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How Fresno County Jail Neglected COVID-19 Data Reporting Throughout the Pandemic

July 29, 2021

In February of this year Fresno County Jail (FCJ) made national headlines. As of February 1, nearly eleven months into the pandemic, the jail had reported more COVID-19 infections than any correctional facility in the nation.

Jail officials attempted to explain the number of infections, which totaled 3,814, by highlighting rigorous testing at the facility. “We’ve been really aggressive with our testing at the Fresno County Jail,” stated Fresno County Sheriff Margaret Mims.

However, for observers monitoring COVID-19 data in California’s prisons and jails, this was news. For months FCJ had scarcely reported any numbers to the media or state agencies. This lack of transparency was concerning and cast doubt on how the institution was handling the pandemic.

Accurate data is a valuable tool in fighting the pandemic when the consequences can be deadly. As of January 2021, FCJ is the only county jail in Northern California that has reported a COVID-related death.

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“It Stirs Up Hysteria When Things Become So Data Driven”

According to Fresno County Public Defender Elizabeth Diaz, the Sheriff’s Office provides her office with information about COVID-19 cases at FCJ, however only when prompted. “We ask the question and we get the answers. It’s not necessarily forthcoming,” explained Diaz to KQED last August.

For the Covid In-Custody Project and other observers, access to regular data has been a struggle throughout the pandemic.

Fresno County Sheriff’s Office Public Information Officer Tony Botti was blunt when explaining why data was not forthcoming. “It stirs up hysteria when things become so data driven.” wrote Botti in a July 21 memo.

This contrasts dramatically with the advice of medical professionals and public health experts. According to Dr. Brie Williams, Professor of Medicine at the University of California San Francisco, “Without accurate, timely and comprehensive data about the impact of COVID-19 in prisons, we are at an extraordinary disadvantage in the fight to keep people who live or work in prisons and their surrounding communities safe from the pandemic.”

Unlike California’s prisons, which are all overseen by the California Department of Corrections (CDCR), California’s jails are run by the Sheriff’s Office of the county in which they reside. Data reporting is at the discretion of the local Sheriff— there is no statewide mandate for Sheriff’s Offices to report cases, testing, vaccination rates, etc. for their jails.

While the California Department of Public Health (CDPH) collects information from the counties through the California Reportable Disease Information Exchange (CalREDIE), they do not publish it because it is unreliable and incomplete.

In July 2020, the Board of State and Community Corrections (BSCC) made an urgent request to the Sheriffs and Chief Probation Officers to provide facility level COVID-19 data directly to them. While some Sheriffs chose to honor BSCC’s request, many did not. Often the data that is provided is incomplete, erroneous and obscures the answer to a simple question like, “How many cases have been identified during the pandemic?”

Despite not having any data reporting requirements, several Bay Area counties have taken it upon themselves to be transparent. Since March 2020, Alameda County has published daily reports on the number of COVID-19 tests administered, positive cases as well as the number of people incarcerated at Santa Rita Jail.

Both San Francisco and Santa Clara counties have followed suit and share regular data with the public through the county website.

Clearly, when there is a desire to make data available to the public, jails are able to do so. As Dr. Williams stated, data is vital to not only understanding the spread of the virus in the facility, but also in the surrounding community and developing public health interventions.

To mitigate the impact of the virus, most county jails instituted some measures to reduce the jail population. In Fresno and other counties, zero bail and cite and release policies were enacted.

While some counties recorded a dip in the jail population during Spring and Summer of 2020 due to these policies, their effect in Fresno County is unknown; The Fresno County Sheriff’s Office did not report its population for this period.

In fact, since Fresno began reporting its population numbers the incarcerated population has only risen. In its first report to the BSCC on August 1, 2020, the total jail population was 2,055. As of July 15, there are 2,754 people in custody.

The BSCC Data

On July 27, 2020, the BSCC began publishing COVID-19 jail data on its website.

