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Why Did a St. Louis Man Die in a Federal Prison Coronavirus Hotspot? 

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Derrick Howard's death has opened a rare window into a prison medical-care system that is widely criticized for its lack of transparency and systemwide failures to protect inmates and staff from COVID-19 — conditions that public health experts say pose a catastrophic health menace both inside and outside the nation's jail and prison walls.

The BOP's failures and shortcomings echo similar problems in state prison and local jail systems nationwide. And even though prisons and jails are some of the worst coronavirus hot spots in the nation, the effort to roll out vaccines to inmates has become mired in partisan politics and bad science. The problems are exacerbated by a punitive philosophy that sorely contradicts the warnings of public health experts.

"There is a general attitude of, 'If you don't want to be exposed to those things, then you should never have done whatever criminal activity you did,'" says Maria Morris, director of the American Civil Liberties Union's National Prison Project.

From a human rights perspective, the governments that run prisons have a duty to protect people in their care and to provide adequate medical care. But even aside from that obligation, public health experts point out it just makes sense from a medical perspective to take an especially aggressive approach to treating COVID-19 in prison, including the rollout of vaccines, because doing so does a great deal to prevent the spread of the virus and protect communities outside jails and prisons.

Inmates moving in and out of prisons and jails serve as highly efficient vectors for infectious diseases of all kinds, especially a virus and its variants that have so far killed more than 540,000 Americans.

Prisoners live in crowded conditions, have little control over what precautions they can take, and share the same toilets and personal spaces. In low-security settings, those spaces are usually open bays, with no barriers separating dozens of inmates sleeping in the same rooms.

What's more, inmates are constantly back and forth into their communities as sentences begin and end, or they are transferred to county and city jails awaiting trial, or moved to new facilities across the country, as was Howard's fate.

And of course inmates come into close contact with prison staff and corrections staff, who go home after their shifts end and can spread COVID-19 to family and friends.

For these reasons, a December editorial in the newsletter of the Harvard T.H. Chan School of Health called for the federal and state prison systems to make inmates a priority when it comes to administering the new COVID-19 vaccines.

"Prioritizing incarcerated and detained individuals with COVID-19 vaccinations is the smart public health strategy," according to the editorial's authors.

In the meantime, inmates must try to survive a prison health-care system that is erratic at best, according to Dave Fields.

Fields spent 22 years in federal prisons after being convicted on charges of possessing and selling crack cocaine.

"They don't deal with people's health problems at all," Fields says of BOP medical care.

The 48-year-old served part of his sentence with Howard at a federal prison in Florida before successfully appealing his conviction and winning release in 2017. He credits Howard with helping him regain his freedom, describing Howard as a good friend with a strong sense of humor and a sharp mind.

When Fields was working on the research to challenge his drug conviction, Howard's knowledge of the legal system proved invaluable, Fields recalls.

"He'd say, 'I happened to come across this case. Check it out,'" Fields says. "Nine times out of ten, he'd be on point."

Howard also possessed a keen sense of humor, which is an essential trait for surviving in prison, according to Fields.

"If you were standing in line, he'd be the one to tell you a story to make you laugh," Fields says. "He'd always be telling you a story about his family. I learned a lot from him."

Fields was saddened to hear of his old friend's death, but he was not shocked when he learned that Howard had gotten sick from COVID-19.

"If you get seriously sick in prison," he says, "you're not going to make it."

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