Latest News

On December 21, 2020, Chicago Appleseed, the Chicago Council of Lawyers, the Coalition to End Money Bond, and over 60 other community-based organizations throughout Illinois sent a letter to Dr. Ngozi Ezike, Director of the Illinois Department of Public Health (IDPH), requesting that people incarcerated in jails, prisons, or other detention facilities in Illinois be given priority access to the COVID-19 vaccine.

Data shows that detained people are amongst the most vulnerable in terms of contracting and dying from COVID-19. However, the “COVID-19 Vaccination Plan” released by IDPH on December 4 does not indicate the priority status of people living or working in corrections facilities across Illinois. To protect the health of everyone living in Illinois, we must treat these individuals with the same urgency in the vaccination rollout plan as people in other long-term congregate settings. Click here to access the full letter (including references) or read it below.

---

December 21, 2020

Dear Dr. Ezike:

We are grateful for the leadership that IDPH continues to provide during the COVID-19 pandemic. We write today to ask that you ensure incarcerated people are given priority access to the COVID-19 vaccine. Across the United States and specifically in Illinois, data has shown that incarcerated individuals are among the populations most vulnerable to be infected with and die from COVID-19. The Illinois Department of Public Health (“IDPH”) has already recognized this vulnerability in your planning documents, and we applaud this recognition. The “COVID19 Vaccination Plan” released by IDPH on December 4, 2020, however, indicates that the priority status of incarcerated individuals and corrections staff has not yet been determined and may be within Phase 2 or even Phase 3. We urge IDPH to follow the recommendations of nationally renowned public health experts and prioritize all incarcerated individuals and the staff who come in contact with them as part of Phase 1a for the COVID-19 vaccine rollout plan—treating them with the same urgency as people in other long-term congregate settings.

In the above-mentioned COVID-19 Vaccination Plan, IDPH notes that it has adopted the equitable framework developed by the National Academies of Sciences, Engineering, and Medicine (NASEM) in regards to which populations will receive the COVID-19 vaccine first. IDPH also noted in your plan that the status of priority populations is subject to change as more is learned about the vaccine and affected populations. We ask that IDPH acknowledge the high risk of COVID-19 exposure for people living in all forms of state custody and the staff who work with them and prioritize them for vaccinations. This includes people in the Illinois Department of Corrections (IDOC), Illinois Department of Juvenile Justice (IDJJ), county jails and juvenile detention centers (including those detained as part of immigration proceedings), the federal Metropolitan Correctional Center, locked treatment and detention facilities, and developmental and mental health centers operated by the state. People and staff in these congregate environments should have the choice to receive the vaccine at the same time as nursing home residents and others living in places where social distancing is difficult or impossible.

When the Centers for Disease Control and Prevention (CDC) recommended the prioritization of long-term care residents, they did so based on science and research. Prioritizing those residents is scientifically supported, implementation is feasible, and the choice aligns with the CDC’s ethical values of (1) maximizing benefits and mitigating harms, (2) promoting justice, and (3) reducing health inequities. Health experts from around the country have noted that this same rationale applies to incarcerated people. Indeed, the ethical and equity concerns are even more pressing for incarcerated individuals than they are for residents of long-term care facilities given that they are disproportionately people of color and disproportionately subject to medical vulnerabilities compared to the general population.

Health experts have been unanimous in their calls for the prioritization of incarcerated people in COVID-19 vaccination programs. The American Medical Association published a statement calling for vaccinations for incarcerated people to be included “in the initial phases of distribution.” The Johns Hopkins Center for Human Rights and Public Health published an open letter that has hundreds of signatories from medical and public health experts across the nation, urging that “people in carceral systems receive the same priority for receipt of a vaccine as both their peers in other congregate settings, such as long-term care facilities, and staff working in the facilities in which they are housed.” On December 16, public health experts from seven nationally renowned universities (Brown, Columbia, Harvard, UNC-Chapel Hill, UCLA, University of California-San Francisco, and Yale) published a research paper strongly recommending that states “prioritize vaccine distribution to all incarcerated people at the same stage as corrections officers (essential workers/first responders) or higher.”

According to the National Commission on COVID-19 and Criminal Justice, people in jail or prison are four times as likely to be infected with coronavirus as the general population and twice as likely to die from the infection. Jails and prisons are known to spread contagious diseases quickly since individuals are confined to close quarters, are unable to social distance, have little to no access to personal protective equipment, and lack easy access to hygiene products. In Illinois prisons, 13.5% of incarcerated people are 55 and over, and thousands of people who are vulnerable to COVID-19 because of age or health conditions are also detained in jails across the state.

