairs when going to the bathroom–and “when the virus came, they were defenseless, and they died.”

Judge Tigar then pressed CDCR counsel Paul Mello on whether the “primary reason” for the alarming infection rates was people’s refusal to move to safer housing. Mello replied that “in some instances people aren’t moved quickly enough but [refusal] appears to be the primary reason.” Judge Tigar urged to increase education, so that people “may appreciate the efforts being made to protect them.” This, again, led to the discussion of the thorny problem of the staff: refusals to wear masks and get tested. Judge Tigar probed as to what the reasons might be, getting very little input from the parties (here on the blog, I’ve looked into the twisted priorities of CCPOA, as well as at the possibility that the rank-and-file, like the rank-and-file of other law enforcement orgs, is a hotbed of Trumpist COVID denialism. I have searched high and low for surveys of correctional officers’ political opinions and found none.)

Even in the face of all this, Judge Tigar insisted that he is not yet at the point at which the PLRA enables him to release people pursuant to a finding of “deliberate indifference.” “if I could let people out I would do it today,” he said, but ” my view of the law is that I’m not allowed to do that.” The plaintiffs, of course, disagree, but Tigar seems very convinced that, legally speaking, his hands are tied, which he says is a “source of incredible frustration” to him. While he is not ruling out a future finding of deliberate indifference, he says, “we’re not there yet.”

While listening to the hearing, I was trying to ponder what was behind this sense Judge Tigar had that his hands are tied. Partly, it seems to stem from his reading of the PLRA, and partly from what seems to be his judicial psychology of this case, according to which “litigation is a very bad way to resolve this… communication is the right way.” A case in point was his effort to get to the bottom of the staff noncompliance. Tigar made an effort to get everyone on board: “Everyone doesn’t like low staff testing rates. We need to get them as high as possible. Why are they where they are to begin with?”

At this point, he turned to the CCPOA representatives, the union lawyer David Sanders and labor attorney Gregg Adam, in an effort to get the union’s collaboration at “[a] moment when CCPOA can become an invaluable partner if they want to, to keep their brothers and sisters safe.” This opportune moment, in my opinion, was ten months ago, but okay. Judge Tigar hammered home the need to get complete buy-in from the leadership: “If the captain says you have to wear a mask, then you have to wear a mask, no exceptions. If that becomes policy, that is how this is going to work.” The back-and-forth between the judge and union counsel offered another insight into Judge Tigar’s cooperative psychology: he told them that the benefit would be that compliance orders from above “create[s] an environment where you can publicly take the position that you don’t like masks but I wear one because I have to, because I don’t have a choice. If leadership is uniform, it creates a position where it is much easier for staff to be uniform. Consistent, off the job too. I’ve been hoping that CDCR/CCHCS would create videos for staff using staff. I asked and asked and asked more than you will ever know. Then I gave up. Then they did it and they’re great, I just saw them yesterday. Your staff will see them. And they make this point. You can’t be in the car with your friends driving to work or going to someone’s backyard thinking, I know these guys. COVID doesn’t care who your friends are. Need to wear is the same, on and off. On that level. [high command gives] order to do on job, expect[s] [compliance] off job, do it myself.”

One of Judge Tigar’s ideas was to solicit a volunteer in each prison who is “down with the goal” to report to a member of Kelso’s staff who “comes from custody and speaks the language.” He also seemed to set a lot of store by Prof. Amy Lerman of the Goldman School, regarding correctional culture and fostering compliance (this is good news, because insights into correctional culture is what we need.) Happily, Adam, one of the CCPOA representatives, also seemed to have respect for Lerman and also mentioned that they were planning to speak to Prof. Elizabeth Linos (whom Tigar referred to as the “persuasion guru” about compliance strategy. At that point, CCPOA counsel Sanders offered what seemed to me a very partial and revisionist history of CCPOA’s involvement in this issue, presenting CCPOA as the great champions of the original Plata release order, both because of the safety of their own employees and because they apparently thought that it was “morally and professionally wrong, what happened in our prisons – warehousing human beings and literally seeing them die because of conditions.” None of this explains why CCPOA, in the same breath, invested 4 million dollars in punitive propositions just in the last elections, while their own members were dying of COVID, or why they are suddenly in a rush to jaunt to Vegas amidst all this, but okay. Another thing we learned from Sanders is that Tigar’s exhortation to model good conduct would likely go nowhere because “we don’t represent captains” and because “sergeants and lieutenants don’t have collective bargaining power.”

At this point, when the conversation turned to isolation and quarantine, the hearing again touched on the heart of the matter. In the previous status conference, the plaintiffs asked that CDCR comply with the Receiver’s directives, but as infections and deaths soared, they changed tacks and asked that CDCR procure vaccinations for everyone. Mello’s reaction to this request was to resort to legalese: not only did they get the request too late, he said, “we think an order will be unnecessary and will constitute undue intrusion on authority.” There are also practical hurdles, he explained, and CDCR was not out of line by addressing this within the confines of current CDC health directives. Getting back to the PLRA hurdle, Mello opined that the plaintiffs face an uphill battle showing deliberate indifference with expert testimony.

