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Health

In Colorado, A Big Prison And A Small Rural Community Share A Coronavirus Outbreak

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KUNC Composite Illustration

As the coronavirus continues to spread across the state, a rural corner of northeastern Colorado has become home to the highest rate of cases of any county due to an outbreak at the Sterling Correctional Facility, a large state prison.

Kim White’s son, Dustin, one of 2,300 inmates there, is two years into serving a 10-year sentence for armed robbery.

“He told me before he went away, he said ‘mom, please take good care of my dog.’ And he goes, ‘don’t let anything happen to her and make sure she has her pillow every night,’” White said of Precious, her son’s Chihuahua pug.

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Credit Henry Zimmerman / KUNC
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KUNC
Sterling Correctional Facility is the largest prison in the state.

White’s son is one of at least 530 inmates at Sterling who have tested positive for COVID-19, the majority of whom are asymptomatic.

“I did a video visit with him last week,” White said. “The mask didn’t quite fit, he had to keep adjusting it… He seemed okay at the time. He did do a lot of holding his head from the pain.”  

Although her son’s symptoms aren’t severe, White is concerned. Dustin has a rare neurological disorder called Guilliain-Barre syndrome (GBS). Since becoming sick with COVID-19, some of his GBS symptoms, like leg cramps and tremors, have returned.

“It is paramount that he be seen by neurology and evaluated to prevent further loss of muscle use of his lower extremities. This is an emergent issue,” his doctor wrote in a letter to the prison dated May 20, 2020.

“I’m stressed, I’m worried, I’m not sleeping much because he's constantly on my mind,” White said.

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Credit Kim White
Kim White (right) with her family, including her son Dustin (center), an inmate at Sterling Correctional Facility who has tested positive for COVID-19.

Prison inmates are particularly vulnerable to the coronavirus. Many have underlying medical conditions; in 2018, 23% of inmates in Colorado correctional facilities had moderate to severe medical needs. Plus, social distancing is difficult. Inmates usually share small cells and use communal areas, like showers and toilets.

DOC has restricted visits from lawyers and family members and also stopped inmate transfers. Through an executive order on March 25, the governor relaxed the requirements for prisoners to get out early.

Still, the coronavirus has spread. At least 900 inmates in prisons, jails and detention centers across the state have tested positive; four have died.

In a statement to KUNC, a CDOC spokesperson wrote:

“Just like the general public is battling to try and prevent the spread of this virus, we are doing the same in DOC despite the inherent challenges that come from a congregant living environment inside a prison… Given that the virus most likely came into our prison from the community via an asymptomatic staff member, just like in the general community, we may not be able to entirely prevent its introduction into our buildings.”

For this reason, Dr. Carlos Franco-Paredes, an infectious disease expert at the University of Colorado Anschutz Medical Campus, calls the spread of the virus into and out of prisons “a bi-directional interaction.”

Since the pandemic began, Dr. Franco-Paredes has visited jails in Colorado, Maryland and Michigan to carry out inspections.

“I usually write on the reports that nobody is safe until everybody is safe,” he said. “Public health in jails is public health in the community because it's an extension of the community at large.”

From his recent work in correctional facilities, Dr. Franco-Paredes recommends three main prevention methods with the goal of protecting the medically vulnerable: infection control, testing and depopulation.

The idea that prison health is tied to rural community health is being tested across the country. Rural America is home to most of the nation’s prisons and right now manyofthosefacilitieshaveoutbreaksof the novel coronavirus.

More than 500 Sterling Correctional Facility staff live in the small, rural city of Sterling and surrounding Logan County. Rural communities like Logan County tend to be older, with more pre-existing conditions and less health insurance, factors that could put those who get COVID-19 at higher risk for worse symptoms.

“Well, I’ve already been exposed, I’ve already been there. And I was actually sick at the end of March,” said Carrie Meis, a correctional officer at Sterling. That sickness gave her a few weeks of fatigue and a dry cough, among other symptoms. She was quarantined, but wasn’t able to get tested at the time so she has no idea if she had COVID-19 or something else.

After returning to work, Meis was able to get tested and that came back negative. She wants an antibody test, which may be able to tell her if she previously had the virus.

Meis is very careful to emphasize that she doesn’t speak on behalf of the Colorado Department of Corrections or her 829 coworkers at the facility (21 of whom have tested positive for coronavirus as of last week). She was speaking as a member of Colorado Workers for Innovative and New Solutions, a union for state employees.

Some staff now work in the same unit or section as much as possible and have 12-hour shifts to allow for more social distancing and reduce crossover. They also get masks and gloves, regular cleaning duties and other new responsibilities to reduce spread of the virus. In a statement to KUNC, the CDOC said cell shakedowns and officer rounds are still ongoing. 

“We were kind of already resilient in that we had changes,you never knew what was happening in the facility one day to the next,” Meis said. “It’s just been magnified more now.”

Inmates are also given masks and are kept in their cells except to shower. Meals and medications are being delivered to them. 

CDOC says Sterling is being cleaned more often and over the last month, testing there has increased; all inmates have now been tested.

As for depopulation, under the governor’s executive order, inmates can be considered for early release for medical reasons, if they have served most of their sentence, or through earned time for good behavior. Of the estimated 16,000 people in prison across the state, 290 have been released early as of May 21, mostly for medical reasons.

But depopulation comes with risks. Earlier this month, a man who was released from prison four months early was arrested for the murder of a 21-year-old woman in Denver.

