An emergency medical team and housing facility provided critical care for San Quentin’s sickest patients suffering from California’s deadliest prison coronavirus outbreak.
“By the end of this week, we will have a 220-bed Alternative Care Site (ACS) in PIA (Prison Industry Authority). This will improve our capacity to provide onsite medical care for those impacted by the virus,” announced Acting Warden Ron Broomfield and Chief Executive Officer of SQ Healthcare Clarence Cryer in a July 9 memo to the incarcerated population.
COVID-19 cases in San Quentin spiked from zero in May to over 1,000 by the end of June, according to California Department of Corrections and Rehabilitation (CDCR) data. The coronavirus outbreak spurred dramatic changes to life inside The Q.
“Your COVID-19 test result from 07/07/2020 is positive for coronavirus,” read the notices from California Correctional Health Care Services (CCHCS) given to dozens of West Block residents.
An hour later, the names of 18 of them were called over the loudspeaker. “Pack your stuff; you’re moving to PIA,” announced the officer. Seventeen of them, with a few of their things, were escorted across the prison, not knowing what to expect. One apparently refused to move, likely resulting in a 115 rules violation “write up.”
The PIA area is several large old factory buildings where prisoners work to create products that range from bed mattresses and furniture to computer coding. All PIA programs had stopped due to the outbreak. One of the buildings was converted into a temporary medical emergency housing facility. According to prison staff, the National Guard disassembled and removed tons of machinery and equipment to prepare the site.
The first incarcerated patient arrived on July 11 to find 240 empty cots set up about six feet apart in rows. Each cot had a cushion mattress, disposable sheet, two blankets, and a small — but fluffy — pillow with a disposable pillowcase, all brand new. A few wooden signs engraved with the words “CAL-PIA SAN QUENTIN CHAIR FACTORY” hung from the ceiling.
Twelve healthcare workers — wearing hair covers, face shields, masks, disposable gowns, gloves, and shoe covers — welcomed their patients and situated them in their assigned bunks.
The nurses, paramedics and doctors were part of a team of about 40 assembled from around the U.S. by VxL Enterprises’ Tactical Medical Services Division, a full-service, international emergency medical services provider that contracts with the U.S. government.
Within a few days, about 100 coronavirus-infected incarcerated patients were living in the factory-turned-medical emergency facility. That doubled a week later.
The patients’ severity of disease covered the spectrum from asymptomatic to critical. All patients were monitored daily for vital signs. Some required EKG monitoring and intravenous fluids. Many breathed oxygen from portable tanks and bedside machines. The medical team provided around-the-clock care in 12-hour shifts.
Most of even the sickest patients recovered over days or weeks, but many deteriorated quickly, requiring immediate hospitalization, so ambulances arrived in moments.
Residents returning from outside hospitalization were brought directly to the PIA care facility for continued medical treatment. Often the sickest, they required close attention and were assigned to beds closest to the nurses’ station.
One such patient was 58-year-old Ronald Melville. He was very sick in West Block for many days and went “man down” twice, to get medical attention, but did not get better.
Melville, still very ill, moved from West Block to the PIA medical care site the day it opened. The medical team there diagnosed him with COVID-related pneumonia and sent him by ambulance to St. Francis Memorial Hospital within a day, where he received emergency intensive care for four days.
“I don’t know if I’d still be alive today if it wasn’t for what’s going on right here in PIA,” Melville said after returning to the hospital. “I can’t thank the people here enough.”
He spent two more weeks recovering in the temporary care site, gradually regaining the strength to walk and talk. “I’m already serving my sentence,” Melville said. “But this COVID feels like another sentence on top of that. I didn’t sign up for all this.”
Melville paroled from prison on Aug. 22, still not feeling 100 percent.
Some patients appreciated the change of atmosphere they experienced upon moving to the care facility.
“I didn’t know how depressed I was until I got outta that cell,” said Lenny, describing moving from his West Block cell after four months of shelter-in-place.
Not everyone, however, was happy to be there. For many patients, this was their first time living in a dormitory. After years or decades of living in a cell with just one other person, being suddenly moved into a room with more than 100 prisoners day and night with no way out was very stressful for some.
Residents asked, “When can I go back to my cell?” a hundred times a day. Nobody knew.
The prisoners had already endured four months of isolation without work, school, religious services, and weeks without fresh air and sunshine. Moving to the emergency care facility meant they now also lost access to the prison canteen, quarterly packages, cell property, telephones and their own television, sink and toilet.
“Why am I being punished?” asked a patient named Marty. “Why am I even here? I don’t have any symptoms.”
Patients had access to a trailer set up outside with flushing toilets and sinks a few times a day most days. Most of the time, however, they were limited to the small restroom inside, where the sick patients frequently had to wait in line.
Creating the emergency care site from a factory in the middle of a local crisis and worldwide pandemic was a Herculean accomplishment. Operating it, it turned out, was also a huge challenge.
Doctors expressed frustration at not being able to let their patients know when they could go back to their regular housing. Normally the doctor alone decides when a recovered patient will be released from care, but in this situation, it is custody staff that directed the movement.
Officers were in an unfamiliar situation with no established procedures. They were concerned about keeping themselves and their families safe from a serious, highly contagious disease. One hundred and fifty staff members had already tested positive. Many officers came in from other prisons, increasing unfamiliarity.
“There’s no guidebook for this,” said CDCR Secretary Ralph Diaz in a video message describing the unprecedented quarantine and distancing measures being implemented statewide.
The uncertainty, changing procedures, and arrivals of more incarcerated people created a fluid atmosphere in the first few weeks. Periods of calm were interspersed with rising tension, including arguments, an assault, a strip search, and a thrown cot.
Many people really worked together to smooth things out. Most patients, as a matter of course, helped each other. Many voluntarily cleaned, organized, helped staff, and communicated with staff on behalf of the residents.
Many officers worked consistently to provide patients access to the services and supplies they needed to recover and stay healthy.
National Guard members, about 20 women and men in full camouflage, worked three days assembling brand-new electric inclining hospital beds with six-inch mattresses and replacing the cots for all the patients.
The VxL Enterprises medical team steadfastly provided quality professional medical care, despite the turmoil.
Food and hygiene items did eventually arrive from the prison canteen. Telephones were installed. A second trailer with restrooms and two trailers with showers that usually had hot water were set up outside. Clean clothing, soap, and toilet paper were distributed. An SQ librarian brought boxes of books and magazines for the patients to read. There were also microwave ovens and large-screen TVs, which are not available in West Block.
Then, as the spike of The Q’s coronavirus outbreak receded, the emergency housing facility emptied almost as quickly as it had filled up.
After peaking at around 200 patients in the second half of July, the population decreased from around 100 in the beginning of August to 20 mid-month, then 12 at the end of the month.
That roughly followed the receding spike in active cases in San Quentin, peaking around 1,400 in early July, falling to around 200 early in August, then around 50 mid-month, according to CDCR data.
“I sure do miss being down there in PIA,” said “D,” getting a breath of fresh air outside West Block. He said he was surprised at how good it felt to be in the open medical dorm, getting care with dignity.
“Readjusting to the cell was rough,” he said. “This up here sucks.”