While Tigar did not lose his temper–and seemingly agreed with Mello about the legal point–he clearly found the resort to legalese somewhat tasteless. “I think about this in a simplistic way,” he said, “I heard Mr. Kelso say that he needs 40,000 doses to get the job done. Two and a half million doses have already rolled in to the state. 40,000 is couch cushion money. Do we think that the governor can shake 40,000 doses loose? We can litigate this, and by the time the litigation will be resolved, this will be a dead issue. There are things I can do to expedite matters, but I have a much simpler question. Do we think the governor could shake loose whatever the number is, 40,000 doses to protect the population that he has already recognized is defenseless, deeply in need of this vaccination, and because of the role of prison [in the larger infection story] greatly affect public health in a positive way? Do you think he would shake them loose if I asked him to?”

Sara Norman of the Prison Law Office responded with a moral call to action. “This is not litigation about vaccination,” she explained, “it’s about quarantine, hundreds of thousands quarantined with shared air, which has resulted in significant illness and death.” The solution, she said, “has been obvious”; releasing people “is their choice and they have continued to place our clieets, their patients, at significant risk of harm. . . We are now saying there’s another solution.” Vaccination of incarcerated people–mandated by virtue of their classification as 1.B.2. in the priority list–is “within [CDCR’s] reach, they can do it.” Norman ended by quoting Yoda: “Do or do not, there is no try. It is up to them to do it.”

I’m left with a lot of questions. First, when will someone tackle the elephant in the room–Trumpist COVID denialism among the staff? Second, is “shaking loose” 40,000 doses a mere issue of friendly persuasion of the Governor? Most importantly, if all the horrors of the last ten months have not persuaded Judge Tigar that the PLRA’s deliberate indifference standard has been met, what is it going to take?

Friends Want Friends Safe: A Special Message from Rasheed Lockheart

Rasheed Lockheart, a formerly incarcerated firefighter, encourages friends behind bars to take the COVID-19 vaccine: “Your chances of survival are much higher with this vaccine. I’m getting it and I hope you’re getting it, too, because until we break those walls and get everybody out, it’s the best thing you can do to protect yourselves. Please.”

To hear Arnold Trevino’s encouragement, click here.

To hear Ken Hartman’s encouragement, click here.

For FAQ about the COVID-19 vaccine from AMEND, a 100% credible source, click here.

Friends Want Friends Safe: A Special Message from Arnold Trevino

Formerly incarcerated people continue to urge their friends and loved ones behind bars to make the right choice and take the COVID-19 vaccine. Today’s message comes from Arnold Trevino of Insight Garden Program, who was incarcerated for 28 years:

For Ken Hartman’s video, click here.

For 100% credible information about the COVID-19 vaccine from AMEND, click here.

Friends Want Friends to Take the Vaccine: A Special Message from Ken Hartman

Please watch this awesome short video by Ken Hartman, a freelance writer and author and the Advocacy Coordinator for the Transformative In-Prison Workgroup (TPW.)

If you want to help this project get off the ground, please tweet and retweet. You can use the hashtag #FriendsWantFriendsSafe.

If you are formerly incarcerated and want to help even more, please send me a short video you can film on your phone–make it shorter than a minute, so someone inside might be able to watch it quickly–in which you address the folks you know and care about inside. Be sure that your video includes:

  • a bit of info about yourself: your name, anything you’d like to share, where you were incarcerated, and when you were released
  • why you care about COVID-19 in prison: your worries and fears about your friends getting seriously sick
  • explicitly state that you plan to take the vaccine when it is offered to you, and why
  • encourage your friends to do the same when the vaccine is offered to them
  • express compassion and empathy for the concerns and uncertainty they may have and counter it with solid facts and with your love for them

Email me your video to aviramh at uchastings dot edu. I will display it prominently, with a little intro about the specific facility where you know people, here on the blog.

Information for Residents of Correctional Facilities: Frequently Asked Questions about the COVID-19 Vaccine

As the first part in the blog’s vaccine education campaign, and following up on yesterday’s post, I’m very happy to offer you a Frequently Asked Questions document created by Drs. Leah Rorvig and Brie Williams with medical/scientific information about the COVID-19 vaccine from a source that 100% wishes you well and you can trust. Drs. Rorvig and Williams are active members of AMEND, the physician organization that issued the memo urging San Quentin to reduce its population to 50% of design capacity. Here goes:

COVID-19 Vaccines: The Basics

  • Vaccines teach the immune system how to recognize and fight off the virus that causes COVID19, which can prevent vaccinated people from getting sick. Vaccines are not used to treat
    people who are currently infected with COVID-19.
  • There are currently two vaccines available in the United States – one made by Pfizer and one
    made by Moderna
  • The vaccines are both 95% effective at preventing illness due to COVID-19
  • The vaccines have now been administered to millions of people and have a strong record of
    safety
  • While the vaccines were developed in record time, they have gone through all of the same
    steps required of any vaccine before it can be approved for use
  • Both vaccines have two doses, either three weeks apart (Pfizer) or four weeks apart (Moderna)
  • The vaccine is given as a shot in the upper arm

Is the COVID-19 vaccine safe? Should I worry that the vaccine was made so quickly?

