SIOUX FALLS, S.D. (KELO) — Prisons with often-cramped quarters, older heating and cooling systems, and shared spaces are ripe breeding grounds for the coronavirus and other illnesses, multiple studies and research shows.

South Dakota’s incarceration rate of 855 people per 100,000 is higher than the national average, according to the Prison Policy Initiative. The rate includes prison, jails, juvenile detention facilities and immigration detention.

The state was operating at 75% capacity in state prisons as of Oct. 31, 2020, according to the PPI.

As of March 31, 2021, the state had 3,274 male and female inmates in nine facilities including work centers and one community program, according to the South Dakota Department of Corrections. That figure does not include jails, immigration detention or juvenile detention.

In a June 25 report, the PPI and American Civil Liberties Union graded each state on COVID-19 response including such factors as providing testing and protective equipment to incarcerated people and prison staff, reducing incarceration, releasing medically vulnerable inmates or those near the end of sentences and other factors.

South Dakota received an F. But no state received a grade higher than a D-.

South Dakota Women’s Prison | KELOLAND News

A September report called COVID-19 in U.S. State and Federal Prisons said that the mortality rate for inmates was twice as large as the general public mortality rate “after adjusting for the sex, age and race/ethnicity of those incarcerated.”

The report was prepared for the Council on Criminal Justice, a nonpartisan criminal justice think tank.

The Federal Bureau of Prisons COVID-19 case rates and standard mortality ratio were about 5 and 2.5 times those in U.S. adults, respectively, consistent with those of prisons nationwide, according to a Feb. 25 report called “COVID-19 case and mortality rates in the Federal Bureau of Prisons,” published by the U.S. National Library of Medicine National Institutes of Health.

COVID-19 studies cited issues in prisons

At least four studies released since September highlight the conditions that led to the spread of COVID-19 within prisons.

A study released on April 2 by the Centers for Disease Control focused on a state prison in Wisconsin from Aug. 14 through Oct. 22.

Within two months, the coronavirus spread rapidly in the prison.

“Factors that likely facilitated transmission include the described intake quarantine procedures, crowded housing units, and movement of incarcerated persons and staff members among units,” the CDC Wisconsin prison study said.

A CDC study on an outbreak in Utah was released on April 2. The study of the correctional facility in Utah was from September 2020 through January 2021.

Inmates and staff were likely exposed to COVID-19 through a dental health provider and other community-associated sources, according to the study.

The study said the transmission highlighted the importance of wearing masks, using personal protective gear, social distancing, testing and other measures to reduce the spread and prevent the spread of COVID-19.

Identifying shortcomings in prisons before COVID-19

An October 2005 study called “Public Health Implications of Substandard Correctional Health Care” published by the American Public Health Association cited conditions that contributed to the spread of tuberculosis that can apply to COVID-19.

“Because TB is an airborne disease, it thrives among people who live in close quarters with poor ventilation. Prisons offer the optimum environment for the growth of TB,” the study said.

“Controlling TB requires a joint effort on the part of health care professionals to diagnose the disease, isolate infected individuals, give proper medical treatment, track reactivation of the disease, and educate both prisoners and the general population,” the study said.

A study by the PPI said prison cells are often smaller than cruise ship cabins or nursing home rooms and in some cases, beds are only three feet apart.

Corrections1, which is a resource for correction facilities, shared a report in 2014 that was updated in February of 2017 by, called “Why indoor air quality is the sleeping monster in correctional facilities.”

“If not properly attended to, HVAC (heating, ventilation and air conditioning) systems can become major pathways for the distribution of diseases, germs, viruses, mold, mites, toxins and other health risks,” the report said.

An April 2009 study called “The health and health care of U.S. prisoners: Results of a nationwide survey” published by U.S. National Library of Medicine National Institutes of Health said it analyzed the prevalence of chronic illnesses, including mental illness, and access to health care among U.S. inmates.

The study concluded that “vast improvements in inmate health care are possible” as many inmates indicated poor or lack of treatment for chronic illness and mental illness and limits to overall access to health care.

Other factors that make inmates more vulnerable to COVID-19

The CDC has said age is a factor with COVID-19 and underlying conditions can make people more vulnerable to COVID-19. Those 65 and older could be considered vulnerable and persons with illness such as chronic lung disease could be considered more vulnerable.

The Bureau of Federal Prisons said as of Oct. 24, about 18% of the prison population was 51 and older.

In 2011–2012, an estimated 40% of state and federal prisoners and jail inmates reported having a current chronic medical condition, according to a 2015 report by the Bureau of Justice Statistics.

Chronic conditions include cancer, high blood pressure, stroke-related problems, diabetes, heart-related problems, kidney-related problems, HIV and others.

A 2009 study showed that 38.5% of inmates in federal prisons and 42.8% of the inmates in state prisons had chronic medical issues. Chronic conditions include heart disease, HIV, hepatitis B and C.