In addition to data reporting being voluntary, the BSCC also has no way to verify the validity or correctness of the reported numbers. In their own words, “we rely on the counties to provide accurate data as the BSCC does not have audit authority.

”Fresno County’s data reported to the BSCC has been incomplete, unnecessarily vague and lacks key data points. There is no data reported for the number of people quarantine, active cases, or any vaccination data.

If the number of confirmed cases is less than 11 for a reporting period, the exact number is not reported at all, it is simply acknowledged that there are active cases at the facility. The BSCC states that this is in accordance with public health de-identification guidelines in order to protect the identity of those tested.

However, this makes the data unusable for statistical purposes. “Since the actual values are not available, data across counties cannot be summed to obtain statewide totals. Similarly, cumulative totals within a country are not calculated,” the BSCC stated in their “COVID-19 in Adult Detention Facilities Data Reporting Guide”.

While the Covid In-Custody Project has used this data to obtain a rough estimate of COVID-19 cases in Fresno County’s jails, it is incomplete. Furthermore, the data does not cover several of the most deadly months of the pandemic.

When the Fresno Sheriff’s Office began reporting numbers to the BSCC on July 27, 2020, the jails were already in the midst of an outbreak that had begun in June, when a large group of transfers to CDCR were found to be positive for COVID-19.

On July 20, 2020 Fresno Sheriff Margaret Mims told The Fresno Bee that as of the previous Friday, July 17, there had been 764 positive COVID-19 cases at the facility, over 40 of which were correctional officers.

According to one person incarcerated at the jail, the virus was spreading throughout the facility long before Mims statement to the media. His entire 72-man pod was placed under quarantine on June 6. “My entire pod had it on the first quarantine…They left everyone there because they came and swabbed us all and we all tested positive.” he explained.

They would remain under quarantine for the next 39 days.

BSCC’s Missing Data

Without concrete data from FCJ for the worst months of the pandemic, the Covid In-Custody Project, has had to rely on statements made by jail officials to media outlets during June and July to estimate the extent of the outbreak. However, once the jail began reporting to the BSCC the data had glaring holes and inaccuracies.

Some weeks FCJ reported no data to the BSCC at all. These include:
September 6 – 12, 2020
December 27, 2020 – January 3, 2021 (missing number of positive tests)
June 6 – 12, 2021

The absence of data for these weeks is disconcerting particularly because they occur during massive outbreaks at the facility.

For the missing week in September, during the previous week, 45 out of the 132 tests administered had come back positive. The week after, September 13 – 19, there were no positive test results out of 522 tests administered.

The missing week which stretches from Dec. 2020 to Jan. 2021 is also disconcerting. This was in the middle of the most severe, and deadly, outbreak in the jail since the summer. Between December 20 – 26, there were 79 positive tests. The week after the missing data, on January 10, FCJ reported 33 positive tests.

Even more alarming, that week is when the jail reported a death at the facility due to COVID-complications. An email exchange with Botti confirmed that one individual had died but was evasive when pressed for details. “He was hospitalized and passed away during his stay.” explained the Officer.

Any follow-up questions regarding the dates of his incarceration, the dates he tested positive, or procedures surrounding hospitalization were ignored. Botti claimed that to divulge such information would be a violation of HIPAA laws. He advised filing an additional PRA request where the Sheriff’s Office would determine what information would need to be redacted.

While COVID-related deaths have occurred in jails in Los Angeles and Orange counties, the death reported on January 10 at FCJ is the only such instance at a facility in Northern California. Given the lack of transparency around COVID-19 data at the jail, the reticence of officials to explain the circumstances is not surprising, however it should be a cause for alarm.

Extreme Variations in Testing

In the data Fresno County has reported to the BSCC, there are extreme variations in weekly testing rates which casts doubt on the efficacy of the testing protocol.

For example, between August 30 – September 5, out of 132 tests administered, 45 came back positive. Two weeks later, the number of tests administered shot up to 522, but none were positive.