  • Both vaccines were found to be safe and effective in tens of thousands of adults (including Bla
    and Latinx people) who participated in high quality research – the same research that any new
    vaccine or medicine must undergo before being approved.
  • Both vaccines were reviewed faster than normal, but this is because so many people are getting
    sick and dying of COVID-19 that it is considered a national emergency.
  • Both vaccines have been authorized by the FDA (Food & Drug Administration) and the
    California Department of Public Health.
  • In the U.S. alone, more than 5 million people have now received at least one dose of a COVID19 vaccine.

Has anyone died as a result of the COVID-19 vaccine?

  • No one has died from the COVID-19 vaccine. More than 350,000 Americans have died from COVID-19.

What are the possible side effects of the vaccine? Should I be worried about them?

  • The most common side effects of the vaccine are arm soreness, tiredness, headache, muscle
    pain, chills, joint pain, and fever. These side effects are more common after the second dose of
    the vaccine and – if they occur – usually resolve within 2 days.
  • These symptoms are normal and they are a sign that your body is building protection against
    the virus that causes COVID-19.
  • Among the millions of people who have now received the vaccine, a very small number of
    people have experienced severe allergic reactions to COVID-19 vaccines. If you have ever had a severe allergic reaction to a vaccine or other substance in the past, you should discuss this with
    the health care professionals giving you the vaccine.

The COVID-19 vaccine is an mRNA vaccine. Does that mean it changes your DNA (also called your genetic code)?

  • The Pfizer and Moderna vaccines both use “messenger RNA” (also called mRNA) to teach the
    cells in your body to recognize the outside part of the virus that causes COVID-19. That way, if
    you are exposed to the virus, your immune system will stop it from making you sick.
  • The COVID-19 vaccine does not change your DNA. mRNA is not the same as DNA, and it
    cannot combine with your DNA to change your genetic code.

Can I get COVID-19 from the vaccine?

  • No. Because of how the vaccine works, it is impossible to get COVID-19 from the vaccine. However, the vaccine prevents 95% (and not 100%) of COVID-19 cases. Even if you have been vaccinated, if you have a cough, fever, or other symptoms, then there is a chance you could have COVID-19, and you should ask to speak to medical staff right away.

I have hepatitis C and/or HIV. Is it safe for me to get the COVID-19 vaccine?

  • Yes. It is safe for people with hepatitis C and HIV to receive the COVID-19 vaccine. There are very few medical reasons not to receive the COVID-19 vaccine.

Do I need to keep wearing a mask after I receive the COVID-19 vaccine?

  • Yes. Unfortunately, even people who have had the COVID-19 vaccine may be able to get infected, and although the vaccine protects them from getting seriously sick, they may spread COVID-19 to others. (We do not know how common this is yet.) Until the majority of people have been vaccinated against COVID-19, everyone needs to continue wearing masks, practicing physical distancing, and frequently washing their hands.

If I already had COVID-19, do I need to get the COVID-19 vaccine?

  • COVID-19 vaccination should be offered to you even if you already had COVID-19
  • COVID-19 vaccination has been shown to be safe in those who have already had COVID-19
  • Right now, research shows that reinfection with the virus that causes COVID-19 is incredibly rare in the 90 days after you first get sick with COVID-19. Therefore, the vaccine should be offered to everyone, although some health systems are currently prioritizing patients who have not already had COVID-19 while the vaccine supply is very limited.
  • You should not get the vaccine if you are currently sick with COVID-19.

Is the COVID-19 vaccine mandatory (required)?

  • No, there is no mandatory vaccination requirement from either the state or federal government. While vaccine doses will be limited in supply at first, public health officials – and the team at AMEND at UCSF hope that by telling people about the safety and effectiveness of the COVID-19 vaccines, we can encourage people to voluntarily take the vaccine. The AMEND team is all planning to get the vaccine and some of us have already gotten it!

I got the COVID-19 vaccine because I want things to go back to normal. When will that happen?

  • We don’t know when enough people will be vaccinated so that things will go back to normal. But the more people that are vaccinated inside and outside of prison, the sooner things will begin to return to normal. Also, when you get the vaccine you protect other people around you by making it less likely for them to get COVID-19.

Did AMEND staff get the COVID-19 vaccine?

  • Yes. All of the AMEND team members who see patients already have received the COVID-19 vaccine.
  • Other AMEND staff will receive it as soon as it is available to them.

I heard the guards/officers, health care staff, or warden at my facility are refusing to get the vaccine. If they aren’t getting it, why should I?

  • There are many reasons that people are afraid to get the vaccine. These include a lack of knowledge about the safety and effectiveness of the vaccine, a lack of understanding about COVID-19 itself, a long history of mistrust of the medical system, and more. We encourage you to empower yourself to learn as much as you can about the COVID-19 vaccine. It is important that you make your own decision about getting the vaccine regardless of what other people are doing. The team at AMEND and our partners on this FAQ all support vaccination. See above for a complete list of our partners.

I still have more questions, what should I do?

  • You can ask your friends or family to get more information about the COVID-19 vaccines at these trusted sites:
    • https://covid19.ca.gov/vaccines/
    • https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html
  • To learn more, you can also call the Transitions Clinic Network Reentry Healthcare Hotline to speak to a community health worker with a history of incarceration. Toll free, M-F, 9-5pm. Call: 510-606-6400.
  • If you or your loved ones have additional ideas for questions that we can answer on this information sheet, please email us at info@amend.us or write to Amend, 490 Illinois St, Floor 8, UCSF Box 1265, San Francisco, CA 94143.

