Every afternoon, state Secretary of Corrections John Wetzel gets a map in his inbox that shows the spread of COVID-19 in Pennsylvania over the last seven days.
During the spring surge in April, the maps showed large clusters of positive cases in the four corners of the state, affecting just a handful of prisons that are part of the state system.
During the current fall surge where cases have topped 12 million nationally as of Saturday, the maps have illustrated a more troubling scenario: The highly contagious virus is everywhere.
“Every one of our facilities is in a high- or medium-growth county right now,” said Wetzel.
The dramatic change means there are now positive coronavirus cases in 22 of the state’s 24 correctional institutions, putting advocates — and families with loved ones on the inside — on edge.
As of Friday, there were 824 active cases. Six days earlier, the total was about half that figure.
To date, 23 prisoners have died from COVID-19 in nine correctional facilities. Twelve have died since October.
“We’re in a very dark period, and it’s not going to get light for several months,” said Claire Shubick-Richards, executive director of the Pennsylvania Prison Society.
Some facilities like SCI Phoenix in Montgomery County have fewer than a dozen active cases. The majority have fewer than 30.
SCI Laurel Highlands, a minimum-security prison in western Pennsylvania that houses geriatric and medically infirm prisoners, has 344 COVID infections — the highest total in the system.
Wendell, who was released from the prison in June, is not surprised by the outbreak. The men at the facility live in dormitory-style cells, making social distancing impossible, he said.
“You’re kind of packed in there like sardines,” said Wendell, 40, who served time for drunken driving. WHYY News agreed to withhold his last name due to fears of retribution while he’s on parole.
Wendell had six cellmates while he was locked up at Laurel Highlands. Others had eight.
“I remember saying if this virus gets inside of here, it’s gonna be a problem. It’s gonna be an extreme problem,” he said. “With God’s blessings, I was able to get out in June.”
Staffing has also taken a hit during fall’s COVID-19 surge.
In Philadelphia, where officials are now reporting several hundred new positive cases each day, the full impact of the fall surge on the city’s jail system is less clear.
As of Wednesday morning, the city reported 41 positive cases of COVID-19 among the incarcerated population. The majority of the cases are asymptomatic.
Two days earlier, there were 33 positive cases.
The city did not report in which of its four jails the positive cases were discovered. It also has not reported how many prison staffers are currently infected with COVID-19 or have been infected since the start of the pandemic. For privacy reasons, the city does not release those figures separately. They are folded into the city’s total number of positive cases.
The system is currently in the yellow phase of its reopening plan, which affords groups of 25 to 40 prisoners up to three hours a day out of their cells depending on the facility. Some people eat their meals in their cells, but can go outside or use the law library when their cohort is permitted to leave.
“We are not in lockdown,” Commissioner Blanche Carney said in an interview.
She said she’s approaching the fall COVID-19 surge the same way she’s approached the pandemic since its start: one day at a time.
There are in-person medical screenings at all entry points, and all newly admitted prisoners are tested and isolated if they test positive for the coronavirus. The quarantine period was five days initially. It is now 14.
“Sometimes, there’s this impression that we’re not doing enough,” said Carney. “We’re doing all we can to keep people safe — staff, inmates, any legal visitor that would come to the Philadelphia Prison Systems.”
“This is unprecedented and I believe we are responding appropriately,” she added.
Recent court documents, part of an ongoing federal lawsuit filed against the Philadelphia Department of Prisons over its handling of the pandemic, paint a different picture. Prisoners who submitted affidavits in late September reported that housing units and phones are not cleaned regularly, and that there’s limited access to soap and face masks. They also said there are days when they don’t get time out of their cells.
“Every time we are let out of our cells, we have to sign a paper. But on many occasions, the [correctional officers] forge our signatures to make it look like everybody is getting out of their cells,” wrote Issac Evans, who is in the Philadelphia Industrial Correctional Facility.
In the latest joint status report on the case, the American Civil Liberties Union, which filed the lawsuit in April, requested that the judge focus on “enhanced and expanded” testing for prisoners and staff and the “defendants’ failure to produce requested videotapes to demonstrate compliance with mask wearing requirements.”
The last month has been particularly challenging. Wetzel said the Commonwealth’s prison system’s workforce has dropped by about 10% during that time.
As of Thursday, 1,783 SCI employees were out for a variety of reasons. Roughly 3% of staff is currently infected with COVID-19, according to the department.