It seems unlikely that within a week FCJ could go from having 34 percent test positivity rate, to not having a single positive test result.

Particularly in the early weeks of data reporting, the number of tests administered showed no consistency. For example in August 2020, 114 tests were administered in a week and 721 in the next. Only in early 2021 did the testing rate stabilize to a consistent 300-400 tests per week.

Strangely in the midst of outbreaks, the number of tests administered has tended to fall. In the first week of December, FCJ reported less than 11 positive results out of 505 tests administered. By Chritmas, when the outbreak peaked, the jail had only administered 222 tests of which 79 came back positive.

Discrepancies Between BSCC Data and Media Reports

In several instances, the data reported by the Sheriff’s Office to the media and the BSCC do not align.

On September 24, 2020 Botti stated in an email to the Covid In-Custody Project that there had been a total of 3,921 tests administered at the facility since March 2020. However, the sum of testing data reported to the BSCC and obtained via data requests, it appears that as of September 19, 2020, only 4,186 tests were administered.

Similarly, on January 12 in a statement to The New York Times, Botti claimed the jail had 3,814 cases since the start of the pandemic and had administered an astonishing 34,000 tests. The sum of testing data reported to the BSCC shows that no more than 10,000 total were administered. The total number of positive test results by our estimate was 1,589.

Sheriff Mims, attempted to address these discrepancies after activist groups questioned the accuracy of the data FCJ was reporting to the BSCC. Mims claimed that although there were 3,814 positive test results in FCJ since the start of the pandemic, it does not equal the number of positive cases, since some individuals tested positive numerous times.

“During the beginning stages of the pandemic, once an inmate tested positive for COVID-19, the inmate was placed in quarantine housing. Inmates remained in quarantine housing until they had a subsequent negative covid test.” explained the Sheriff. “This resulted in inmates testing positive for a second and third time…It was relatively unknown at the time, but an inmate may continue to test positive for months, while no longer being contagious.”

According to Mims, the actual number of unique cases at FCJ between March 3, 2020, the date of the first case in the facility, and March 1, 2021 was 1,365.

While it is not unreasonable to conclude that the amount of positive test results does not equal the number of cases due to double testing, the Sheriff’s Office has provided no evidence as to how they arrived at the total of 1,365 cases.

FCJ has provided no rationale as to how they have administered 34,000 tests when the calculation shows that no more than 10,000 were given.

Public Records Request

When the numbers reported by the Fresno Sheriff’s Office to the BSCC appeared to be incomplete and inaccurate, the Covid In-Custody Project requested data from the jail under a Public Records Act (PRA) request.

Under state law, government institutions must supply interested parties with publicly available records upon request.A request was filed on January 4, 2021 to obtain data from the jail. The Covid In-Custody was met with reactions ranging from hostility to indifference from jail officials. While we requested ongoing updates on data coming from the jail, we were told each new week of testing would require a new PRA request.

According to the PRA law, once a request is filed the institution in question has 10 days to respond and confirm if the documents are available. Then, according to the California Public Utilities Commission, the request should be fulfilled in a “timely fashion.” Fresno County Jail did not fulfill its records request till May, a full five months after the data was first requested.

The data finally received were swab reports, which is the raw data the jail uses to report to the BSCC. The data is broken down by the three different buildings at the facility, and then subdivided into floors, and then each individual pod. There are five floors in the Main Jail, four in the North Jail, three in the South Jail, as well as the intake facility.

Each week the data is reported and the totals are broken down by the number of tests administered in a pod within the jail, those administered at intake, as well as the overall total.

The swab reports also include one data point not reported to BSCC; the number of refusals to take a COVID test.

Other data from the PRA request, such as, such as vaccination data for the staff and incarcerated population, the number of people currently under quarantine, and the number of active cases, was never supplied by the authorities. The request was simply ignored despite multiple follow-ups.

Incomplete Swab Data

The data received had many holes and only covered the months of September 2020 through January 2021. Any hope that the data would shed light on testing in FCJ prior to reporting to BSCC began, particularly during the worst outbreak in July, was dashed.

