The Relentless School Nurse: Prisons are Petri Dishes for COVID19

There will be lessons learned from the pandemic of COVID19 that we will only begin to understand once this is in our rear-view mirror.  In the meantime, we are hunkered down and wondering what our world will be like once the curve is flattened. Life as we knew it has ground to a halt as the virus spreads. People are sick and dying, and the healthcare workforce is putting their own lives on the line without proper protection. 

Social distancing is now a term that is beginning to filter into the COVID19 lexicon. But how do you conform to social distancing where large groups of people live in close quarters? Prisons, for example, are petri dishes for COVID19. 

Prison reform advocates say prisoners present unique risks. There are overcrowded cells and hallways. How do you cover your nose and mouth when you cough and sneeze if you are handcuffed? There is no social distancing in small cells. Effective handwashing is lax because sinks often lack soap.  Hand sanitizer is considered contraband due to its alcohol content.

Martha Paynter is an activist nurse who presents a compelling case for nurses to be prison abolitionists.  Her essay opened my eyes…

Nurses should be prison abolitionists. Perhaps it is easiest to see this now, as demands mount daily to release prisoners to protect them- and correctional staff including nurses- from COVID. But it has always been true. Nurses follow codes of ethics that call us to promote justice, to foster health, to prevent harm. Prison abolitionists concede that reforming prison, making it incrementally better, is never enough, and worse, wastes effort that must be directed to radical change. An inhumane system cannot be made better. Nursing may be threatened by the political demands of abolitionism, by the radical call. While it may be radical in this moment, it is foundational, critical, and normal within nursing to seek equity and to strive for wellbeing.

Prisons were always sites of horror. The super-acceleration of COVID in prison spaces is causing whole societies to question their acceptability at this moment, but our society should have done so long ago- nurses most so. The horror of prisons- isolation, restraints, infection, injury- is borne disproportionately by those on the margins. Too many prisoners in North America are people of colour, most are victims themselves of physical and sexual abuse, and most are poor, inadequately housed, unemployed, and unwell. Prison is a bastion of the racist and colonial practices nursing itself needs desperately to renounce. To seek care while in prison requires compliance with traumatizing security protocols- strip-searching, observation, violations of confidentiality. Can nurses work in these spaces at all, and follow our code?

How can nurses work to improve health while employed by a system actively harming it? Not only are prisons petri dishes for infection- communities in which prisons are found report higher rates of illness. The prison goals of punishment and control conflict with nursing aims to treat, care for, and promote self-governance of body and health maintenance. The consequences of prison, increased risk of homicide, suicide, death, and disease, challenge the effort of nursing at its core.

Nurses are one of if not the largest workforce in North America. We are held in extraordinary esteem- especially now, as the frontline heroes of COVID response. We can use this leverage to demand an end to prison systems and to create alternatives that support accountability without violence, deprivation, and death.

Abolitionism aims both to prevent the growth of prisons and the creep of criminalization. In this pandemic era we see on the one hand the release of tens of thousands of prisoners, such as from Iran, and on the other, the arrest and charge of individuals who cough in public, or who go to the grocery store while the city is under lockdown. Nurses must champion decarceration as an appropriate response to minimize COVID transmission while also resisting the criminalization of illness and the transformation of public health actions into policing.

The structural shifts made necessary to respond to COVID will always be necessary, as COVID is a strong marker of our public health failures. Prison is itself a failure of public health. No amount of investment- such as for cleaning supplies, more cells, more staff- will adequately reduce the harm of prison. Inevitably these investments always increase the acceptability of prisons, and result in increases in prison populations.  

Prison will not solve our public problems. It will not contain COVID any more than it will contain “crime”. The extreme danger prisoners face at this moment forces a public reckoning with this often-hidden population. The immediate problem is COVID inside. The forever problem is that prison severs people from direly needed social support systems, communities of both care and accountability, and from personal autonomy and worth.  

Prison is not a “golden opportunity” to seek health services. As nurses we must recognize that inadequate investment in actual treatment for trauma and in guaranteed basic income to remedy poverty and homelessness is what drives the process of criminalization. We must call for health spending in communities, in health and social services, and not inside prison walls.  This matters now, but it will matter always.