As Coronavirus deaths escalate in California’s prisons, advocates say medical parole could help stem the pandemic.

With a third of the population at San Quentin State Prison infected, the chronically ill and the elderly are scared that without intervention they could be next. [Note: This article was written in June. By mid-July, half the population of SQ was infected, by mid-August, more than 20 had died.]

Two more San Quentin State Prison inmates died of what appears to be complications related to COVID-19 over the weekend, according to the California Department of Corrections and Rehabilitation (CDCR), heightening fears that the prison’s outbreak is spinning out of control. Scott Thomas Erskine, 57, and Manuel Machado Alvarez, 59, are the 23rd and 24th COVID-19-related deaths of incarcerated people in California’s prison system. San Quentin alone currently has 1,379 people who have tested positive for COVID-19— over a third of the prison’s population.

“I’m scared as hell because of coronavirus,” said Willie Mixon, who is a 70-year-old African-American incarcerated at San Quentin. “Who do you think would be the first person knocked off? Not a moment goes by that I don’t think about that.”

Mixon uses a wheelchair and is currently on dialysis for his kidney failure. For treatment, he has a stent placed in his left arm. Three days a week he must go through two to three hours of blood transfusions to stay alive.

“When I first started the dialysis, it wasn’t so bad. After it, I could get up and talk,” Mixon said. “Now it feels like someone’s pushing on my chest, like I’m taking off in a jet. I lose my voice and I’m tired. I can’t explain the tiredness—it’s draining. I get fuzzy.”

A variety of factors make incarcerated people like Mixon high-risk during a deadly pandemic. Prisons are notoriously overcrowded (in some cases with beds placed just three feet apart) which can make maintaining the recommended six feet of distancing next to impossible. An estimated 40 percent of incarcerated Americans report having a chronic condition, many of which (including chronic kidney disease) make them high-risk for developing severe complications from COVID-19. The availability of face masks and other protective gear has been extremely limited, resulting in the American Civil Liberties Union of Southern California to file a statewide lawsuit in May.

In response, a mix of prosecutors, doctors, and prisoner rights advocates have called for immediate or expedited release of people like Mixon who have serious chronic health conditions. This move, they argue, could save lives by reducing overcrowding and getting the most vulnerable into safer conditions. It’s a prospect that makes Mixon perk up.  

“What can I do, except stay home, babysit my grandkids and get them to teach me how to use the computer?” Mixon said of the prospect of an early release. “My daughter would be able to take my social security and take care of me.”

In California, CDCR announced in June that those convicted of nonviolent offenses who had less than 180 days on their sentence were eligible for supervised release and at the end of March, 3,500 people were let out on parole a few days or weeks early. 

Mixon is serving a life sentence for drug possession under California’s Three Strikes Law. Violent offenses, dating back to 1978, disqualify him from early release from previously passed Three Strikes reform measures.

“Seeing Mixon struggle is hard. But he always bounces back and never complains,” said Ron Ehde, who works for the Inmate Disability Assistant Program (IDAP) and has been incarcerated 23 years. He’s doing a 50-year-to-life sentence under California’s Three Strike Law for second-degree robbery. “Since I’ve been assisting him, he’s become like ‘family.'”

In 2014, California expanded medical parole in an attempt to reduce prison crowding. This allows medical staff to assess medically incapacitated prisoners for how much help they require with things like mobility in bed, using the bathroom, and eating. If they’re not deemed to pose an “unreasonable risk to public safety,” this could potentially make them eligible for medical parole.

While prison medical officials should assess everyone who may be eligible, a prison’s family or other advocate can request that they’re evaluated for medical parole. If a parolee’s condition improves or if they’re deemed a threat to public safety, their parole can be revoked.

No prison official has discussed the possibility of medical parole with Mixon.

Despite what many advocates say is a common-sense response to a growing crisis, the use of medical parole during the pandemic has been limited.

“Expanded Medical Parole might not be as productive an avenue for releases as it should be,” said Keith Wattley, the Founding Executive Director of Uncommon Law which provides health and legal counseling to incarcerated people. “It requires medical staff at a prison to issue a report finding a person to be totally medically incapacitated, after which a referral is made to the parole board, which might schedule a hearing months later to consider whether the incapacitated person could safely be transferred to a skilled nursing facility in the community. This process is slow and depends on prison medical staff, parole board staff, and community facilities.”

Some local jails have been proactive, including Alabama’s Mobile Metro Jail, which in April released almost a third of those incarcerated, some because they had underlying medical issues.  About 100 people were released from Boulder County Jail in Colorado, including some of those who had pre-existing medical conditions.

In comparison to local jails, prisons like San Quentin “are releasing almost no one,” according to the Prison Policy Initiative, a nonprofit that researches mass incarceration, for medical issues or otherwise. 

In Louisiana, which has the highest incarceration rate in the country, a review panel was created to review up to 1,100 people for temporary release but that panel was suspended in June after less than 600 cases were reviewed. Just 63 people were released.

Like many incarcerated people, Mixon’s medical issues have plagued him for years and have gotten worse during his time at San Quentin. People often age prematurely when in detention, experiencing health problems associated with much older individuals.

Mixon noticed serious swelling below his knees around 2018. He sought medical attention but didn’t get any answers about what was wrong.

“Then one day everything from my knees down blew up, like elephant feet. A couple weeks later, while using the toilet, I couldn’t get up. I couldn’t wipe or anything. I fell on the floor and couldn’t get up.”

Mixon said he was so weak that he couldn’t yell loud enough to call for help. He tapped on the cell wall to get the attention of his neighbor, who called, “Man down!”

A correctional officer arrived and asked him to step out of the cell, but Mixon couldn’t get to his feet. The CO radioed for assistance before coming inside the cell to turn on the light. Mixon told the COs that he didn’t feel bad, but couldn’t stand. Three COs tried to pick him up, but couldn’t get a good grip—his body was too bloated. They pulled him out by his arms and legs.

“I couldn’t even raise my head to see what was going on,” Mixon said. “They put me in a wheelchair and took me to TTA [San Quentin triage].”

Mixon desperately wanted to see himself and kept asking for a mirror. When he got one, seeing his swollen body brought him to tears.

He was taken to Marin General Hospital (outside of San Quentin) and treated for kidney failure before he was returned to San Quentin’s hospital for continued treatment.

“At first, I was still big and couldn’t move on my own. The nurses had to come every few hours to turn me over,” Mixon said. 

The initial recovery took about two months during which he experienced mental and physical fatigue and weight loss as a result of the dialysis.

“When I got back to North Block, I was very small. The biggest thing on me was my head,” Mixon said. 

“It’s crazy that this is what it has come to: We’re keeping people in prison until they are so medically disabled that they can’t even take care of themselves. And even then we’re using a months-long, resource heavy process just to transfer their care to a facility in the community,” said Wattley. “This is a miserable substitute for the Governor and prison leadership releasing the thousands necessary to keep people safe.”

Mixon is scheduled to appear before the parole board next year but has struggled to do the preparation his parole commissioners have asked of him. 

“Everything went downhill because of the high-potent psych meds. I haven’t adjusted to them.  They mess me up. Plus, I’m in and out of the hospital,” said Mixon.

Mixon’s memories of his family and the hope of spending time with them again is part of what keeps him going. He smiles when he recalls the day his daughter was born.

“When I complained to my mother that I wanted a boy, she told me ‘Jesus blessed you with what you need.'”