The data also had a two week gap at the end of November, at a time when the BSCC showed 19 positive tests at the facility for the week of November 15-21, and 12 positive cases for the week of November 22-28.

In other parts, data was duplicated. The same swab report from the dates December 26, 2020 through January 1, 2021 was submitted on January 2 and again on January 9. Even stranger is the data showed only 11 tests administered in the jail pods for that period, but 33 positive test results.

While the Covid In-Custody Project had hoped the swab data would fill in the blanks and supplement the BSCC data, it is too incomplete to accomplish that.

Contradictions with BSCC Data

Alarmingly, the data in the swab list diverged in numerous places from data supplied to the BSCC.

A swab list from September 25, 2020, showed that 459 tests administered in the jail in one week. The data reported to the BSCC for the corresponding week lists a total of 84 tests. This type of under-reporting was common.

Between November 7-13, the swab reports showed 19 positive cases. For the same time period, “less than 11” cases were reported to the BSCC.

Other times the data reported to the BSCC seemed much more dire than that contained on the swab list. Between October 25 – 31 FCJ reported that 674 tests were administered in the jail and 21 were positive. The swab lists for the corresponding period show only three cases for 337 tests.

Testing Refusals in FCJ

A key piece of data that the swab lists shed light on is the number of refusals. As noted earlier, a surge in positive cases at FCJ was often quickly followed by a drop in the total tests administered. However, there is also a simultaneous increase in the number of individuals refusing tests.

For example, the screen capture above shows only nine completed tests and 63 refusals for a single floor of the Main Jail.

What this makes clear is that FCJ was not attempting fewer tests during outbreaks, but that incarcerated people presumably did not want to take them. Across the country, COVID-19 quarantine units have been compared to solitary confinement, causing many to decline testing to eliminate the chance of being positive.

Under quarantine, a 72-man pod will be unable to leave their area of the jail for up to or over a month. Access to amenities is curtailed. Individuals cannot see their attorneys or attend court dates, resulting in longer periods of incarceration.

“It’s like you’re damned if you do and damned if you don’t.” described one inmate. “You go over the speedy trial 90-day deadline, I saw that happen three times to one guy. Dropped him and refiled and added charges.”

If a positive COVID test can trigger a quarantine, many decide it is in their best interest not to take the test at all.

FCJ: Looking Back, Looking Forward

Without accurate data to rely on, it is impossible to understand the true scope of the pandemic in California’s jails, and how best to ensure the safety of those living there in future. The data supplied by FCJ is so incomplete, erratic and contradictory it is impossible to draw firm conclusions from it.

On several occasions, Jail officials have acknowledged that the numbers they reported were inaccurate and misleading. For example, Mims has publicly stated double-testing in the jail has been a problem and the number of unique COVID cases in the facility must be revised.

While this is an acceptable goal, there is no apparent methodology they are using to ensure an accurate total. The data they supplied to the Covid In-Custody Project certainly provides no indication. To the contrary, the totals the jail has reported differ so radically from their swab sheets, there seems to be some degree of guesswork used by the jail to arrive at official numbers.

As the spread of COVID has slowed and jails are reporting fewer cases, it is tempting to declare that the pandemic is over. The population in jails across the state is climbing steadily and attention at many institutions has turned their attention to vaccination efforts.

Again, FCJ is behind the curve in reporting the relevant data. There is currently no data available for vaccination rates at the jail. Observers must rely on media reports and rare public statements to get a glimpse of conditions inside the facility.

What is being reported does not look good; According to a local ABC affiliate, 57% of people incarcerated at the jail are refusing the vaccine.

FCJ has already seen the deadly consequences of haphazard testing and reporting at the facility and made no efforts to revise or improve its protocols. Should infection rates begin to rise again, that could spell danger for the people incarcerated there.