“This is much more complicated — this one,” Wetzel said of the current surge.
In late March, a day after the department reported its first positive coronavirus case, Wetzel proactively implemented a system-wide quarantine to limit the spread of the virus behind bars. Prisoners ate meals in their cells, but were allowed out for 45 minutes each day to shower, make phone calls or use the law library.
The restrictions were lifted in May. Wetzel doesn’t expect to have another system-wide lockdown. He doesn’t think it’s necessary at this point in the pandemic.
“If we start having multiple symptomatic cases at a facility that hasn’t had them, we may lock down for 48 or 72 hours to do a full cleaning of the facility, but that’s it,” he said.
When there’s a positive case at a prison, that person — and anyone the prisoner came in contact with — is placed in so-called enhanced quarantine, meaning only one cell is allowed out at a time, and only for between 45 minutes and an hour a day.
The Corrections Department has also recently started testing sewage at each facility using an antigen test designed to detect virus levels in wastewater. COVID-19 can be shed in the feces of infected individuals who are symptomatic or asymptomatic.
Staffers who test positive will be out for at least two weeks and must be asymptomatic before they can return to work.
“It’s a handful,” said Wetzel. “The reality of COVID is that it’s an outside-in threat and so whatever happens in the community eventually is going to happen to us. Our hope and our framing is to delay it as long as possible.”
Richard Marra, 57, is serving a life sentence for first-degree murder at SCI Chester. He was convicted of fatally shooting Michael Ragno during a fight at a Philadelphia nightclub in January 1986.
The Delaware County facility has 24 active cases within the incarcerated population and 86 among staff. Despite the rise in infections, Marra praised the administration’s response, adding that he’s more worried about his family on the outside than what may happen to him on the inside.
“We can’t de-stress by working out or going for a run. We can’t talk to that friend who always got us through a tough spot. But we learn to adapt. We have to,” Marra said in an email.
With COVID-19 cases on the rise in Philadelphia and across the country, many people are changing their Thanksgiving plans. A holiday that may have been spent with family and friends, for many this year, is a thing of the past. This year many people are choosing to stay safer home. Mental health professionals said this new “normal” can take a toll on a person’s mental health.
“I think for pre-COVID days, patients were a lot more concerned with the hustle and bustle of the holidays,” said Chimère G. Holmes, owner of Be Ye Renewed Counseling. “Now I find that because of COVID-19, people are just feeling bluer and pretty much discouraged at the fact that they’re not able to congregate under the same roof with their loved ones and spend the holidays together like before.”
She said just because things look different, that doesn’t mean that Thanksgiving has to totally canceled.
“We’re all less than thrilled with what’s going on around the world and with this virus, and how it’s kind of stunting the holiday season, but I think just acceptance is a huge component. The holidays are modified this year and it may feel peculiar but that doesn’t mean that we can’t have a nice celebration, even if it looks different in terms of not having face-to-face contact,” Holmes said.
The therapist said the key to surviving these pandemic holidays is reflection.
“Try to cultivate gratitude. I think that’s huge, being able to count your blessings. Think of three to five things that you’re grateful for. Thinking of things that remain intact and haven’t gone astray since COVID can definitely enlighten one’s mindset and put things in better perspective,” Holmes said.
Psychotherapist Tyra Gardner said now is the perfect time to embrace self-care, especially if this is your first time spending the holidays alone.
“If you’re doing things by yourself, try doing a lot more self-care during this time, as opposed to focusing on the issues that are currently happening. We definitely have to maintain our mental health as best as we can right now,” she said.
Gardner said having a person you can reach out to when things start to feel overwhelming can make a world of difference.
“Do things to take your mind off of what’s going on. Maybe that means talking on the phone to a friend. Find someone that is a calm person to talk to because everybody should have at least one safe person that they can go to. You want to find someone that you can rely on and talk to about some of the things that they have experienced, whether it is a friend or a religious figure,” she said.
Gardner said these are uncharted waters and suggested navigating them the best you can.
“When you look at the issues that we had in 2019 versus what we’re going through in 2020, it’s really amazing. Last year you were running from people. Now this year it’s like, OK, I need to be with the people that I’ve been running from for the past 10 years,” she said.
The psychotherapist said she hopes that people will learn from the difficulties of the past year.
