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To: The Los Angeles Department of Health Services, Correctional Health Services, and the Local Health Officer

COVID-19: Los Angeles Must Immediately Release People from the County Jails!

We are writing as physicians, nurses, social workers, public health researchers, medical and public health students and other members of the health care community. We are writing urgently to ask that you prepare with utmost effort, coordination and speed for the enormity of the threat that COVID19 poses to your incarcerated patients, as well as to officers and your correctional health care colleagues.

There is no means of preparation as effective and therefore necessary and urgent as releasing incarcerated people from the jails, including but not limited to your medically vulnerable patients currently in the correctional settings. Correctional institutions are among the most dangerous places to be during a pandemic: the principle prevention and containment strategy of social distancing is straightforwardly impossible and the institutional prerogative of control will always supersede basic hygiene, access to care and the prevention of disease transmission. The long and ghastly history of epidemics in jails and prisons belies any notion that this moment will be different.

The only safe solution is to join other countries and counties around the U.S. in identifying and helping coordinate the release for as many incarcerated people as possible -- but especially those who we know are most medically vulnerable and most susceptible to serious consequences from COVID19 infection.

These groups include, but are not limited, to people age 55 and older, pregnant people, people with chronic lung conditions such as COPD, hepatitis C, HIV, diabetes mellitus, hypertension, and/or cardiac disease who will be most vulnerable to COVID19 infection. Epidemiological data shows that, once infected, these groups of people may suffer not only serious illness but death. Thus, in addition to the wider public health stakes of mitigating the epidemic’s spread in correctional institutions, we must have the clarity to state that it is absolutely unconscionable that these vulnerable groups of people could be exposed to conditions that precipitate their death as part of their punishment, in clear violation of the 8th Amendment.

As health care professionals and those charged with providing care under the mandate to do no harm, Correctional Health Services and the Department of Health Services cannot ignore its legal obligation to advocate for and facilitate the release of people currently being housed in the county jails. Section 26602 of the Government Code states that one of the duties of a Sheriff is that the Sheriff “may execute all orders of the local health officer issued for the purpose of preventing the spread of any contagious or communicable disease.” The “local health officer” is appointed by the Board of Supervisors (Health and Safety Code § 101000). Both DHS, CHS, and the Local health Officer should coordinate and immediately use their authority to begin releasing people in the jails. In addition, the Sheriff, under Rutherford vs. Block, is granted the authority to release people from the jails in order to address overcrowding and interruptions in the provision of services. Given that the jails are at least 4000 people above state capacity guidelines and given the rapid infection rate of COVID19, we urge you to implore the sheriff to use this authority widely and advocate for people to be released to their homes, shelters, or other forms of safe and meaningful housing.

Without immediate action, COVID19 will exacerbate the already untenable health crisis of criminalization and incarceration here in Los Angeles. LA operates the largest jail system in the world and manages facilities that are currently overpopulated by as much as 87%. Criminalization and incarceration disproportionately targets the poor and contributes to the overall worsening of those already in poor health: nearly half of the 17,000 people incarcerated on a given day have a chronic disease, approximately 1,000 have diabetes and approximately 500 have HIV. This crisis also distinctly burdens our Black and Latinx communities, who are disproportionately represented in the jail populations to a staggering degree. It must be noted that Black men and especially Black women, who are only 9% of the county’s population but who make up 33% of those booked into jail, have been particularly vulnerable to this repression.

Why is this important?

We are not alone in recognizing this crisis of criminalization and incarceration here in Los Angeles and how COVID19 will exacerbate that crisis. Last week, the Los Angeles County Board of Supervisors approved the recommendations outlined in the Alternatives to Incarceration Working Group’s historic and unprecedented report, “Care First, Jails Last: Health and Racial Justice Strategies for Safer Communities.” Shortly thereafter, Supervisor Mark Ridley Thomas published a letter outlining his concerns about COVID19’s spreads to the LA jails and calling for a reduction in jail bookings, early release, plans for quarantine and treatment, concerted efforts to reduce virus transmission and a plan for expected staffing shortages.

We are also not alone in calling for significant and timely steps towards decarceration. On Saturday, March 14, Judges from the Cleveland, Ohio’s Cuyahoga County Court announced their intention to seek the release of hundreds of people incarcerated in their county jails. Like us, these judges recognize that jails pose threats to our larger community and the incarcerated people themselves. On Tuesday, March 17, the New York City Board of Corrections, the independent oversight Board for the city’s jail system, issued a call for incarcerated people at high risk to be immediately released and for the overall jail population to be rapidly and drastically reduced. Also on Tuesday, March 17, thirty one elected prosecutors from around the country, but not from Los Angeles, published a letter advocating that counties “implement concrete steps in the near-term to dramatically reduce the number of incarcerated individuals” to prevent the potentially “catastrophic” spread of COVID19.

We also join epidemiologists in warning that it is not a matter of if COVID19 enters your facility -- but when. For these reasons, we demand that you, as correctional health care leaders, do your part. We ask that you:

1) Prepare a list of your incarcerated patients who are most medically vulnerable and who require immediate release. We demand that you prepare that list within one week, notify the public that the list has been made available to correctional authorities, the courts and city/state leaders, and advocate for their early release with linkages to housing and healthcare services.

2) Use the legal authority granted to you to declare COVDI19 a liable danger to those currently held in the county jails and advocate for their immediate release to safe and meaningful housing.

3) Identify, coordinate and provide the services incarcerated people need upon their release (e.g. HIV care for those who are HIV+, substance use treatment centers for those with substance use disorders, homes and shelters for those who are houseless, etc) to ensure their ongoing protection from this epidemic. The County should use the recently approved recommendations from the Alternatives to Incarceration Working Group to build infrastructure that addresses and also outlives this emergency to achieve our shared goal of reducing the jail population.
Los Angeles, CA, USA

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2020-03-20 17:16:58 -0700

1,000 signatures reached

2020-03-18 17:47:12 -0700

500 signatures reached

2020-03-18 09:12:08 -0700

100 signatures reached

2020-03-18 07:14:55 -0700

50 signatures reached

2020-03-17 22:41:21 -0700

25 signatures reached

2020-03-17 21:54:32 -0700

10 signatures reached