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Everything to Know about Vaccinations for Santa Rita Jail’s Staff and Population

While the United States’ COVID-19 vaccination rate of 59.6% has been of much concern to health administrators and vulnerable community members, several carceral institutions across the country have even lower rates leaving those in congregated settings even more vulnerable to contracting the virus.

August 23, 2021

The Covid In-Custody Project partners with the Davis Vanguard to bring quantitative and qualitative reporting on the pandemic’s impact on county jails and CDCR to the public eye. This story is authored by the Covid In-Custody team.

While the United States’ COVID-19 vaccination rate of 59.6% has been of much concern to health administrators and vulnerable community members, several carceral institutions across the country have even lower rates leaving those in congregated settings even more vulnerable to contracting the virus. Alameda County’s Santa Rita Jail has administered over 800 vaccines to its population, however, due to the transitory nature of county jails, 300 of them were released, resulting in a 25% vaccination rate for those currently in custody.

These statistics are even more concerning in light of the Delta variant, which is known to be more virulent, contagious and deadly.

In Santa Rita Jail, there is a widespread availability of vaccines, however, the resistance to get vaccinated appears to arise primarily from a distrust in the medical field. According to a survey conducted over March and April — the beginning of the vaccine rollout — roughly 50% of respondents felt that the vaccines had not been thoroughly tested by doctors or scientists. One even wrote, “It kills people.”

To ensure that anyone in custody who wants to be vaccinated is able to do so, Wellpath staff offer vaccines to newly booked individuals on day 12, 13, and 14 of the mandatory intake quarantine period. Incarcerated people can also submit a medical request form or make a sick call if they want to get vaccinated.

With a vaccination rate of 25% for the population and 10%* for jail staff, recent data on COVID-19 cases and housing unit quarantines suggest that the jail is far from being out of the woods with the pandemic.

Active COVID-19 cases among jail staff and contractors surged to 16 on Aug. 4 — a 90% increase overnight. A similar surge of 110% overnight occurred on August 15 for the incarcerated population, leaving 21 active cases in custody, after months of declining numbers.

Several studies have shown that infections among staff are a primary vector for outbreaks in incarcerated populations. In fact, an independent consultant who monitors Santa Rita Jail’s COVID-19 response, identified that cases among staff triggering the jail’s largest outbreak to date — over 100 active cases were reported on a single day during December. A Wellpath representative also admitted, “contact tracing revealed that the outbreak could have been linked to staff positives.”

Health administrators have attempted to curb this transmission by mandating testing for jail staff, but a vaccine mandate is not in sight. In March, Dr. Nicholas Moss, the Alameda County health officer, ordered all Santa Rita Jail staff to get tested once every two weeks. On July 26, the health officer for California ordered all county jails t0 ascertain the vaccination status of their staff, and ensure that unvaccinated staff are being tested weekly.

While these are steps in the right direction to curtail the transmission of COVID-19, medical evidence unequivocally shows that testing cannot substitute vaccines in terms of protection against the virus.

Additionally, the implementation of protocol is often far from the official narrative. The Sheriff’s Office failed to meet the requirements of the March mandatory testing order for jail staff since the compliance rate never reached 100%, and staff members were not being tested in exactly 14-day intervals. The statewide-mandate for weekly testing of unvaccinated jail staff is yet to be implemented — jails have until August 23 to put a plan in place.

For the incarcerated population, the test acceptance rate is all the more concerning. The acceptance rate in housing units quarantined due to exposure to a positive case averages to 74%. Roughly 42% of new books consent to a test during the intake process.

The refusal rate for testing offered to individuals medical vulnerabilities, pod workers, and those housed in open-air dorms, averages to roughly 62%. Individuals awaiting release or transfers have an average refusal rate of 10%.

The beginning of vaccine rollout for jail staff

In December 2020, a vaccine distribution plan for Alameda County outlining eligibility criteria was adopted by the public health department. The county was expecting their first shipment of the Pfizer vaccine by Dec. 18.

