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Coronavirus | Criminal Justice | State Government

Doctor underscores stakes of keeping COVID-19 out of prisons, need for 28 temporary nurses

A cell that holds two inmates as seen Wednesday, Feb. 28, 2018 at the Florence McClure Women's Correctional Center. (Jeff Scheid/The Nevada Independent)

The chief doctor in Nevada’s prison system acknowledged this week how high the stakes are in keeping COVID-19 out of the state’s inmate population, noting that there are large numbers of prisoners who are susceptible because of chronic medical conditions.

Dr. Michael Minev’s statements to lawmakers on Thursday come as the Nevada Department of Corrections has reported that 11 staff members have tested positive for the virus. Of 39 inmates tested as of earlier this week, none have turned up positive — a fact cited as prison officials pushed back on calls to further depopulate prisons in court and at meetings of the Nevada Sentencing Commission.

“We do have a very large susceptible group of inmates and we have been extremely fortunate in not having any COVID positive inmates at this time,” Minev, the prisons’ chief medical officer, said at an Interim Finance Committee meeting. “I’m doing everything in my power to prevent any type of infections from getting into our facilities.”

Lawmakers discussed a plan to use $416,000 to help hire 28 temporary nurses at prisons through June 30. The funding is initially coming from the state’s inmate welfare account, with the intent that the federal government will reimburse the state from federally approved coronavirus relief funds. 

Prison officials want to station the additional nurses at gatehouses in seven prison facilities, where they can screen staff and visitors for COVID-19 symptoms. When they aren’t doing screening at entrances, the nurses will be backup for health care personnel who are out because of COVID-19, such as the seven prison nurses who are currently in quarantine as a result of the pandemic.

Asked why the agency wanted registered nurses rather than licensed practical nurses, who have a lower level of training and cost less to hire, staff noted that there is a larger pool of RNs than LPNs. But Minev also pointed out that they’ll be looking for an increasingly wide range of symptoms, and the clinical expertise of an RN could make a difference in detecting the highly contagious illness that has no vaccine or treatment.

“I see this investment in the RNs at our gatehouses and the entrance of our institutions as really an investment as our only line of defense, as a firewall … against presumably our employees bringing in COVID-19,” he said.

Aside from COVID-19’s potential to spread quickly among inmates living in close quarters, Minev said he’s not confident community hospitals would be able to absorb a large influx of inmates. Many are located in rural, remote communities such as Ely and Lovelock.

Taking inmates to hospitals is also a staff-intensive ordeal — inmates must be securely transported by officers and then accompanied 24 hours a day when they are admitted to the hospital. 

Lawmakers brought other questions up to prison officials at the virtual meeting, including whether the inmates making hand sanitizer and masks for first responders through a prison industries program are allowed personal protective equipment themselves. Prison officials confirmed that they are not, and that inmates generally do not wear masks in the prison because of security concerns.

The exception is for inmates who are leaving the facility, mainly to receive medical care. GOP Assemblywoman Robin Titus, who is a doctor, questioned whether the cotton-polyester masks that inmates wear when they are outside of the prison are adequate to protect against disease they might contract in the community. She noted that only N95 masks are effective in preventing droplets containing the virus from entering the nose and mouth.

“I want you to kind of rethink how you’re sending your inmates out because we can’t afford one inmate getting this COVID virus,” she said.

Democratic Sen. Yvanna Cancela asked how the prisons decide who to test, including the severity of the symptoms needed before a test is administered. As of earlier this week, the agency had more than 500 tests on hand.

“I have instructed all providers at our facilities to have a very low threshold for calling me about any type of flu-like or cold symptoms,” Minev said, adding that the state medical director advised testing anyone with upper or lower respiratory tract symptoms. “It’s a very broad list of symptoms, and we are not taking any chances in terms of allowing any individuals with those symptoms to go untested.”

Democratic Assembly Speaker Jason Frierson requested more information about how many inmates are over the age of 65, how many are incarcerated on non-violent and non-sexual offenses, and how many have served at least 75 percent of their sentences. Those are among the categories that have been discussed as possible candidates for early release to depopulate the prisons.

“I think that those numbers would give this body some insight into what we might need to do. Not what anybody in custody is entitled to — that’s not what this is about — but we’re gonna try to mitigate exposure,” he said. “Once it happens in an environment like that, if it happened, it would be completely exacerbated beyond the normal population.”

Frierson said he watched some of the Sentencing Commission meeting Wednesday, when several proposals to recommend broader depopulation of the prisons were rejected in favor of a modest recommendation that might only allow the early release of six prisoners. Frierson called the meeting “painful” and offered oblique criticism of some of the strong advocacy against reducing the prison population.

“While I recognize that NDOC is not in a position to advocate for policy with respect to prison population, I will say I was disappointed in the Sentencing Commission — some members’ advocacy not to,” he said. “We can’t say that we’re not weighing in on certain policy, but then weigh in on the policy when it’s convenient.”

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