“In 2020, all of our ‘normal’ holiday issues are now placed on the back burner because of this pandemic. People can really understand the meaning of these holidays, and hopefully start to begin to let go of trying to be perfect. Hopefully, they’ll get hindsight and understand the true meaning of happy holidays,” Gardner said.
The National Urban League and the Black Coalition Against COVID-19 hosted a virtual conversation with medical professionals Friday highlighting the need for equity in the national response to the pandemic.
The conversation came as coronavirus infections have surged locally and nationally.
“This is a serious crisis facing this nation with disproportionate burden on America’s Black communities,” NUL President Marc Morial said during the virtual media briefing.
“The cost to our communities is immeasurable.”
He noted that Black Americans are being infected with COVID-19 at three times the rate of whites. In Philadelphia, Blacks account for 52.9% of coronavirus hospitalizations and 49% of deaths from the virus.
Morial said decisions about the development and approval of a global vaccine should be made in close consultation with the Black medical community. He said people with underlying conditions such as cancer and sickle cell disease should be given priority for receiving a vaccine and that vaccine distribution sites should be located within the hardest-hit communities.
To help build confidence around the vaccine development process, the NUL and the Black Coalition Against COVID-19 have partnered with Meharry Medical College, Howard University College of Medicine, Morehouse School of Medicine and Charles R. Drew University of Medicine and Science, along with the National Medical Association, National Black Nurses Association and BlackDoctor.org.
Moderna and Pfizer Inc. are on track to apply for emergency use authorization of their vaccines within the U.S.
Dr. Wayne A.I. Frederick, president of Howard University, said caution must used when interpreting the results of Moderna and Pfizer’s clinical trials.
“We have to be very careful when we try to interpret these results that we don’t get ahead of ourselves,” he said.
“People who got the vaccine did not contract COVID at the same rate, but we don’t know if all participants were exposed to COVID at the same level.”
Frederick also spoke about African Americans having a distrust of vaccine development.
“The mistrust that exists in our country today is a mistrust of institutions — our government institutions, law enforcement, etc.,” he said.
“So it spreads across our community and what we must do is to make sure that we as Black health professionals are at the front of bringing the story to our community, and making sure they can feel confident when we do say that a vaccine is available.”
Dr. Valerie Montgomery Rice, Morehouse School of Medicine president, said 14% of the Moderna and Pfizer trial participants were people of color.
“We believe that there has been good representation of people of color in the trials, which we think is critically important,” said Montgomery Rice, who serves on a COVID-19 National Institutes of Health panel with other African-American scientists.
“We have the opportunity to look at many of the trials and actually opine on the information that was going to be in consent forms and how the information was going to be marketed to the public.”
She highlighted the importance of African-American participation in clinical trials for a vaccine. The nation’s four historically Black medical colleges and universities are COVID-19 clinical trial sites.
“We want people of color to participate and we must participate,” Montgomery Rice said.
“The reason why I say this to people is because we don’t want any gap in the data. That’s why we need diversity in a clinical trial because during this phase you can see those unanticipated side effects and then have a plan of action for them.”
During the briefing, physicians addressed topics ranging from access to coronavirus testing to health disparities and challenges faced by front-line health care workers such as burnout.
“There is an urgency in regards to meeting these problems with appropriate resources,” said Dr. Leon McDougle, president of the National Medical Association.
“When you look at the national lack of leadership and a 50-state strategy that is uncoordinated, it affects our population the most. Our physicians, nurses and pharmacies — we’re on the frontline — making it very critical that we not only participate in clinical trials but we also have access to safe and effective vaccines that are developed.”
Dr. Martha Dawson, president of the National Black Nurses Association, said some nurses in hospitals are having to make critical decisions with other medical personal about who gets access to ventilators.
“I was talking to a young nurse earlier this week who shared with me that her hospital had already started the protocol to make a decision as [to] how they are going to determine which patients will be placed on a ventilator and which patients will not be given a ventilator — based on a preexisting condition [and] the likelihood that they are going to survive,” she said.
Montgomery Rice addressed the link between social determinants of health and the higher rates of coronavirus in African Americans.
“When you think about this disease we have to make sure everyone understands that your race is not the risk factor,” she said.
Rice said those who are disproportionately burdened with the coronavirus are front-line workers, essential health workers, people who live in ZIP codes where they don’t have access to optimal health care, and people in multi-generational households.
