Since the beginning of April, Louisiana has tested about 10 percent of the state inmates that reside in the state prison system for COVID-19, and over 40 percent of the prisoners tested have been positive for the virus, according to data provided by the state Department of Corrections Thursday.
Since the beginning of the pandemic, Louisiana has boasted about being able to contain the coronavirus relatively well within its prison system. It’s had relatively few deaths overall – 16 inmates and three staff members — in its eight facilities over the last few months.
But the data released this week indicates Louisiana isn’t doing nearly enough COVID-19 testing to know what the scope of the prison system’s outbreak might be, public health experts said. The rate of positive tests in prisons is far higher than would be tolerated in the wider Louisiana community. In the general population, state health officials are hoping to keep the positive test rate to under 10 percent.
Louisiana also has little idea about what’s happening with state inmates and detainees housed outside its prison system. The state isn’t tracking coronavirus testing in local jails, though the Department of Corrections houses more than half of the 31,000 state prisoners in those facilities.
Tracking infections in incarcerated settings has become more important, as the nation’s largest coronavirus hotspots have moved from nursing homes and meatpacking facilities to correctional facilities — almost exclusively. Nine of the top 10 largest coronavirus clusters in the country are now prisons or jails, according to a New York Times analysis.
Large outbreaks in correctional facilities can also affect the spread of the virus in the general community, according to recent health care studies. That should be of particular concern to Louisiana, which has the largest prison population per capita in the world.
“While people tend to think that prisoners are hived off in the community, that is not the case,” said Chris Beyrer, a public health and human rights specialist at Johns Hopkins University.
Louisiana prison testing is not as widespread as recommended
As of July 5, Louisiana had tested 1,529 of its approximately 15,000 inmates living in the state prison system, according to information provided by the Department of Corrections. About 640 people — 42 percent of inmates tested — tested positive for COVID-19.
The extent of the testing and percentage of positive cases varies widely from prison to prison. The state tested its women prisoners en masse this spring. Those inmates are housed in temporary facilities because their permanent prison hasn’t been inhabitable since a massive flood in 2016. The women inmates have had the highest positivity rates of any prison cohort. Seventy-five percent of them have tested positive over the past three months.
But some of the men’s prisons have had extremely high positive test rates as well, although their testing in those prisons has been less extensive. Both Rayburn Correctional Center and Raymond LaBorde Correctional Center had positive test rates of around 60 percent, according to data provided by the Department of Corrections. But both facilities also appear to be testing far fewer than 10 percent of their inmates.
Beyrer says that the average positivity rate of Louisiana prison testing makes it clear the system doesn’t have a good idea how widespread the coronavirus is within its facilities.
“If you have 40 percent positive testing, you are not doing anywhere near enough testing,” he said. “That means for the most part, you are only testing people who are symptomatic.”
The state should test every prisoner and staff member initially to get a better idea of how infected the population is with coronavirus, Beyrer said. Then, it should follow up with more testing at regular intervals to make sure it’s aware of any new outbreak, he said.
Beyrer’s suggestion echoes some recommendations made this week by the U.S. Centers for Disease Control. The public health agency is urging all jails and prisons to do baseline testing of its current inmate population and to test all new arrivals.
That’s because people who do not have symptoms can still carry coronavirus and spread it to others. In a communal living situation like a jail or prison, that spread can happen very quickly. The Centers for Disease Control announced that conclusion after it conducted serial testing in an unnamed Louisiana prison in May.
“Prompt detection and isolation of cases through serial testing might reduce further exposure within the congregate living environment and outside community,” the study says.
But the Department of Corrections says its positive test rate may be high because, for weeks earlier on in the pandemic, the Centers for Disease Control and state health officials only recommended they test people exhibiting symptoms, said Ken Pastorick, spokesman for the corrections department. So for several weeks, they were only testing people who were likely to be infected, he said, and they didn’t have enough testing to do anything more extensive.
