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The Nebraska State Penitentiary in Lincoln. 

Townley M.D., is an associate professor of internal medicine and pediatrics at the Creighton University School of Medicine. Plaehn and Dorchuk are Creighton medical students.

As medical professionals and students, we appreciate the work of Gov. Pete Ricketts, prison system director Scott Frakes and county board members in protecting Nebraska’s incarcerated individuals and correctional staff from COVID-19, including increasing access to soap, quarantining new admissions and halting visitations. However, COVID-19 may still hit Nebraska’s inmates hard, just as it has devastated multiple facilities throughout the United States. Furthermore, this pandemic exposes the inherent problems in the U.S. and Nebraska’s system of incarceration.

It is time for the U.S. to stop leading the world in incarceration. Twenty-two percent of the world’s incarcerated population resides in U.S. jails and prisons despite the U.S. having only 4% percent of the world’s population. Of the world’s female inmates, 30% reside in the U.S. There is no need for such high incarceration rates. This pandemic gives Nebraska the opportunity to explore new ways to exact justice.

In prisons and jails, non-pharmaceutical interventions recommended by the Centers for Disease Control, such as social distancing, cannot be maintained. COVID-19 is spread when a person is in close contact with someone infected or by touching a surface or object that has the virus on it and then touching one’s own mouth, nose or possibly eyes.

COVID-19 spreads quickly in crowds. The average prison facility in Nebraska is functioning at 160% capacity. Previous deadly prison riots (such as those at the Tecumseh facility in 2015 and 2017) illustrate the dangers of overcrowding. Overcrowding is directly due to the massive rates of incarceration in Nebraska as well as the U.S. Nebraska’s rate of incarceration, at approximately 0.577 per 1,000 people, although less than other states, is much higher than multiple other countries. Nebraska with a population of about 2 million has more people behind bars than entire countries such as Denmark, Norway and Finland.

The protective steps taken are commendable. However, we are concerned that access to soap is insufficient. Furthermore, inmates should be able to utilize some of the hand sanitizer that they are making. Small amounts of this are unlikely to result in contraband alcohol. We are grateful to learn of the increase in free phone time to 10 minutes per week. However, this remains woefully inadequate for individuals to contact family, friends and legal representation.

Prisoners without financial support to increase phone time will become even more distant from their community. This isolation can exacerbate existing mental health problems, which are present at high rates in this population. Studies have shown decreased recidivism with increased contact with communities. More phone contact can help alleviate isolation while preparing inmates for re-entry after incarceration.

Additionally, African-Americans, Hispanics and Native Americans are at higher risk of severe COVID-19 and are overrepresented in deaths due to COVID-19. These populations are overrepresented in U.S. jails and prisons and should be able to practice hygiene and social distancing to avoid increased illness and death from COVID-19.

The goal of incarceration should be to exact justice while providing an opportunity for rehabilitation. For the vast majority of inmates, incarceration should not be a death sentence. The combination of advanced age of many inmates, along with high rates of hypertension, diabetes, COPD and HIV/AIDS, increases inmates’ risk of acquiring COVID-19, of requiring critical care and of dying from COVID-19.

Such individuals are exactly the patients that social distancing efforts are designed to protect, yet their current environment precludes effective adherence to these national recommendations. We must capitalize on the opportunity that COVID-19 presents for us to re-evaluate policies that can offer clemency.

In summary, the COVID-19 crisis offers Nebraskans the opportunity to re-evaluate the massive, harsh and expensive incarceration system seen in Nebraska and the U.S. Multiple groups such as the Federal Bureau of Prisons, Prison Policy Initiative, ACLU and the Justice Collaborative have offered guidelines for de-carceration in order to decrease the spread of COVID-19. These measures include decreasing admissions, early release of inmates in prisons based on their proximity to parole, and pretrial release for nonviolent offenders awaiting trial.

It is time for Nebraskans to stand up for this often invisible population. It is time for Nebraska to adopt these policies and become a leader in a new approach to incarceration. It is time for Nebraska to act before a health crisis erupts in our criminal justice system.

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