“What we want people to understand is, it is those social determinants that are influencing the outcomes,” she said.
As Philadelphia enters a new phase of the novel coronavirus pandemic, the virus will continue to disproportionately affect African-American residents.
Stricter coronavirus restrictions went into effect Friday in the city to combat a surge in COVID-19 cases and hospitalizations. The spread of the respiratory virus, as well as the flu, will be fueled by colder weather.
Health Commissioner Thomas Farley said this week it was “unlikely that we’re going to have this problem solved by Jan. 1,” referring to rising case counts that led to the additional restrictions.
Yet eight months after the first COVID-19 case was reported in Philadelphia, Black residents face the same health care-related challenges that led to the virus hitting them hardest, said Dr. Delana Wardlaw, a family medicine physician for two decades.
A lack of access to quality health care, chronic health conditions, putting off preventative care during the pandemic, and systemic racism remain key drivers for why African Americans are disproportionately affected by the disease, Wardlaw said.
“All those things that existed before the pandemic are still allowing African Americans to have disproportionate rates of COVID-19 infections and complications.”
The U.S. Centers for Disease Control and Prevention is urging Americans to stay at home this Thanksgiving and celebrate with only household members to stop the spread of the virus.
“Gatherings with family and friends who do not live with you can increase the chances of getting or spreading COVID-19 or the flu,” the CDC says on its website.
Dr. Anthony Fauci, the country’s top infectious disease specialist, told The New York Times during the week that “December, January and early February are going to be terribly painful months.”
Philadelphia logged 1,054 new COVID-19 cases on Friday, bringing the total confirmed cases to 58,291, and seven new virus-related deaths increased the total to 1,952.
Philadelphia hospitals were treating 602 patients with COVID-19, including 60 on ventilators on Friday.
African-American Philadelphians account for the most COVID-19 cases (35%), hospitalizations (52.9%) and deaths (49%), according to city data.
Those trends for Black Philadelphians won’t change, said James Garrow, a spokesman for the city’s Department of Public Health, in an email Friday.
“It is a fact that African-American people in Philadelphia are more vulnerable from COVID-19 and this disease hasn’t changed,” Garrow said.
The city did not have the resources to adequately conduct contact tracing in neighborhoods where spikes occur, Farley said this week.
“We don’t have, though, the staff to go into those neighborhoods when they light up and do all the contact tracing,” Farley said. “There’s just too many cases right now.”
Those limitations contributed to the city banning indoor dining at restaurants, placing limits on gatherings, and closing gyms, libraries and museums — collectively known as Safer at Home guidance.
Dr. Ala Stanford, a pediatric surgeon who heads the Black Doctors COVID-19 Consortium, said African-American communities need more access to testing and contact tracing as conditions that allowed the virus to spread in those areas remain unchanged.
“The only thing now is that there’s more of it around,” Stanford said, referring to COVID-19.
Stanford has operated free COVID-19 testing at pop-up sites for months through a grant with the city, focusing primarily on Black and brown neighborhoods. Demand has never been higher, which has caused people from outside those communities — including from New Jersey — to seek testing there, she said.
“I know when we show to test and there’s BMWs and Land Rovers and Teslas in the parking lot, OK, that it’s changing,” Stanford said.
Stanford warned that not everyone who needs a test can receive one and that barriers to accessing testing remain, including some sites requiring a physician referral.
While city officials monitor various metrics, such as virus-related hospitalizations and deaths, they have not set thresholds that will trigger further restrictions, Garrow said.
“We are looking at trends, and right now the trend looks bad, so we’ve started implementing the Safer at Home guidance,” Garrow said.
Whether the Kenney administration reimposes another full stay-at-home order will depend on residents following the restrictions, Garrow said.
“We don’t want to go back to a stay-at-home order like in the spring and feel that, if everyone does their part, we won’t need to,” Garrow said. “But, yes, it’s an option.”
Wardlaw, who practices medicine at Temple Physicians Inc. in Nicetown, said more coronavirus restrictions could be implemented incrementally in Philadelphia as health officials gauge how effective current limitations are.
Wardlaw was cautious about whether new coronavirus restrictions were a prelude to a full shutdown.
“It all depends on how the numbers respond to this current shutdown,” Wardlaw said. “If the data shows the numbers are continuing to increase, then, yeah, that will likely lead to a larger shutdown.”