Activists Press ​“Harm Reduction” Response To Covid-19

Town and gown advocates for the incarcerated, sex workers, drug users, and the homeless have teamed up to promote a ​“harm reduction” approach to tackling the Covid-19 pandemic.

They’re calling for government action ranging from the rapid release of prisoners to greater access to public restrooms.

Roughly 25 people virtually gathered on Thursday afternoon to issue those calls during an hour-long Zoom press conference.

The presser was organized by a coalition of local, statewide, and Yale-affiliated advocacy groups, including Stop Solitary-Connecticut, the Connecticut Harm Reduction Working Group, Sex Workers and Allies Network (SWAN), Greater Hartford Harm Reduction Coalition, Katal Center for Health, Equity, and Justice, Alliance for Living, Yale Program for Recovery and Community Health, Yale Global Health Justice Partnership, and One Standard of Justice.

It was anchored by long-time local social justice activists Barbara Fair and Beatrice Codianni and by Yale-affiliated infectious disease experts Gregg Gonsalves and Rick Altice.

“Harm reduction” broadly speaking refers to efforts to reduce negative legal, social, and health impacts associated with drug use.

Over the past nearly two months since the start of the novel coronavirus outbreak in Connecticut, Gonsalves (pictured) said, activists have consistently petitioned local and state government to prioritize releasing the incarcerated . The activists cite as reasons the near impossibility of practicing social distancing behind bars, inmates’ limited access to clean hygiene and quality health care, and their frequent exposure to staff who cycle between prisons and their home communities and may inadvertently spread the virus.

“You name it, the call has gone out,” he said. ​“The level of frustration has risen to such a level that we all have gathered across our different areas of work, constituencies, and political views to make an appeal to the governor and to mayors across the state” to address the issues faced by the society’s most vulnerable populations, not just prisoners, but also the disabled, sex workers, and the ​“street-involved.”

“Incarcerated people are among the least talked about during Governor Lamont’s daily briefings,” Fair said. And they’re ​“among the most invisible people in our state because they’re disproportionately poor and nonwhite.”

She criticized as ​“half-truths” the state Department of Correction’s published data so far that the state prison system has significantly increased its number of discretionary releases and end-of-sentence releases, particularly for African American and Hispanic inmates, during the pandemic.

She and fellow Stop Solitary CT organizer Joe Gaylin said that those numbers belie how a disproportionate number of black and brown Connecticut residents were locked up before the pandemic started, and how so many thousands of inmates not deemed by the state to be most medically at risk or close enough to the end of their sentence are still behind bars.

Click here for a fact sheet recently Wednesday by the DOC. It states that the department reduced its offender population by 1,455 between March 1 and May 1, and that there was a 72 percent increase in discretionary releases between February and when the pandemic hit in March.

“In addition to modified operational plans and preventative measures implemented at all correctional facilities, the agency is closely monitoring its overall count in an effort to further reduce the population by releasing low risk offenders with stable home plans verified through the reentry planning process,” reads a DOC email press release sent out on Wednesday.

Altice, a professor of medicine and of epidemiology at the Yale School of Medicine and the director of the school’s HIV in Prisons Program as well as of its Community Health Care Van, said the number of people released from state prisons so far represent ​“a start, but it’s insufficient.”

“Prisons are places that concentrate people with very at-risk conditions,” he said, including diabetes, HIV, and obesity.

But a release plan focused on just those most medically vulnerable to suffering serious harm or death from Covid-19 would still be too limited, he said.

“It is impossible to deal with issues of containment of an infection like Covid-19 in prison,” he said. Inmates inevitably share common spaces, food, restrooms, showers, and bunkbeds. On top of all that, he said, prisons are ​“often at the bottom of the bucket in terms of public health responses,” with limited access to personal protective equipment like gloves, gowns, and masks and too few doctors and nurses on hand.

“You really have to depopulate the prisons to effectively” protect inmates and staff alike.

Altice was asked about concerns that large-scale releases of prisoners might endanger the communities they return to because of the seriousness of the offenses some people have committed.

He responded that pandemics like this one force governments to figure out the right ​“balance between public health and public safety.

“There are many people who are in prison for completely nonviolent offenses who really no longer pose a risk to the community.”

He said that these people, convicted of nonviolent drug offenses or even of violent offenses committed many years ago, should be prioritized for release.

“When you have a pandemic, you have to really move very quickly on this,” he said.

Codianni called for bringing port-a-potties to places where people congregate, like Ferry Street and Grand Avenue in Fair Haven. She also called for including vulnerable populations in policy-making decisions regarding their own health and safety.

“They should talk to the people who are directly impacted and find out what they need,” Codianni said when asked what response she would like to see from city government. ​“When planning, they need to have people at the table, people who know what it’s like to be out on the street and dealing with drug issues. They need to hear from them.”

In a separate virtual press conference held later Thursday afternoon, Mayor Justin Elicker said that the city is already working with SWAN to staff the recently opened drop-in center for the homeless in Blake Field.

“We want to make sure we’re helping as many people as possible,” he said in noting his continued willingness to talk with groups like Codianni’s about what vulnerable populations in New Haven need during this pandemic.

When asked about activists’ call for the release of more prisoners from state detention and for his thoughts on a federal judge’s recent decision not to allow the state to dismiss the ACLU’s ongoing lawsuit against the prison system, Elicker (pictured) said, ​“I do think it’s appropriate, for lower-level crimes and nonviolent crimes, to release people, and also for the DOC to do everything possible to separate people out so that they are kept as safe as possible” while still locked up.