References

  • Centers for Disease Control and Prevention: COVID-19 Vaccination
  • https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html
  • https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html
  • State of California COVID-19 Vaccine Information Center https://covid19.ca.gov/vaccines/
  • UCSF COVID-19 Vaccine Information Hub https://coronavirus.ucsf.edu/vaccines

CDCR Vaccination: The Staff Is the Problem

A few weeks ago, when I pushed to prioritize prisons in California’s vaccine plan, I identified two serious problems: historically understandable mistrust of CDCR by the incarcerated population and COVID-19 denialism among prison staff. Earlier this week I participated in an extremely informative call with lawyers, AMEND doctors, activists and advocates, regarding the progress of CDCR’s vaccination program, the upshot of which is: The staff is the problem.

Here’s a quote from an email sent by the excellent Sara Norman of the Prison Law Office:

The State is currently vaccinating people in Phase 1A, which is three million people; they only have about two million doses so far, though, and have only vaccinated about 500,000.  Phase 1A includes people in long-term care facilities and some frontline medical workers, which in CDCR means people incarcerated at CCWF skilled nursing facility, CMF, and CHCF (all of which are in the middle of their first serious outbreaks) and some staff at all the prisons.  So far, we know that at least 1200 incarcerated people have been vaccinated (first dose).  As I mentioned on the call, CCHCS (the federal Receiver who runs health care in CDCR) expects to offer the vaccine to everyone at those three prisons within the next week or two. 

Our understanding is that at some point today, the California Department of Public Health will officially post the Phase 1BTier Two vaccine eligibility list, which will include all people who are incarcerated.  Statewide, there are about eight million people in Phase IB, counting both Tiers 1 and 2.  We are told that CCHCS expects to receive vaccine to start its Phase IB work in about 10 to 14 days. 

Sara added a few important points in her overview on the phone call. The acceptance rate among incarcerated people was not 100%, but it was quite high; as of Tuesday, 1227 vaccines were offered and only 108 were refused (this is a considerably higher rate of compliance than the rate in the general population.) The PLO spoke to the people who refused and identified some problems with vaccine education and communication, which should not surprise you if you’ve read this post.

The vaccination plan at CCWF, CMF, and CHCF is quite ambitious–they plan to offer the vaccine to every single person at these facilities in the next few days. The challenges they face involve serious nursing shortages. Not only do they need medical personnel to administer the vaccines and care for the sick, but they need to check vitals for the thousands of isolated people twice a day. The strain on the nurses is incredible, but they are forging through with the plan, including exhortations and threats of dismissal from Shereef Aref, the Chief Executive Officer of CCHCS. Paige St. John of the Los Angeles Times reports:

“A refusal to a mandate is insubordination,” Dr. Shereef Aref wrote. “It is not acceptable and it will not be tolerated.”

First refusals will result in a write-up, Arf wrote. “A second refusal will be referred, as a request for Adverse Action, to the Hiring Authority.”

One prison medical worker, who spoke anonymously out of fear of losing her job, said the stress was intense.

“Nursing staff [have] children out of school; to be away 16 hours not including walk time to the parking lot and drive time home could add up to 18 hours a day,” she said. In many cases, both spouses work at the prison. “It’s stressful. There is no such thing as ‘social distancing’ in prison.

“Also, the office staff have masks, but if you go on a housing unit, very few have masks because of the scarcity. … We are confused as to why they seem to have masks for administrative posts.”

She added, “Oh, and an inmate committed suicide yesterday. And two officers committed suicide in March.”

The Prison Law Office personnel were told that other incarcerated people, particularly people who are under inpatient care, were next on the list, and that the plan would roll to other prisons in mid-January, prioritizing people according to a complicated COVID-19 risk algorithm, which highlights the need to target people who are “covid-naive,” i.e, who have not contracted COVID-19 in last 90 days. Among those people, the first to be offered the vaccine are at higher risk due to age, preexisting conditions, or both. Reportedly, no thought is being given to the differences between CDCR facilities who have and have not reached herd immunity the hard way. Nor has there been an effort to prioritize incarcerated firefighters, despite the obvious transmissibility reasons that put them at the top of the list for other vaccines.

But even these are minor problems compared with what is emerging as the most serious problem: the staff. Vaccines have been rolled out for staff at all institutions, prioritizing medical and frontline workers or people who work directly with patients, but generally the plan is to offer the vaccine to all staff throughout January and February. The administration of staff vaccination has been contracted out of CDCR/CCHCS to another organization. So far, 6,700 staff members have been vaccinated, most of them at CHCF and at CMF. However, there is disconcerting evidence of significant refusal rates among staff. Incarcerated people have heard rumors that 40% of staff members are refusing the vaccine. Also, in response to a CDCR survey, about 40-50% reportedly expressed reluctance about vaccination, citing reasons such as “I wanna wait and see what happens.” The people on the call were unsure whether there was any educational campaign targeted at the staff, nor did anyone seem to know whether CDCR, as employer, would condition employment upon vaccination. In case you’re wondering whether terminating vaccine refusers from employment at CDCR would be legal from an employment law perspective, the answer is: yes, it would be.