Experts also urge states to recognize the unique challenges of vaccine distribution in custodial settings and to draw on the expertise of medical and public health officials familiar with these systems, and on incarcerated people themselves, to determine how to most effectively distribute the vaccine. These experts emphasize that in many states, prisons and jails have consistently been left out of COVID-19 response plans, leading to shortages in PPE, tests, and basic sanitation supplies, while other institutions in the state were better resourced. We cannot let this disparate treatment happen again.

The lives of incarcerated people are just as important as other people’s lives. But unlike many other people, they are fully dependent on the state to provide them with health care—in this case, life-saving healthcare—and to protect them from exposure and harm that they cannot control. Incarcerated people in Illinois have already fallen victim to some of the worst suffering caused by the pandemic. The state must not neglect its duty to provide adequate health resources to those in its care during the vaccine rollout process.

In addition to the dangers to people inside, jails and prisons are also significant contributors to community spread of COVID. Illinois is infamous for the damage caused by inaction during the first wave of COVID-19 outbreaks in prisons and jails—particularly the one at Cook County Jail last spring. Cook County Jail (CCJ) is one of the largest single-site jails in the country, detaining over 5,500 people as of December 17, 2020. In April, the jail was named the “top U.S. hot spot” for COVID-19 cases by The New York Times. Not only did the CCJ outbreak lead to seven deaths and dozens of hospitalizations, it also exacerbated community transmission—especially in communities of color. A study in the Journal of Health Affairs by Harvard and University of Chicago researchers found that one in six cases in Chicago could be tied back to the outbreak at Cook County Jail. A report released this week estimates that incarceration added over 500,000 additional infections nationally during summer 2020 alone. By providing incarcerated people and staff priority access to the COVID-19 vaccine, we can go a long way toward protecting the public health of everyone in Illinois.

Guards and other staff are the primary pathways for the virus to enter facilities, and once the virus hits the general population in jails and prisons, it is impossible to contain. In Cook County Jail, only 38% of people are housed in single cells. The rest are either double-celled or in dormitory settings with shared bathrooms and other facilities. Social distancing and other methods of decreasing transmission are simply not possible or effective in a congregate setting like a jail or prison. Currently, there are more people confirmed positive for COVID-19 (350 people) in Cook County Jail than at the height of the pandemic in the spring (307 people). Since March, eight people in the custody of Cook County Jail have died from COVID-19.

Isolation is the default infection prevention protocol inside custodial facilities. While people who are incarcerated await vaccination, they do so largely in solitary confinement like conditions (via quarantines and lockdowns) that put them at heightened mental health risk. People with mental health conditions are overrepresented in jails and prisons, and the impact of isolation is particularly severe on them. Confinement until the vaccine is available is also especially injurious for adolescents in custody.

In Illinois prisons, the number of infections are already staggering. There are over 1,200 imprisoned people who are currently positive for COVID-19, along with over 400 staff members. Since the IDOC began publicly releasing data, the positivity rate for prisoners is 17.6%, higher than the general population in any of Illinois’ 11 regions. Overall, almost 6,000 imprisoned people and over 3,000 staff have contracted COVID since March. Dozens of incarcerated people have died from contracting the virus in prisons, far from their homes, families, and communities. Even more concerning as a matter of public health is the fact that our prisons are mostly located in small downstate towns that lack the healthcare capacity to handle a major outbreak. When there was a major outbreak in Stateville, the National Guard had to be called in to handle the surge in cases. As we vaccinate the country, offering the vaccine to incarcerated individuals and staff members first can help avoid major shortages of hospital beds in small communities with prisons and jails nearby.

For Illinois to continue to be a national leader in containing the pandemic, we must distribute the COVID-19 vaccine equitably and strategically. That requires including incarcerated people in the first round. Six states (Connecticut, Delaware, Massachusetts, Nebraska, Maryland, and New Mexico) have already explicitly included incarcerated people and the staff that work with them in Phase 1 of their vaccine rollout plans.26 Given Illinois’ particularly dangerous experience with COVID-19 outbreaks in jails and prisons in the spring and now, it is vital to update Phase 1a of IDPH’s vaccination rollout plan to include incarcerated individuals. Vaccinations of staff will not be enough to stop the spread of COVID-19 in correctional facilities. COVID-19 outbreaks are currently raging through our prisons and jails; it is imperative as a matter of fundamental human rights that we protect the lives of vulnerable individuals, whom the state has sentenced to serve time in these facilities, by offering them the option of COVID-19 vaccination as soon as possible.

The signatories of this letter urge the Illinois Department of Public Health to assign incarcerated individuals and corrections staff to Phase 1a of its vaccine rollout plan, so that we can avoid the unnecessary loss of life that will continue if outbreaks in jails and prisons are not immediately addressed. Thank you for your consideration.

Sincerely,