“I don’t agree that we should go as far as to release everyone from prison,” he continued. ​“I think that’s too far. We need to make sure that we’re keeping members of the public safe.”

He and Police Chief Otoniel Reyes pointed to the reduced number of people held in the city’s lockup as well as reduced numbers of custodial arrests during the pandemic as evidence of the city’s proactive measures to keep the city safe while also reducing the number of people entering the criminal justice system during this public health crisis.

See below for the full list of calls for government action put out by the coalition of advocates behind Thursday’s press conference.

Harm Reduction Calls For Action

1. Rapidly reduce the number of people in prison, jails, and halfway houses. Decreasing the density of these facilities is critical to mitigate the spread of COVID-19; Connecticut would be following both the best public health evidence and precedent set by numerous other states that have either begun releasing incarcerated people or are imminently preparing to do so;

2. Coordinate non-congregant housing arrangements by renting vacant hotels and college dormitories for people released from incarceration; ease restrictions on sponsorship that prevent incarcerated people from identifying housing upon releases. Each of these steps requires transparent and accountable public policy guidance; to the greatest extent possible, avoid releasing people to halfway houses.

3.In those cases where the preferred and evidence based option of release is not reasonably available, the treatment of those individuals who test positive for Covid-19 includes high quality care in medical isolation. Solitary confinement and quarantine do not provide the protections of medical isolation and should not be used as an alternative. The CDOC should follow the recommendations of David Cloud, JD, MPH, Dallas Augustine, MA, Cyrus Ahalt, MPP, & Brie Williams, MD, MS articulated in their paper, The Ethical Use of Medical Isolation – Not Solitary Confinement – to Reduce COVID-19 Transmission in Correctional Settings;

4. Immediately discontinue transfer of COVID-19 positive persons to the Northern Correctional Institution and only utilize appropriate medical facilities or isolated housing units to treat Covid-positive individuals;

5. Require the CDOC to make their plans for prevention and management of COVID-19 in each correctional institutions publicly available; all plans should be coordinated with the advice of independent medical experts; any reports of medical neglect, unsanitary conditions, or violation of protocol should be immediately reported to an independent body that includes public health, medical and legal experts who can swiftly develop a an actionable remedy that meets both Constitutional and individual medical and public health requirements;

6. Monitor and ensure the availability of sufficient soap and hand sanitizer for all staff and incarcerated individuals, without charge; provide all incarcerated people with appropriate PPE.

7. In order to meet the needs of street-involved and other populations in precarious housing situations, immediately improve and increase access to restrooms by strategically placing portable latrines and washing up facilities, and partially opening public libraries or schools in areas of greatest need as determined in consultation with affected populations and communities.

8. Open low-barrier, harm reduction-oriented, indoor drop-in centers for street-involved persons who are COVID-19 negative in areas of greatest need to help bridge gaps in services and facilitate access to food, water, phone and charging stations, bathrooms, clothes washing facilities, harm reduction supplies, medical and mental health care, and health education.

8. Release clear and concise plans for how cities and towns intend to accommodate people who are experiencing homelessness, especially those who are unsheltered, who are either unable to or are disqualified from accessing the city and town-based emergency housing at this critical moment. Plans should be developed in consultation with the most affected and be reviewed and revised in a transparent and accountable way over the course of the pandemic.

9. Issue guidance and regularly review actions to cease arrests, charges, and citations for drug possession, possession with the intent to distribute, paraphenelia-related charges, and other laws criminalizing survival, including but not limited to trespassing, loitering, sex work, panhandling, occupying and sleeping in public places and erecting shelter. Publicly release existing policies regarding policing during COVID-19 and revise policies as necessary with public consultations with most affected to conform to evidence on the health and other harms of policing during the pandemic and more generally, and best practices simplify, expediting processes for reporting negative police encounters and abuses of power.

10. Direct the Department of Public Health to implement enforceable guidance that will prohibit providers of health care from rationing health care based on disability or on perceptions of the value of a life.

11. Direct the Department of Mental Health and Addiction Services to begin the process of planfully releasing individuals from inpatient facilities to community placements that will allow them to practice social distancing.

12. Direct the Department of Mental Health and Addiction Services to develop enforceable guidance to permit individuals residing in inpatient facilities to practice social distancing; to develop enforceable guidance that will require all healthcare facilities to provide live ASL and live Deaf-Blind interpreters; and to develop enforceable guidance that will permit support people to stay with an individual who needs communication and comfort support to stay with that individual while they are hospitalized.

13. Direct the Department of Mental Health and Addiction Services to begin the process of releasing individuals from inpatient facilities to community placements, and to develop enforceable guidance to permit individuals residing in inpatient facilities to practice social distancing.
Direct the Department of Social Services to develop enforceable guidance that will provide Personal Care Assistants with personal protective equipment.

Previous articles about political organizing during the pandemic. Series logo by Amanda Valaitis.

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• Academics Seek Security, ​“Joy”
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• Can Covid Spawn Public Health ​“New Deal”?
• One Year Later, Protesters Pack Zoom
• Pandemic Prison Protests Pioneered
• ​“Food Garage” Feeds Families During Covid
• Pro-Immigrant Crew Tackles Covid Crisis
• Mutual Aid Teams Tackle Covid-19 Challenge