This distressing information suggests that the problem is not only with CCPOA leadership, who have been far more interested in spending millions on losing punitive voter initiatives than in the health of their membership, but also with the rank and file, where Trump-style COVID denialism seems to have found a solid foothold. Just this week, we had ample proof of what happens when vast ignorance, misinformation campaigns, and fetid ideologies come together, right? To my shock and amazement, in the face of thousands of their colleagues sick and twelve staff deaths, including two in December, prison guards are planning an excursion to… Las Vegas for a board meeting. Wes Venteicher of the Sacramento Bee reports:

The union for California state correctional officers has invited representatives from every prison to gather in Las Vegas for a board of directors meeting even as their institutions contend with surging coronavirus outbreaks.

The California Correctional Peace Officers Association’s board includes representatives from all 35 prisons plus some members who represent officers outside prisons, such as parole agents and officers who work at fire camps.

Also invited to the two-day meeting, scheduled for Jan. 26 and 27 at Caesar’s Palace, are roughly a dozen members of the union’s committees along with retired chapter members, according to a website set up for union members to make travel arrangements.

A dozen state prisons have reported more than 200 new COVID-19 infections among inmates in the last two weeks, and another six have reported more than 100 new infections. More than 2,500 prison employees have reported new infections in the last two weeks and about 13,000 out of 55,000 have contracted the virus since the start of the pandemic.

Most large in-person meetings have been canceled during the coronavirus pandemic due to concerns about creating “super-spreader” events in which an infection may be passed around and then spread far beyond the group when the gathering is over.

California has prohibited most in-person gatherings of more than one household, whether they are held indoors or outdoors, under emergency orders. Nevada permits gatherings of up to 50 people.

Glen Stailey, the union’s president, referred questions to a union spokeswoman when reached by phone Wednesday.

“These meetings are important to the association and its members as it relates to many topics including COVID-19 inside prisons,” CCPOA spokeswoman Nichol Gomez said in an email.

Gomez said the group would follow all Nevada and California state protocols and is “constantly evaluating the situation and will make decisions accordingly.”

Gomez did not respond to questions about how many of the members who have been invited plan to attend, nor did she say whether the members plan to get tested or quarantine before or after the trip.

Note that the quarterly meeting is typically held in Sacramento. Apparently, CCPOA leaders decided that early 2021 was the right time to party. If, as Gomez stated, the meeting “relates” to COVID-19 inside prisons, they don’t apparently mean “relates” as in “aims to prevent.” The risk that Christmas gatherings of COVID-denier staff members may be partly to blame for the horrific infection rate does not seem to have been considered. In the absence of any positive educational or other initiative from their employer or union, the only visible effort addressed at reducing COVID-19 denialism among correctional staff comes from our good friends at Amend SF. In the off-chance that you, dear reader, are a correctional staff member and are reading this and open to persuasion, please, in the name of everything that is holy, watch this and share it widely with your colleagues:

COVID-denialism among staff affects not only the odds of infection among incarcerated people, but also the messaging they receive from staff members. Several people with good friends and loved ones behind bars mentioned that their connections inside have heard correctional officers tell incarcerated people that they can die from taking the vaccine and that COVID-19 is not real.

In the face of this problem, and the dearth of efforts by CDCR to quash this ignorance, I have two proposals. The first involves health officers in all cities and counties surrounding prisons in California–people like Dr. Matthew Willis, Marin County’s top health official, who tried to stop this disaster and were sidelined and ignored. This is your moment. Please organize and liaise not only with the prisons in your respective counties and demand that they condition employment upon vaccination. Tell them that there is now quantitative data, some of which comes from our original research and some from the work of others, to show the impact of their neglect on your communities. These COVID-19 deniers among the staff are endangering you and the people who live in your county. Please get involved, as there is not a moment to lose.

The other proposal is mine, and its logic is simple: If the staff won’t do their part to protect incarcerated people, we need to raise the vaccination rate among incarcerated people as close to 100% as we possibly can. And so, dear reader, if you are a formerly incarcerated person–especially if you’ve only recently been released and you still have some good friends inside–I need your help. I can also use help from family members and loved ones of incarcerated and formerly incarcerated people. Please send me a short video you can film on your phone–make it shorter than a minute, so someone inside might be able to watch it quickly–in which you address the folks you know and care about inside. Be sure that your video includes:

  • a bit of info about yourself: your name, anything you’d like to share, where you were incarcerated, and when you were released
  • why you care about COVID-19 in prison: your worries and fears about your friends getting seriously sick
  • explicitly state that you plan to take the vaccine when it is offered to you, and why
  • encourage your friends to do the same when the vaccine is offered to them
  • express compassion and empathy for the concerns and uncertainty they may have and counter it with solid facts and with your love for them

Email me your video to aviramh at uchastings dot edu. I will display it prominently, with a little intro about the specific facility where you know people, here on the blog.

Thank you very much for your collaboration–let’s save as many lives as we can together. As Rabbi Hillel said almost two millennia ago: If I am not for me, who will be for me? And when I am for myself alone, what am I? And if not now, then when?