When the distribution plan was developed, specifically as of Dec. 10, 2020, there were 33,736 total cases of COVID-19 and 525 deaths in Alameda County. The jail had 277 total cases and no deaths during that time.

According to the plan, “… people in prisons, jails, detention centers, and similar facilities, and staff who work in such settings,” were included in Phase 2. Phase 1A, however, included high-risk health workers, first responders and those in long-term care facilities. This meant that medical staff who worked at Santa Rita Jail were eligible.

Mike Durbin, Health Services Administrator for Wellpath, stated that they received 120 doses from the county for eligible medical staff in February. At the time, only 62% of clinical staff had consented.

As of July 20, data from Wellpath shows that the vaccination rate has improved by 15% in 5 months. Out of 216 staff members — 134 full-time and 82 part-time — roughly 77% are fully vaccinated. 35 reported that they have chosen not to get vaccinated, and 14 refused to disclose any information on their status.

Currently, there is no prioritization framework in place — anyone who wants to get vaccinated is able to do so.

Lack of data on vaccine acceptance among jail staff

In Santa Clara County, only 50% of deputies accepted the vaccine according to a Public Safety and Justice Committee report in early February, a “shocking and disappointing statistic” according to Supervisor Wilma Chen. Unlike Santa Clara, counties like San Francisco and Sacramento did not make any data on vaccine acceptance among staff publicly available until months after the rollout.

Until May, Alameda County also did not provide any statistics on staff vaccinations despite multiple requests by the Covid In-Custody Project. Under Phase 2 of the distribution plan, law enforcement officers in city police departments, Sheriff’s Office, Probation Department, etc. were eligible to get vaccinated through clinics organized by the Office of Emergency Services. Their data tracking system, however, failed to record the law enforcement body and division a recipient belonged to. Consequently, no data could be compiled on Sheriff’s Office staff or Santa Rita Jail staff who got vaccinated through these clinics.

Herd immunity among jail staff is far-fetched

The lack of clean data did not stop jail representatives from making unfounded claims about the vaccine acceptance rate.

In March, speaking for the Alameda County Sheriff’s Office, Undersheriff Richard Lucia told the Board of Supervisors that roughly 75% of staff were willing to be vaccinated and 25% were not sure and/or would want to wait for the second vaccination period. “We’re pretty confident that a very large number of deputies will get vaccinated,” he assured them. Lucia also promised that the official numbers would be provided soon.

Captain Dan Brodie similarly indicated that jail staff had taken advantage of the vaccine availability, leading to low case numbers among staff or contractors.

These empty statements had no basis in fact or knowledge. As of May 30, 39% of Sheriff’s Office staff are fully vaccinated and 56% have received at least one dose according to the public health department. Since data from the Office of Emergency Services’ vaccine clinics was not available, they matched records of vaccinated individuals in California’s Immunization Registry with the Sheriff’s Office roster.

While the state’s immunization registry has limitations like missing data and improper identification, the biggest limitation with the data obtained is the lack of disaggregation among Sheriff’s Office divisions. It does not specify how many staff under the Sheriff’s Office custody division are vaccinated, and instead pools all divisions together, masking the degree of immunity among jail staff who interact directly with the incarcerated population on a daily basis.

To combat this issue, the Covid In-Custody Project (a). requested the Sheriff’s Office to conduct a survey to ascertain the vaccination status of staff and record the division they belong to, and (b). requested Commander Sanchez and Captain Luckett-Fahimi to tally the number of vaccination cards submitted by Sheriff’s Office staff to Human Resources. While an update on the survey has been pending for several months, the latter request was fulfilled.

Using the Human Resources data as of August 2, among 1722 total Sheriff’s Office staff, only 456 or 26% are fully vaccinated. Even more concerning is the custody division’s vaccination rate. Of the 746 staff permanently assigned to SRJ — 466 sworn and the remaining civilian — only 77 or 10% are fully vaccinated. There are 448 sworn staff from other duty stations that work at the jail on mandatory over-time, however they are not included in the custody division vaccination rate.

