Dr. Scott Bauer usually treats veterans on the San Francisco Veterans Affairs Medical Center. But when the internist heard about a possibility to volunteer at San Quentin State Prison through the coronavirus outbreak, he raised his hand.
San Quentin, a Bay Area-based prison for males and the oldest establishment of its type in California, has skilled a staggering Covid-19 outbreak in current months. About two-thirds of its residents have examined constructive for the coronavirus and 25 folks have died up to now. Now, about two months after the outbreak took off, infections are beginning to slow down. Internal prison information exhibits that there are solely 37 confirmed lively instances of the virus and solely three constructive assessments inside the previous two weeks.
While San Quentin and different prisons might have seen the worst of the outbreak, it isn’t over for the incarcerated males and workers. For some sufferers, it has been months since they first examined constructive. And the street to recovery has been stilted and slow.
Dr. Bauer had by no means been to a prison earlier than he walked into San Quentin. During his first go to again in mid-July, he was accompanied by a correctional officer whereas seeing inmates on loss of life row and in the loss of life row medical clinic. In different blocks, he might transfer round extra freely. Many of the sufferers reminded him of the veterans he treats, as they have a tendency to be older and have comorbidities, that means they produce other medical circumstances which may put them at a better danger of dying in the event that they catch Covid-19.
Earlier in the summer season, a number of doctors from Amend, a bunch at UCSF and the University of California, Berkeley that is working to remodel correctional tradition, wrote an pressing memo about vulnerabilities at San Quentin. What these doctors noticed alarmed them. That memo referred to as for extra sources on the bottom and a plan to handle overcrowding to stem the outbreak.
“We saw incredibly rapid transmission there,” Dr. David Sears, a director of healthcare high quality at Amend, mentioned in an interview in July.
The group advisable some quick reforms, together with higher air flow, extra quarantine isolation areas, and elevated testing with a quicker turnaround time.
“The urgent resources San Quentin requires range from human capital to environmental risk reduction and rapid testing,” the group wrote in the June 15 memo. “Failure to meet these urgent needs will have dire implications for the health of people incarcerated at San Quentin, custody, staff, and the healthcare capacity of Bay Area hospitals.”
Some of the measures appeared to have made an affect, together with the discharge of about 1,000 inmates to scale back overcrowding. The prison additionally elevated its testing program. But the adjustments weren’t made in time to cease the virus from spreading rapidly, ultimately infecting greater than 2,000 folks.
Dr. Bauer has now labored a few dozen shifts on the prison the place he normally will get in at eight a.m. and leaves at 5 p.m. An enormous a part of the job entails evaluating those that have been handled in neighborhood settings, reminiscent of native hospitals, after which returned to San Quentin after their signs alleviated.
Many Covid-19 sufferers exterior of San Quentin have advised him they’re nonetheless experiencing fatigue, muscle aches, shortness of breath and different signs for months after recovering from the coronavirus.
Many sufferers nonetheless have a persistent cough, lingering fatigue and a restricted capacity to train weeks after testing constructive. Recently, Dr. Bauer mentioned, San Quentin has been opening up entry to the yards.
He’s additionally seen proof of cognitive impairments, developmental delays, melancholy, anxiousness and a few proof of Post-Traumatic Stress Disorder from sufferers who have been placed on a ventilator. For volunteers who’ve solely been there a couple of months, it is onerous to say how a lot of that stems from Covid-19 and the way a lot of that was current earlier than the an infection.
“There’s a very robust mental health system at the prison and I know everyone has been working very hard,” he mentioned.
For Dr. Bauer, the expertise has been an “eye opener” as a result of it is helped him perceive extra broadly how international locations might wrestle to address giant volumes of people who find themselves nonetheless experiencing signs in the long-run, significantly these with restricted sources. He suspects that it would weigh on well being programs and suppliers exterior of the correctional services. One suggestion entails bringing in pulmonologists, who specialize in treating lung circumstances, at locations like San Quentin and share greatest practices for post-Covid-19 care.
Outside of prisons, hospitals are organising specialised clinics for individuals who are nonetheless struggling. Doctors throughout the nation are nonetheless studying why sure folks proceed to expertise signs for thus lengthy, whereas others bounce again extra rapidly.
“More direct access to people with expertise in managing symptoms would be helpful,” mentioned Dr. Bauer.