Herd Immunity at CDCR, and the Worst of All Worlds

Remember this headline? You might have missed it, what with the onslaught of news and scandals. In mid-December, emails made public by the House committee overseeing the government’s pandemic response show that Paul Alexander—who was installed by President Trump in April to lead the HHS’ communications efforts—wrote to his higher-ups multiple times throughout June and July arguing that there is “no other way” to tackle Covid-19 except establishing “herd immunity” by allowing non-risk groups to expose themselves to the virus.

“Infants, kids, teens, young people, young adults, middle aged with no conditions etc. have zero to little risk,” wrote Alexander in a July 4 message to his boss, Assistant Secretary for Public Affairs Michael Caputo, saying “we want them infected” to help “develop herd.”

Similarly, on July 24, Alexander wrote to the Food and Drug Administration’s Commissioner Stephen Hahn, Associated Commissioner for External Affairs John Wagner and numerous top HHS officials arguing that it “may be best to open up the flood zone and let the kids and young folk get infected.”

In the emails, Alexander also acknowledged that the Trump administration was aware its policies would increase the spread of Covid-19, urged HHS staff to release more “positive statements” in support of the administration’s pandemic response and cast blame on scientists like Dr. Anthony Fauci for offering less rosy assessments of the situation, accusing them of trying to “make the president look bad.”

The published emails don’t include the replies from Alexander’s supervisors to his guidance aside from a skeptical—“How can this be researched and proven true or false?”—written by Caputo in response to a claim made by Alexander about herd immunity on a cruise ship.

The HHS has previously disavowed herd immunity, with Secretary Alex Azar in October insisting it was “not the strategy of the U.S. government with regard to the coronavirus,” although the House watchdog pointed out that high-profile members of the administration on multiple occasions echoed the messaging promoted by Alexander soon after his emails were sent.

The agency drew a thick line between itself and Alexander in a Wednesday statement to Forbes, saying “his emails absolutely did not shape department strategy” and emphasizing that he was a “temporary Senior Policy Advisor to the Assistant Secretary for Public Affairs and is no longer employed at the Department.”

I’m quoting this because the idea of herd immunity by infection offers a useful, if grim, lens to look at the status of CDCR infections. Right now, CDCR has 6406 new confirmed cases in the past 14 days, and the overall infection number has risen to 41,449 cases–more than 40% of the entire prison population. All prisons have outbreaks, and 29 out of 36 prisons have serious outbreaks (more than 50 cases.) But in some prisons, the rate of infection is staggering. According to today’s data, eight prisons have had more than 60% of their population infected:

CVSP    96%
ASP     92%
CRC     91%
SQ      81%
PVSP    71%
CIM     70%
SATF    68%
FSP     62%

We chose 60% and above because estimates of the rate of infection necessary for herd immunity is estimated by experts to hover between 60% and 80%.

In case you are inclined to see this as good news, don’t. Here’s a primer from Johns Hopkins about herd immunity, which was written in April, when the current infection rates in the U.S. seemed horrendously farfetched. “As with any other infection,” they explain, “there are two ways to achieve herd immunity: A large proportion of the population either gets infected or gets a protective vaccine.” They go on to explain why the former option is not a good idea:

With some other diseases, such as chickenpox before the varicella vaccine was developed, people sometimes exposed themselves intentionally as a way of achieving immunity. For less severe diseases, this approach might be reasonable. But the situation for SARS-CoV-2 is very different: COVID-19 carries a much higher risk of severe disease and even death.

The death rate for COVID-19 is unknown, but current data suggest it is 10 times higher than for the flu. It’s higher still among vulnerable groups like the elderly and people with weakened immune systems. Even if the same number of people ultimately get infected with SARS-CoV-2, it’s best to space those infections over time to avoid overwhelming our doctors and hospitals. Quicker is not always better, as we have seen in previous epidemics with high mortality rates, such as the 1918 Flu pandemic.

 It would be tempting to juxtapose the Paul Alexander emails and the CDCR numbers and suggest that CDCR’s COVID-19 policy team have lifted their prevention strategy straight out of Trump’s playbook, but I think that assumes a much higher degree of premeditated planning than what is actually going on, which is chaos. Systemwide, the percentage of infections (more than 40%!) is staggering, but not at a high enough level to provide herd immunity for a minority of non-infected people; institution-wide, this means that CDCR’s explicit party line–transfers, rather than releases as its modus operandi–is likely to backfire spectacularly. Shifting people from places with fewer infections to places with more infections puts their lives in danger and risks transferring the new strain of COVID-19 before the vaccination plan is completed (I will post about how that’s going tomorrow, but for now just know that vaccinations are not underway in the worst outbreak sites and that the priority process raises serious concerns.) Shifting people from places with lots of infections to places with fewer infections, as the so-called “remedy” CDCR has fashioned for the San Quentin disaster, dilutes herd immunity and generates horrific outbreaks like the ones we’ve seen at Avenal, Folsom, SATF, CVSP and other facilities.

These problems are going to persist as long as CDCR willfully ignores the obvious solution: release aging, infirm people to the community, where they are safer for all of us.