It is possible that several staff members who are fully vaccinated may not have reported their status to Human Resources, evidenced by the higher vaccination rate using the immunization registry data. However, all staff have been urged to submit their vaccination cards and are given consistent reminders, according to Captain Luckett-Fahimi.

Despite the claims from Undersheriff Lucia and Captain Brodie that their staff have taken full advantage of vaccination opportunities, the official data tells a different story.

Jail staff vaccinations across Bay Area

The Santa Clara County Sheriff’s Office has reported that as of May 7, 58% of custody sworn staff and 73% of custody civilian staff are vaccinated.

In response to a Public Records Act request on jail staff vaccinations for the San Francisco County Sheriff’s Office, out of the 455 sworn staff assigned to custody, 269 or 45% have self-reported as fully vaccinated to Human Resources.

New health order for jail staff could be a game changer for data transparency and better COVID-19 protections

A Public Health Officer Order issued on July 26 by the California Department of Public Health states that current mitigation strategies such as universal masking for staff in healthcare or high-risk congregate settings, are not proving to be sufficient in preventing transmission of the Delta variant, which is much more contagious and may cause more severe illness.

The order requires that high-risk congregate settings, including state and local correctional facilities and detention centers, must verify and track the vaccine status of all workers. Additionally, the records of vaccination verification must be made available, upon request, to the local health jurisdiction for purposes of case investigation.

Unvaccinated or incompletely vaccinated workers are also required to undergo screening testing, where they must be tested at least once weekly.

Kimi Watkins-Tartt, director of Alameda County’s public health department, and Captain Luckett-Fahimi stated that since the July 26 order has been issued by the state, the local county public health body cannot enforce or monitor the implementation. The Sheriff’s Office Human Resources will be responsible for tracking the vaccination status of all staff members and providing a list of those who must get tested weekly. “It is our expectation that the Sheriff’s Office will comply as this isn’t guidance, it’s a Health Order,” Watkins-Tartt emphasized. She also stated that her office will be requesting monthly reports in order to track the Sheriff’s compliance.

While testing will reduce the occurrences of transmission between staff and population, medical studies have shown that it is not as effective in doing so as vaccines. Mandatory testing not only provides insufficient protection, but also introduces heavy financial costs. According to the Sheriff’s Office, the first bi-weekly testing requirement issued by the county’s health officer cost approximately $36,000 per month. The Sheriff is attempting to utilize the Coronavirus Emergency Supplemental Funding (CESF) grant of $1 million to cover the expenditure.

If the vaccination rate does not improve, the cost of implementing the new weekly testing requirement may be double that of the first testing mandate, in which testing occurred every 14 days. The expenditure could come up to anywhere from $60,000 to $70,000 per month — a cost that can easily be avoided if the majority of staff were vaccinated.

Captain Luckett-Fahimi was unaware of how the weekly testing requirement would be funded.

The beginning of vaccine rollout for incarcerated people

On March 1, Wellpath, the jail’s medical provider, began administering vaccinations to medically vulnerable patients. They initially offered 101 first-doses, of which 79 people or 78% accepted.

However, the vaccine acceptance rate dropped significantly over the next 5 weeks. By April 5, around 1201 vaccines (first-dose Moderna and Johnson & Johnson) were offered within a population of nearly 2200 people, of which only 412 individuals or less than 34% accepted.

In the month of May, Wellpath discontinued reporting the number of individuals who have been offered vaccines due to potential duplicates. According to Mike Durbin, duplicates arise when individuals who previously declined a vaccine request one at a later point. In response, the Covid In-Custody Project argued that this data point is crucial to quantify vaccine hesitancy and devise solutions to improve uptake.

