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Recently news emerged that over at a single Ohio Correctional facility and of inmates in North Carolina tested positive for COVID-19. While COVID-19 cases across the U.S. increased twofold over the last month, the corresponding rate of increase in state and federal prisons is several times higher.

As a professor of justice administration I have been tracking the positive COVID-19 cases in state and federal prisons nationwide, and we are not just looking at a public health problem, but a matter of human rights.

For a variety of reasons, the data available are incomplete. In early April only 32 state departments of corrections made the number of positive COVID-19 cases publicly available on their websites.

Now that number has increased to 45 states. Yet each state still decides what type of data and the frequency with which they provide the public with this information.

Based largely on self-reported data from each state, on April 9 there were 1,175 state and 318 federal inmates with COVID-19; a total of 1,493 across the U.S. Over a month later on May 13 there were 21,032 state and 4,173 federal inmates with COVID-19 for a total of 25,505 nationally.

This is an increase of over 1,608% or 16 times compared to less than three times the national rate. As you can see, COVID-19 is growing much faster in prisons than among the general population.

To date Hawaii has largely been spared, but public health experts have warned about a second wave of COVID-19 infections. We must be ready when that happens.

While these numbers are staggering, the true rate of COVID-19 in prisons is unknown due to lax testing.

Overcrowding And Disease

Few prisons have undertaken wide-spread testing. Those that have found up to were asymptomatic suggesting that the positive cases are actually much higher than reported.

Hawaii Corrections Division has only conducted , including the facility in Arizona, a state that is experiencing an outbreak.

Overcrowding contributes to the spread of the disease. As of May 14 Oahu Community Correctional Center was still over capacity. Yet, even at its design capacity social distancing is nearly impossible due to the size of each cell. Hawaii must do a better job of housing inmates in a way that allows for social distancing.

Policies and procedures around access to health care, availability of hygiene products, and even cell size vary by state. Hawaii, for example, still requires co-pays for inmate clinic visits, except for respiratory issues during this pandemic, disincentivizing wellness visits and visits for things that appear to be minor, but could turn serious.

Clean linens are often rationed to prevent inmates from fashioning ropes or other non-approved items, soaps and other hygienic products must often be purchased from the commissary, and personal protective equipment is often locked away to prevent theft, making them difficult to access.

Along with long-standing underfunding of corrections, the slow response of administration to stem the spread of COVID-19 indicates, at worst, a lack of value for human life, and at best, exposes the lack of a rapid response system for outbreaks. Hawaii Corrections Division needs to revise its pandemic policies before it is too late.

While most of the country was operating under strict stay-at-home orders many inmates continued to work in factory-type settings. In some cases, like Mississippi, inmates are for others. Well after the pandemic started Wyoming had inmates working overtime to to issue to staff and inmates in their facilities.

Solutions are not beyond us. The American Civil Liberties Union recommends targeted release of low-risk older, immune-compromised prisoners and those within six months of their release date. At a minimum, Hawaii must reduce the number of incarcerated individuals to each facility’s design capacity, if not lower, to allow for single occupancy of sick inmates.

The only way to get a full picture of the risk of COVID-19 infections in the prisons is to provide testing, regardless of whether inmates are showing symptoms. Some facilities are conducting 100 percent testing of inmates and staff; though sadly in each case this occurred only after an outbreak.

Hawaii should adopt a broad testing policy. At a minimum, all inmates should be tested upon entry and prior to release, as these individuals have the potential to expose either the prison population and the community, respectively.

Hawaii should adopt a broad testing policy.

If this pandemic has shown us anything it is that public health is a component of security. Our state needs to be in front of this issue and make the changes necessary to protect staff, inmates, and the public.

America has been playing Russian roulette with prisoner health for decades. When the COVID-19 pandemic emerged the bullet entered the barrel of the gun. It is now pressed against the temples of 2.3 million prisoners and hundreds of thousands of prison staff.

While there are no perfect solutions, it is time to agree that our nation’s corrections system cannot ignore the public health of its staff and prisoners. Right now, we most certainly are.