BREAKING NEWS: Important Legal Developments in Quentin, Plata Cases

The last few days have seen key developments in all three major COVID-19 lawsuits against CDCR. On the San Quentin front, the California Supreme Court granted CDCR’s petition for review… but this is not necessarily bad news, just complicated. I’ll start by providing the decision in Von Staich and the order in the Marin cases, and follow up with commentary. Here’s the grant of petition for review:

The Attorney General seeks review of the judgment of the Court of Appeal, First Appellate District, Division Two, which found that prison officials have been deliberately indifferent to the health and safety of prisoners at San Quentin State Prison during the COVID-19 pandemic. The court ordered officials to remedy the constitutional violation by designing a plan to reduce the population of the prison to 50 percent of its June 2020 population, through either additional releases from custody or transfers to other institutions.

The questions raised by the petition are undoubtedly substantial. The health and welfare of individuals in the state’s custody during the pandemic, and the appropriate measures for their protection, are matters of clear statewide importance. As the Court of Appeal explained, “[t]he Eighth Amendment to the United States Constitution and article I, section 17 of the California Constitution both require correctional officials to provide inmates adequate medical care” and prohibit prison officials from being ” ‘deliberately indifferent to the exposure of inmates to a serious communicable disease’ [citation].” (In re Von Staich, filed opn. at p. 18.) 

The Court of Appeal ruled on the basis of the documents submitted and oral argument, without holding an evidentiary hearing. As the case now comes to this court, it appears that there are significant disputes about the efficacy of the measures officials have already taken to abate the risk of serious harm to petitioner and other prisoners, as well as the appropriate health and safety measures they should take in light of present conditions. For this reason, we return the case to the Court of Appeal with instructions to consider whether to order an evidentiary hearing to investigate these matters before judgment is pronounced. (See People v. Duvall (1995) 9 Cal.4th 464, 482-483, 485.) As we have repeatedly advised in other cases raising similar issues, the matter should be resolved as expeditiously as is consistent with sound adjudication, given the exigent and evolving circumstances concerning COVID-19.

The request for judicial notice is granted. 

The petition for review is granted. The cause is transferred to the Court of Appeal, First Appellate District, Division Two, with directions to vacate its decision and reconsider the cause in light of People v. Duvall, supra, 9 Cal.4th at pages 482-483 and 485, the Attorney General’s Return to the Order to Show Cause at pages 13-19, and the supporting Memorandum of Points and Authorities at pages 32-38. (Cal. Rules of Court, rule 8.528(d).) 

The request for depublication is denied.

Votes: Cantil-Sakauye, C.J., Corrigan, Liu, Cuellar, Kruger, Groban and Jenkins, JJ.

And here’s the order in the 311 Marin County cases:

122420 Order Staying Further Proceedings & Vacating Individual Orders by hadaraviram on Scribd

Here’s what’s going on. Von Staich was decided on the basis of a case called People v. Duvall, which clarified how habeas corpus cases should be heard in court. Under Duvall, when someone petitions for habeas corpus and claims that the government is holding them under unconstitutional conditions, the government must provide a return that “allege[s] facts tending to establish the legality of petitioner’s detention. . . The factual allegations of a return must also respond to the allegations of the petition that form the basis of the petitioner’s claim that the confinement is unlawful. . . In addition to stating facts, the return should also, “where appropriate, … provide such documentary evidence, affidavits, or other materials as will enable the court to determine which issues are truly disputed.”

The Court of Appeal in Von Staich relied on a fairly straightforward application of Duvall. Because the AG representatives of the San Quentin warden did not actually present evidence showing that the prison authorities’ behavior was appropriate, all the Court was left with was the AMEND report, which stated that no appropriate social distancing could take place unless the prison population were to be reduced to 50% of design capacity. The return did not provide any contrary medical opinion. The Supreme Court seems to disagree with the Court of Appeal, finding that the “significant disputes about the efficacy of the measures officials have already taken” to ameliorate the Quentin catastrophe, an evidentiary hearing might be warranted. As a consequence, the actions taken by the Marin court toward relief for the hundreds of San Quentin petitioners have been frozen until the Court of Appeal determines whether to hold an evidentiary hearing to examine whether the steps taken by the prison authorities can undermine the findings of “deliberate indifference.”

This is not necessarily a bad development, for several reasons. First of all, it is dubious that CDCR, and the AG, could put on any convincing evidence to show that the measures they took, short of releasing people, adequately put them out of “deliberate indifference” territory. Their own doctors are horrified by what they are doing and have said on the record that they want nothing to do with the transfers. Their claims about other precautions, such as screening and wearing PPE, have now been refuted by two Inspector General reports, and they have been excoriated by the legislature for not rising to that level. Only this week did they show any signs of enforcing proper protection on their own staff (so, even the ameliorating steps they claimed to have taken, which the Court of Appeal found “commendable”, turn out to be fictional.)