For new books, vaccines are offered on days 12, 13, and 14 of their mandatory intake quarantine period. Meaning, anyone entering Santa Rita Jail custody is given an opportunity to get vaccinated at the beginning of their incarceration. Further, the general population can request to get vaccinated through a sick call or medical request form

Vaccine hesitancy and medical distrust

A survey developed by Alameda County’s public health department to track incarcerated people’s views on COVID-19 vaccinations and testing was offered on tablets and on paper between March 23 through April 16. A bilingual phone line was also available for translation.

The survey and various flyers were also translated into all threshold languages.The survey was recently featured in a report that was prepared by the Community Assessment, Planning and Evaluation (CAPE) Unit of the Alameda County Health Care Services Agency and Public Health Department.

Out of over 2000 people in custody who had the opportunity to participate in the survey, only 60 submitted viable responses.

30% of respondents reported that they currently have, or have had, COVID-19. Around 35% of respondents reported that they received at least one dose of a COVID-19 vaccine.

The top reasons for respondents choosing to get tested for COVID-19 were for protecting their health, or other people.

The most common answer for not having had a COVID-19 test was that it had not been offered to them.

Similarly in regards to vaccine distribution, four people said that they had not been offered a vaccine, or that they had asked and are still waiting.

One individual noted quarantine issues, stating that, “I took the test, and it didn’t matter people around me were still contracting the virus. We were not really quarantined as we were supposed to be.”

The second most common answer for not having had a COVID-19 test was due to lack of trust. One individual responded, “I don’t trust it,” when asked.

Among the 40 unvaccinated respondents, 43% said they would take it as soon as possible and 18% said that they would refuse.

When respondents were asked if they believed there was enough information available on the vaccine to decide on taking it, 43% said that they disagreed or were not sure.

“I got the vaccine because I didn’t wanna risk coming home with covid and passing it to family, friends, and those that I come in contact with,” one respondent said after being asked why they would take the vaccine.

After being asked why they would not take the vaccine, one respondent said that, “they ask us if we want the shot, they don’t tell us which manufacturer they have, until we agree to get it.”

Improving vaccine acceptance rates

Currently, there have been no shortages of vaccines identified since the early stages of vaccine rollouts. Vaccines are offered to the population on Tuesdays, Wednesdays, and Thursdays of each week.

In the past, in order to encourage individuals to take the vaccine, educational flyers were posted around the jail. Currently, the Sheriff’s Office is developing a new educational flyer based on the Delta Variant, as well as vaccination data. A small commissary item and a telephone gift card are being provided as incentives to those who accept either two doses of Moderna, or one dose of Johnson & Johnson in order to increase vaccine acceptance.

Looking forward

Since the surge of the Delta Variant, businesses have been increasingly making vaccines mandatory for employees with limited exceptions.

Under a recent mandate in San Francisco, city employees who work in the jails or other high risk congregate settings are required to be vaccinated by Sept. 15. The union that represents San Francisco Sheriff’s deputies, however, stated that a number of their employees will either quit or retire early if they are forced to get vaccinated.

When Kimi Watkins-Tartt was asked whether a mandatory vaccine order could be issued for Santa Rita Jail staff, she stated that neither public health nor the county have determined that they will mandate vaccinations. However, as more institutions and workplaces start to implement their own mandates, she would not be opposed to the idea.

Recently, the Covid In Custody Project reported that federal receiver J. Clark Kelso, who oversees medical care inside California’s prisons, asked a federal judge for a mandatory COVID-19 vaccination order for guards and staff at the prisons given the Delta variant risk.

“We cannot afford to be lulled by the decline in infections in CDCR, which mirrored the fall in rates in the larger community.” Kelso wrote to the court regarding the conditions within CDCR facilities.

Kelso stated that only 42% of custody staffers in state prisons have received at least one dose of the vaccine, and that overall only 53% of all staff have had one shot. Further, the report states that half of all outbreaks between May and July were traced back to employees, claiming that testing as a substitute for vaccination is not sufficient.

Likewise, the risk is just as great within California jails, especially since it has already been reported within Santa Rita Jail. Echoing the words of federal receiver Kelso, testing cannot be used as a substitute for vaccines.