CORONAVIRUS

He Got COVID In Prison. The Government Said He Was 'Recovered.' Then He Died.

The death of a federal prisoner in Indiana illustrates the incomplete and often misleading nature of COVID-19 data released by correctional facilities.

When Joseph Lee Fultz arrived at the federal prison complex in Terre Haute, Indiana, in January to begin a 27-year sentence, the prison was fighting to contain a COVID-19 outbreak.

Positive cases at the sprawling complex ― which consists of a maximum-security prison where death row prisoners are housed, a medium-security prison and an adjacent camp ― had jumped from fewer than a dozen in early November to more than 400 by the end of December, coinciding with a rash of executions conducted there.

But according to the federal Bureau of Prisons, which posts information about its COVID-19 cases online, prisoners in Terre Haute were recovering at a rapid clip. In a spreadsheet updated every day, the health status of dozens of inmates was changing from “positive” to “recovered.” By Jan. 7, when Fultz set foot in the facility, only 108 people were listed as having active cases. Everyone else, the BOP said, was no longer sick.

Four days after his arrival, Fultz tested positive for the coronavirus. Then, exactly 14 days later, the BOP added him to the “recovered” column. But Fultz, a 52-year-old man with a serious heart condition and epilepsy, had not recovered. On Feb. 8, a month to the day after his arrival in Terre Haute, he died of COVID-19-related illness, his unresponsive body discovered in his cell.

Fultz’s death illustrates the incomplete and often misleading nature of COVID-19 data released by correctional facilities, and underscores how little we understand about the damage the virus is wreaking behind bars.

At the outset of the pandemic, public health experts warned that without serious changes to the penal system, the deadly virus would run rampant in America’s prisons and jails. Their fears have come true: Infection rates among incarcerated people are nearly five times higher than the national average, and the death rates are three times higher, according to data collected by the COVID Prison Project, which compiles data on COVID-19 in correctional facilities.

A year into the pandemic, an estimated 386,396 incarcerated people have been infected and 2,331 have died due to the coronavirus ― and those are just the cases we know about. The true numbers are likely to be much higher.

There is a troubling lack of publicly available data about the spread and severity of COVID-19 cases in the nation’s jails and prisons. Some correctional systems fail to report any data on testing, cases and deaths, while others share incomplete information at random intervals. The vast majority do not share data on hospitalization ― a key metric to gauge the severity of an outbreak ― or disaggregate the data based on demographic categories such as race, age or gender, which would offer insight into disparities.

“We are getting all kinds of different data points from lots of different systems, which makes it really hard to have an accurate picture of what’s happening,” said Lauren Brinkley-Rubinstein, a professor at the University of North Carolina School of Medicine and co-founder of the COVID Prison Project. “We know tip-of-the-iceberg information, which is good. But it’s clearly not enough.”

Democratic lawmakers are pushing for improved data collection on COVID-19 behind bars. The COVID-19 in Corrections Data Transparency Act, originally introduced in August and reintroduced last week, would mandate the collection and public reporting of information about the spread of COVID-19. Federal and state authorities would be required to collect and share detailed data about COVID-19 cases, hospitalizations, deaths and vaccinations in correctional facilities.

The bill is sponsored by Sens. Elizabeth Warren (D-Mass.), Patty Murray (D-Wash.) and Cory Booker (D-N.J.), along with Reps. Ayanna Pressley (D-Mass.) and Sylvia Garcia (D-Texas).

“As a result of their confinement, incarcerated people are at increased risk of contracting COVID-19, and reports show that COVID-19 has spread like wildfire in correctional facilities across the country,” Warren said in a statement. “This bill takes a necessary step towards containing the pandemic and supporting the health and safety of incarcerated individuals, correctional staff, and the general public by strengthening data collection, reporting, and transparency.”

One of the major problems with the data being reported is that it is not standardized, which makes it difficult to compare data sets accurately. “There’s no standard way in which they’re defining any of the variables that they’re giving out,” Brinkley-Rubinstein said.

The variable of “recovered” is a prime example. Most states provide information on “recovered” cases, Brinkley-Rubinstein said, but there is no standard definition of a recovered COVID patient. Many jurisdictions define it as a period of time after diagnosis, such as 10 days or 14 days, after which a person is considered recovered.

Brinkley-Rubinstein said this metric is meaningless, as it does not take lingering issues into account or provide a true snapshot of health. In some cases, people who have had COVID-19 have relapses or experience long-term health consequences.

“It’s not based on severity of disease or whether someone’s doing well or not. They’re just using some arbitrary time to move people, which is really concerning, and why you see things like this man dying after he’s technically been defined as recovered,” she said. “We’ve seen this happen in a fair number of places.”

A BOP spokesperson said the agency follows guidelines from the Centers for Disease Control and Prevention to determine if someone is recovered from COVID-19. However, the CDC has not provided an official definition of what it means for a person to be considered recovered. The CDC has guidance on when a person can leave medical isolation, which the BOP pointed HuffPost toward.

In a press release, the BOP said Fultz, the man who died in Terre Haute, was categorized as recovered “in accordance with” CDC guidelines after he completed medical isolation and had no symptoms.

He is not the first prisoner in the federal system to die of COVID complications after being listed as recovered.

On Nov. 9, Kevin Gayles tested positive for COVID-19 at a federal prison in Jesup, Georgia, and was placed in medical isolation. Ten days later, he was listed as recovered. Then, on Jan. 8, he complained of chest pains and was transported to a local hospital. He died that same day.

On Dec. 20, Harry Edward Cunningham tested positive for COVID-19 at a federal prison in Memphis, Tennessee, and was placed in medical isolation. Nine days later, he was listed as recovered. A week or so passed. On Jan. 10, he was transported to a local hospital for care. Two days later, he was pronounced deceased.

In press releases, the BOP emphasized that Fultz, Gayles and Cunningham all had pre-existing conditions that put them at higher risk of developing more severe COVID-19 disease.

Fultz was worried about contracting the coronavirus at Terre Haute, his girlfriend, Stacy Dorsey, told HuffPost. He had been housed in an Iowa jail while awaiting his sentencing, and was transferred to Terre Haute via a stop at a prison in Oklahoma.

“We were both a little concerned, because I had heard that Terre Haute was a superspreader of coronavirus, as far as the Bureau of Prisons went,” she said. 

The Indiana prison complex had been in the news because it was the site of 13 federal executions during the pandemic. Two inmates in the prison had sued the federal government to halt the executions, arguing that the events were spreading the virus and putting all the prisoners at risk of death.

Before Fultz arrived at Terre Haute, Dorsey spoke to him every day by phone, she said. Once he got to the prison complex, she never heard his voice again. She received a hastily composed note, written right after Fultz entered the facility, where he explained that he was on a three-week lockdown as a precautionary measure to prevent the spread of COVID, as he had come from another facility.

“He said he would contact me as soon as he could,” she said.

The three weeks came and went with no contact. She grew even more worried, she said, and sent him multiple letters enquiring about his health. 

On Feb. 8, Dorsey received a call from a chaplain at Terre Haute, who broke the news that her boyfriend was dead. The chaplain did not tell her that Fultz had tested positive for the coronavirus, she said. She did not learn his death was COVID-related until she was contacted for this story.

“I don’t like the fact that they were not upfront with me ... It was almost like they’re trying to hide something,” she said.

She was still in shock about Fultz’s death.

“Having not talked to him for four weeks just adds to the devastation of it,” she said. “I don’t know how they were treating him.”