Webinar presenters Dr. Robin Timme, Dr. Jennifer Horney, Scott Semple, and Elias Diggins answered a number of your questions after their presentation, Corrections & COVID-19: Maintaining Mental Wellness of Staff and Inmates during Custodial Pandemonium. Here are just a few of their responses.
Robin Timme: So the first thing I’m going to say just to your comment before about next week’s presentation is that what we’ve noticed over the last two years at Falcon is that we want to prioritize the wellness of our staff working at facilities. We believe that the staff needs to be well in order to take care and custody of other humans. So that’s the reason that we let off with this one focusing more on staff. Next week, we will talk more about special populations inside jails and prisons. Thanks so much for that question, Susan. I think I might kick this over to Elias. If you want to speak to that one, Elias was very familiar with the CDC guidelines, which I would also refer you to I believe that this is addressed in those guidelines but Elias do you want to speak to that?
Elias Diggins: I certainly do. Thank you, Robin. They are addressed in the CDC guidelines and what they recommend is performing verbal screening and temperature checks for staff daily upon entry. You know, the first one the verbal screening is probably a little more easy to do for them the temperature checks. We’ve been discussing this inside of our agency because we have talked to staff about when they come to work whether or not they’re feeling sick, if they are exhibiting any of the three symptoms by either having a fever, a cough, or shortness of breath. We’ll take them to our medical staff for further evaluation. The temperature checks are a little more complicated because you might have as in our jurisdiction unions and they may feel that this could be an invasion of privacy. You will have to walk through with your HR department as well as with your Command Staff to follow through the policies and procedures and on how you can execute those. I would point you to the CDC guidelines to address that question.
Robin Timme: Yeah, I’m sure we all have thoughts on this. I’ve been on several conference calls about this specific topic. The first thing I’ll say is that we need to be very considerate and deliberate in who is being released. I think that people see this as an opportunity to release people that they feel probably shouldn’t be in custody to begin with and that may be true. But the issue that has come upon a lot of our calls lately is that the folks that are most likely to be released are your misdemeanants, they are your low-level offenses which also happened to be your homeless population, those with substance use disorders, those with serious mental illness, right? So they come with a host of risk factors and if you add on top of that a potentially positive case of COVID, releasing them into a situation that they may be less safe. I don’t think we really know which is safe or whether you’re safe in the facility or in the street in that situation. In terms of the second part of the question is one that I don’t necessarily have the best answer to which is this idea that let’s take it a step further. What if you have someone who’s waiting for the results of the test and then they make bail and I don’t know the answer to that. I don’t have a good answer. I have some experience. I have heard a couple of jurisdictions that instruct that person to self-isolate and provide them with the results of the tests after that but I have not seen specific guidance on that. If anybody else on the panel here has any thoughts on that I welcome them now.
Scott Semple: I’ve actually dealt with this. We released three people who have actually been positive for COVID back into the community of one woman and two men and prior to their release, what we’ve done is contacted our local Department of Public Health and Environment to alert them of the release and what they have done is issue a public health isolation order, which is essentially a document that compels someone to stay at home. Those states across the country now have stay-at-home orders but this goes a little bit further. This one comes with some teeth, a violation of that order could subject that person to penalties up to and including re-incarceration. I just read another story where some states or municipalities are actually enforcing this by placing people in electronic monitoring. So, I would say contact your local Public Health Department to find out how they believe they should best be handed. We’ve done that and it’s worked out very well. The folks that have been released understand the risk that they pose by getting back to the general community and have agreed to go home and stay in isolation under that order.
Robin Timme: That’s a good question as well isn’t anybody on the panel want to take that one?
Elias Diggins: According to the CDC guidelines, which I spoke up earlier generally the staff that needs to wear PPE are those that have direct contact with either a confirmed or suspected COVID-19 case. And as PPE specifically N-95 is in short supply, I would recommend creating a tiered system for deployment for your PPE so that those folks that are in intake, that are working in the medical units, that are working in those isolation pods are the first to receive those PPE because they will be working with folks that are perhaps confirmed or suspected COVID case. At this time PPE for all staff is not recommended, and if you go those CDC guidelines they have a matrix which shows you which staff they recommend you get PPE for. They actually list out which PPE they should be wearing to include the N-95 face mask, eye protection, gloves, and gowns or overalls. So I will use those guidelines.
Elias Diggins: Yes, the answer is yes, incoming mail should be considered something that possibly could be at risk in coming to your facility. I would say a UV light or if you are able to have something such an autoclave or another mechanism to the clear the mailroom with the mail in there that can reduce the risk. I would ask Dr. Horney about the additional risks that mail presents to coming into a facility, but I can tell you in our agency that we are utilizing those precautions before we introduce it into the facility.
Jennifer Horney: Yes, I mean, I think from the laboratory data we can expect that the virus could still be transmissible for 24 hours from paper and cardboard products. So if there is an ability to leave things aside for a period of time, I’m not familiar with the typical processes that was handle mail but certainly, while it might be a small risk it certainly is a risk that should be dealt with as possible.
Jennifer Horney: I think the important thing to remember is that there are a number of models and they are all using highly imperfect information. So you can find different models online from the University of Washington, the University of Pennsylvania, from Harvard as well as from London and then some more independent effort. We are seeing a wide range of different dates for the height of the surge in terms of the healthcare capacity. That’s what most of the models are trying to predict is the date at which healthcare capacity would be highest. And so really I think that there’s it’s difficult to think about using a model as a decision tool because we’re going to have a very wide range of potential futures. And so what I would say is that almost all of the models are showing us now that we are making progress with the social distancing measures that have been put in place. So for example, we are seeing an increase in the number of days that it takes for the case count to double given that we are increasing our testing. So we are definitely seeing models moving in the right direction. Nationally, we’re seeing that doubling time increase. And so, I think we just need to think that models identify potential concerns that we want to be prepared for but that if our social distancing works, our models will be proven to be too pessimistic.
Robin Timme: So, I think that the suggestions that were offered today are designed specifically for those folks. What I’m trying to focus most of my attention on these days are not the people that are typical pathological population those with anxiety disorders already, for example, but rather you and me and the people who are just trying to go to work, trying to do our jobs and how do we deal with that? That’s why I’m not talking much about the cognitive behavioral therapy for anxiety but rather systemic interventions that can help people to reduce those levels of anxiety that are normal reactions to the abnormal situation. So doing things like coming together as a team and writing out your plan that applies to the things that you can control and updating that plan regularly creating checklists for people helping them to feel less ambiguity will help people to feel less uncertainty and will help them to feel less anxious as a result. I think also just communicating with your peers about this is really critical right now, and I guess I would also just say go check out the interventions that we talked about right here that I have on the screen. I probably should have left these up to begin with so that people can have this.