In addition, consider the dire developments for our friends behind bars before the Supreme Court’s grant. Recall that the Von Staich decision offered CDCR the choice between releases and transfers, urging them to consider releases of aging, infirm people. CDCR proceeded to abuse the discretion it was given to cook up a “remedy” that turned out worse than no remedy at all: as of a week ago, CDCR was still taking active steps to move people out of San Quentin, where the outbreak has abated (for now), to places like RJD and VSP, which experienced horrific outbreaks to the tune of hundreds of cases. Even in the face of realities on the ground–an outbreak in every single prison, a third of the entire prison population infected, a ninth of the entire prison population experiencing an active case, 104 deaths–they were going to shortsightedly confine their energies toward begrudging formal compliance that actually endangered people even more (in addition to the obvious contagion risks, I’ve received emails from folks inside expressing real fears of retaliation from people in the prisons to which they were to be transferred.) Meanwhile, flying in the face of the obvious public health priorities, the folks who should have been first in line to be released were at the very end of the line. This new development buys us more time to push for releases.

The last point is crucial, because the big legal case involving the entire CDCR apparatus, Plata v. Newsom, took a drastic turn in our favor yesterday. At the oral argument, Judge Tigar was exceedingly critical of CDCR’s handling of this crisis. He mentioned a conversation he had with Dr. Elizabeth Linos of the Berkeley Goldman School regarding a much-needed cultural change inside CDCR–a shift in approach from making demands (which Tigar referred to as a “sledgehammer” approach) toward emulation and leading by example, going as far as expressing doubt that the new CDCR policy to ensure testing compliance–and any measures taken by CCPOA, the prison guards union–went far enough, given the existence of significant “pockets” of noncompliance among the staff. Judge Tigar became visibly emotional as he discussed his visits at CMF, mentioning that Gov. Newsom called him and expressed a desire to tour CMF as well. Judge Tigar discussed in detail several people he had met behind bars, including a man in his 90s and a man who became eligible for parole in 1993. He displayed pictures of several people who had died of COVID-19 behind bars, speaking at length and in detail about Eric Warner, 57, an amputee, reformed Christian, and volunteer, and about Sergeant Gilbert Polanco, 55. When speaking of Mr. Warner’s passing, Judge Tigar had to stop to wipe his tears.

Judge Tigar then made a lengthy and forceful plea with Katheleen Allison to consider releases, stating that the time had come for that remedy and giving Gov. Newsom is support in this effort. Judge Tigar used the term of art “deliberate indifference”–a term indicating a finding of Eight Amendment violation–several times–even though he said that it had not been technically met, but explicitly said that CDCR’s behavior will fuel further lawsuits. The upshot of the hearing was the following order:

gov.uscourts.cand.76.3523.0 (1) by hadaraviram on Scribd

The order requires the parties to brief Judge Tigar on the physical possibilities to create quarantine and social distancing (including, for example, the existence of solid doors), as well as on the extent to which pandemic prevention guidelines might have changed during the course of the litigation. The situation on the ground makes it plainly obvious that what is needed here is an all-encompassing solution for the entire prison system; while state courts should be the vanguard of safeguarding Eighth Amendment rights in prisons, their jurisdiction is limited to their counties, and we are simply no longer in a situation in which this makes geographical sense. The thing to do now is push aggressively for releases and for early, effective, and broad vaccination behind bars, and to bring Plata to a successful and effective conclusion.

BREAKING NEWS: Vaccine Available for Staff AND Incarcerated People This Month

Today, CDCR Secretary Kathleen Allison communicated excellent news. The letter above reads:

To All Loved Ones of Incarcerated Individuals and Valued External Stakeholders,

We have an important update in our response efforts against the COVID-19 pandemic. As most of you know, the vaccine has arrived in California, and it is safe and effective. The vaccine is being made available on a phased basis, and as a state, we are committed to a fair and equitable allocation and distribution process.

To that end, California Department of Corrections and Rehabilitation (CDCR) and California Correctional Health Care Services (CCHCS) will receive our first vaccines allocation as soon as this month, and we are currently working with our public health partners on a distribution plan. The initial focus will be on people at high risk of becoming infected or severely ill from COVID-19, as well as frontline workers.

We will have information on our website, and will update it regularly to ensure we are keeping everyone informed on these efforts.

CDCR and CCHCS have also sent out a similar communication to the incarcerated population and staff. We encourage everyone to accept the vaccine once they are eligible to receive it, and in accordance with the phased distribution approach. These collective efforts will set us on the path to recovery, and will allow us to reduce the risk of COVID-19 in our institutions, and safely reopen to in-person visiting, group programming, volunteering, and other opportunities.

If you have questions please email COVID19@cdcr.ca.gov. We are unable to address questions about specific individuals with this correspondence; however, we value your feedback and welcome your questions about the vaccine program and our COVID-19 response efforts.

In the meantime, we are continuing to ensure everyone is taking every precaution to ensure the safety and wellness of everyone who lives and works in our institutions. We are thankful to the families, friends and loved ones of our incarcerated population, as well as our stakeholders. Your hard work, dedication, and sacrifice this year has not been lost on us, and we are appreciative of all your efforts.

For more information on these response efforts, please visit the CDCR/CCHCS COVID response page. For more information about this project and the COVID-19 vaccine, visit this web page.

Take care of yourselves and take care of each other.

Kathleen Allison Clark Kelso

Secretary Receiver

I received the above in a format that did not have clickable links, but I assume the links take you here and here. I have many questions, which I will email to the above address tomorrow morning, including whether the vaccine is mandatory for staff, whether readiness/buy in questionnaires have been administered, and whether choice to vaccinate will be linked to incarceration conditions. I hope to provide updates soon.