More recently, Louisiana has started testing some asymptomatic prisoners, Pastorick said, though it’s unclear if that’s being done across all of its facilities.
Hundreds of older inmates at Louisiana State Penitentiary — the country’s largest maximum security prison — have been subjected to widespread testing, including of asymptomatic people, Pastorick said. This prison is commonly referred to as Angola.
At one point, about 10 percent of a 350-person section of Angola for inmates who are senior citizens — called Camp F — tested positive for coronavirus, but the outbreak has cleared up, Pastorick said. There have been no positive tests in Camp F for three weeks and the prisoners returned to their jobs this week, he said.
The state has also started doing widespread testing of Angola’s assisted-living areas. Pastorick said just one inmate out of 144 people in an assisted living dorm tested positive. The prison has moved on to testing other assisted-living areas recently.
“Based on the test-based strategy, one assisted living area has been cleared and we are waiting on the last round of testing to clear a second area. Earlier this week, we began testing another assisted living area,” Pastorick said.
The prison system is also testing staff, as Beyrer said it should, but it’s not clear to what extent that’s happening. The corrections department provided data that shows about a quarter of the staff has been tested, though most of those numbers reflect self-reporting from employees who are getting tests on their personal time, Pastorick said.
The overall positivity rate for the staff testing is high, around 18 percent. Beyrer said the corrections department should be testing its staff regularly to make sure they are not spreading the virus in the prison system. It cannot rely on its staff to personally test themselves and report the results to the agency.
“Prison staff are like health care workers and like nursing home staff, they have a lot of interactions,” with the inmates and the public, Beyrer said.
The prison system may not have the resources to test all of its inmates and staff as would be best practice. The Louisiana Department of Health gave the prison system 10,000 coronavirus test kits. That wouldn’t be enough tests to cover all the inmates and staff even once — let alone through more than one testing cycle.
When the populations of the prison system and staff are combined, it’s close to 19,900 people. And interval testing plans call for people to be tested multiple times. Those who test positive for COVID-19 also have to be tested multiple times before they can be confirmed as recovered.
Louisiana may not be meeting its own testing goals for jails and prisons
Louisiana incorporated jails and prisons into its statewide testing plan submitted to the federal government in late May. It laid out a goal of performing 15,500 tests on people in jails and prisons, as well as the staff that work there, in June. This month, the state was hoping to perform 20,500 tests on people detained and staff in jails and prisons, according to that public testing plan.
But it’s not clear if the testing goal will ever be met. The health department estimates about 48,000 people are held in a prison or a jail — or work as an employee at one. They are spread across 128 facilities, only eight of which are in the state prison system. The state is not tracking testing in any of the other facilities.
The bulk of those incarcerated settings are local jails under the control of sheriffs, over which the health department says it has no oversight. The federal government does not require testing in jails and prisons to be reported, as it does with nursing homes, said Alex Billioux, head of the state’s office of public health. That means it’s not being monitored by the state government.
Sheriffs are doing some testing. It’s just not clear how much. The health department supplies tests to some sheriffs through its local regional directors. The Louisiana Sheriffs Association did not return calls or emails seeking comment on whether it has a coordinated plan.
This past week, the state reported outbreaks in several other locations that it doesn’t have the responsibility of tracking– in bars, on university campuses and at weddings — in an effort to warn the public to stay away as much as possible. Billioux said potential prisons and jails are not necessarily as much of a concern.
“The difference is whether it’s a contained population where we can manage the exposure or if it’s a non-contained setting where we think there is a public health risk,” he said at a press conference Wednesday.
Still, Beyrer said there are examples in which major coronavirus outbreaks in corrections facilities have exacerbated coronavirus rates in the greater community.
A study in the journal Health Affairs found that one in six coronavirus cases in Chicago was associated with people moving in and out of the Cook County jail, one of the largest coronavirus clusters in the country in early days of the pandemic. And Beyrer said some of the first outbreaks in Wuhan, China — where coronavirus originated — took place in detention centers and were attributed to staff moving between the communities and their workplace.