“Nobody should be released simply because of COVID-19,” Gov. Polis said during a news conference after the incident. “Of course the parole board is making the individual evaluations, and that’s a tough job that they do. They couldn’t have held that person much longer than they did.”

Effects Of Outbreak Ripple Through Community

While many are concerned about conditions and health inside correctional facilities, the devastating economic impact of COVID-19 to those on the outside have local officials scrambling to make up for losses.

On April 28, Logan County put together a variance request, which basically asks Colorado’s Department of Health and Environment for permission to ease some safer-at-home restrictions within the county, like allowing local movie theaters, gyms and restaurants to open at 30% capacity.

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The Logan County Courthouse is home to the county commissioner's offices. They put in a variance request to the state to reduce COVID-19 restrictions for certain businesses.

The request had the support and signatures of county commissioners, the Sterling city manager, Sterling Regional MedCenter (the local hospital) and Northeast Colorado Health Department.

“It would get the businesses back and help stabilize their future,” said Sterling City Manager Donald Saling. He knows of at least two businesses which will likely not open their doors again due to losses. The city’s sales tax revenue was down by 6.9% last month compared to last year.

CDPHE rejected that version of the variance request. Just about 10% of Logan County’s COVID-19 cases, both now and then, were non-inmates. And the overall non-inmate case numbers have remained fairly steady.

“It’s frustrating when you’ve really spent a lot of time trying to get the resurgence of interest downtown and then you drive down there and nobody is there,” he said.

In a letter explaining the decision, the state health department said it was concerned employee exposure at the correctional facility could mean more community spread. It also needed more information about the MedCenter’s capacity to deal with an influx of cases.

Days after the first variance request was rejected, the county sent a second which addressed CDPHE’s concerns directly.

“Logan County respectfully requests that CDPHE considers that even though ‘Logan County has the highest rate of COVID-19 in Colorado,’ the high rate of COVID-19 positive cases are contained in the Sterling Correctional Facility which is overseen by the Colorado Department of Corrections and for which Logan County has no jurisdiction,” the county wrote in its second request. “Outside of the correctional facility, the greatest spike in numbers occurred in early April when five positive cases were reported for a single day.”

The health department accepted that request on Saturday, allowing certain businesses to open at 50% capacity so long as there is at least 28 square feet of room per person. With a very important caveat: the state can pull the plug and bring back restrictions at any time if the county gets 22 or more non-inmate cases in a two-week span.

“Logan County, overall, I think that they haven’t had much community spread and I think that people are taking responsibility to protect themselves,” said Trish McClain, Public Health Director for NCHD. She also has a lot of faith in correctional staff.

“They’ve been very diligent and are taking good care of themselves,” she said. “So I think further community spread would most likely not come from them.”

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Downtown Sterling just days before the state announced its "stay-at-home" order in March to curb the spread of COVID-19.

Four out of the six counties NCHD serves have applied for variances, McClain said. When it comes to deciding whether to sign onto a variance request, she relies heavily on hospitals like the MedCenter.

“If the healthcare facilities feel like they, indeed, are in a good place and they can handle potential cases then I will go ahead and sign off on it,” she said.

The MedCenter has an agreement with hospitals in Denver, Greeley and Fort Collins to transfer patients from the Correctional Facility that might overwhelm the smaller hospital. They also already send inmates who need a greater level of care to those hospitals and have the resources and staff to about double its capacity in case of a coronavirus-related surge.

With all of that in mind, Wade Tyrell, CEO of the hospital, is pretty confident they can handle the county reopening, even with the outbreak nearby.

“Related to Sterling Correctional, the worst is probably over,” he said. “But I will say, just from the community standpoint, knowing that some of their employees do live in Sterling, Logan County and surrounding counties, it will be interesting to see if that plateau, I guess if we want to call it that, continues.”

He made sure to clarify that he was interested, but not highly concerned about that possibility becoming reality. Conversations with the Department of Corrections between the first and second variance request made him confident in their efforts to curb the outbreak. In fact, he was far more concerned about people gathering in large groups on Memorial Day.

When she gets home from work in the morning, Sterling Corrections Officer Carrie Meis immediately throws her uniform in the laundry.

“We’re careful about that. Try not to expose our homes and our loved ones,” she said. She lives alone, so there is no one at home to risk infecting, but she does it anyway.  “It’s hampered my social life for sure. I haven’t seen my daughter for several months.”

Families with loved ones inside the prison are working to keep them safe too. Kim White is trying to get her son Dustin out early.

“I just want him home so that he can get the medical treatment,” White said. “You know, this GBS (Guillain-Barré syndrome) is not something to mess with.”

But Dustin is ineligible for early release under the governor’s executive order. CDOC is only considering offenders who do not have victims and Dustin was convicted of a violent crime. White sent her medical records in for review for compassionate release but recently found out it was denied.

“I try to stay busy,” she said. “Otherwise, my mind starts wandering. Who can I call? What can I do? Who can I write?”

As the state and city around her open up, Meis has noticed working at the prison is a “red flag” for some. The outbreak isn’t over yet, case numbers still tick up as prevalence testing at Sterling continues. And CDOC is not planning any major changes to how it is dealing with the coronavirus spread.

Meis understands the concern, but believes that so long as she takes the right precautions, like keeping distance, wearing protective equipment and clean clothes, she’s no more of a risk than anyone else.

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