When Teresa Bebeau remembers losing her friend Mark Trammell, she doubles her mourning. South Carolina's prison system had two chances to save his life, she said, and they failed him both times.
On July 6, Trammell would become one of 31 South Carolina prisoners killed by the virus during their sentences, falling ill in conditions that inmates call inhumane and South Carolina Department of Corrections authorities say are the best they can manage as prisons across the nation struggle with understaffing.
Several months into Stage 4 liver cancer that rose from hepatitis he and many fellow inmates were diagnosed with in prison, the 60-year-old convicted killer had hoped to win parole from his life sentence for kidnapping, and spend his final weeks with his mother.
Instead, inmates and prison medical staff took care of Trammell as he lost energy, wheeling him to the infirmary phone so he could call Bebeau and his family. They talked about family, hopes, and his condition — Trammell knew he would die soon, but wanted to comfort her.
One day, another inmate called with disturbing news: A new patient with several coronavirus symptoms had joined them in the infirmary. Trammell hadn’t been transported for many of his scheduled chemotherapy treatments, Bebeau said, so he was concerned about both the cancer and the pandemic.
There wasn’t much Trammell could do. On days he was in less pain than usual, Bebeau said, he’d palm his morphine pills to swap with other inmates for sanitation supplies in hopes of protecting himself from infection.
Inmates like Trammell who’d struggled with health concerns for years say conditions at prisons have grown worse since the pandemic hit the Palmetto State in March, and that even prisoners who don’t fall ill themselves have dealt with subpar food, cramped rooms and minimal hygiene as the department’s staff struggles to keep an already strained system afloat. The ACLU of South Carolina filed a lawsuit in April demanding prison officials increase protections and release inmates with health risks to reduce crowding.
“I’m trying to keep what happened to Mark from happening to others,” Bebeau said. “These guys, they weren’t sentenced to death.”
The Corrections Department has long had to balance expensive upkeep with tight budgets and has struggled to maintain safety protocols while understaffed.
The department had won a promise to expand funding for better staff pay and inmate programs, but coronavirus crushed the state’s budget. In hopes of quashing the viral spread within prison walls, Corrections Department Director Bryan Stirling has funneled money toward rapid testing, overtime for staff and purification devices for aging air-conditioning systems.
Stirling said he stands by the system’s daily routine of check-in calls to strategize response, and admires staff members who've worked to mitigate the difficulties, including wardens who cook for inmates on weekends. But, he said, it's difficult to monitor programming and living conditions when staffers are struggling to get enough people to transport a prisoner to the hospital.
At least 15 states have higher rates of confirmed cases among prisoner populations, according to The Marshall Project, though uneven testing standards mean the numbers may not be reliable. Early adoption of masks and cancelled visitations helped SCDC stave off higher numbers in early spring, Stirling said, and the department's testing data shows a sharp decrease in the spread after August.
“We’re managing risk,” Stirling said. “That’s what we do every day and that’s what we’ve always done.”
When inmates show any illness symptoms they’re isolated, and usually sent to the infirmary, according to Dr. April Clarke, the department’s deputy director of medical services. Medical staff evaluate the patients and test them on-site if the symptoms seem coronavirus-related. Inmates in the Midlands can get test results back within an hour, Clarke said, while others have to send samples outside the facility.
As testing availability improved across the state and Medical University of South Carolina teamed up with the department to analyze saliva-based testing, SCDC has managed to do dorm-wide tests all at once. It has focused those efforts on facilities like Tyger River and Broad River, which have seen overwhelming outbreaks.
The focus is on new arrivals, and medical staff also tests those who leave for parole, release or medical appointments, Clarke said. Even so, some health care providers have turned inmates away after learning they come from an infected facility. Officials are focused on keeping the virus from spreading past prison gates in addition to within dorms.
“We have a duty to the people of South Carolina to keep them safe, not only from violent people but from sick people,” Stirling said.
Betty Cochran was among the prisoners kept from her regular medical appointments by the pandemic, staff members told her daughter. When Pamela Lydia followed up on the blood in her mother's urine — especially of concern because Cochran had been in remission from bladder cancer — nurses said staffing and concerns about coronavirus spread prevented them from taking her.
While those prisoners wait for their results, they’re moved to isolation areas, Clarke said, which look different in each prison.
When Cochran tested positive for coronavirus, Lydia said, staff moved her from Leath Correctional Institution near Greenwood to an isolation unit near Columbia. But Lydia said her mother didn't go to a hospital until her fever hit 105 degrees. Her parole hearing, postponed due to the virus, was pushed forward, and Cochran was released from custody while in her hospital bed.
Lydia picked her up from the hospital and took her to her sister's home to recover from coronavirus and prepare for a full bladder removal surgery — unavoidable since she'd been untreated for so long, her doctor told Lydia.
In general, when a test comes back positive, an inmate is moved to full isolation and the dorm is put on a 14-day quarantine. Staff and National Guard troops monitor the prisoner's vital signs. If anyone else falls ill, the 14-day period is restarted.
“In most instances, I can say that we’ve been able to really separate the two,” Clarke said. “But they could have been exposed during that time, that wait period.”
Several prisoners told The Post and Courier that’s exactly what’s happened to them, with officers ignoring requests for tests and medical attention until symptoms begin washing over entire dorms.
Inmates say they're fending for themselves
Basil Akbar said he’s lucky to have survived the first few weeks of infections before he was granted parole from his murder sentence at Lee Correctional Institution in early April. Now he’s trying to keep track of evolving conditions in the facilities, and get cleaning supplies to his friends, who he says are left to disinfect their own cells with makeshift sanitizers they craft from soap. By October, six Akbar's acquaintances in the system had caught the virus and died, he said.
Akbar said the early days of the pandemic were the worst he’d witnessed since the 2018 Lee prison riot, when barebones staffing left officers unable to quell a rash of violence that resulted in seven prisoner deaths.
Many of the prisoners who’ve fallen ill — over 2,200 as of Friday — are recovering in their facilities. Stirling said prison infection rates tend to follow the surrounding community’s. When a town near a prison sees a spike in cases, SCDC has about three weeks to brace for a similar wave behind prison walls as staff and prisoners with medical appointments travel in and out.
One elderly convicted murderer, who requested his name not be used because inmates aren’t allowed to speak to reporters, believes he caught the virus in the Broad River prison.
“The guys were medicating me with Alka-Seltzer plus vitamins,” he said. “There’s no social distancing they can do.”
So prisoners sleep in their cells head-to-foot and stay as far apart as possible, keeping themselves occupied with electronic tablets provided so they can do legal research. Stirling said the department is working to get them access to the Westlaw online legal research service so quarantined inmates can work on their cases. He wasn't sure when that would be possible. Facilities with low case numbers have been able to keep some common areas open, but most inmates have been restricted to smaller areas than usual.
The elder prisoner said he went eight days without a shower in August. Many prisoners take fewer than the usual three showers per week because there aren't always enough corrections officers to supervise. And sometimes the staff has to send everyone back to their cells if a fight breaks out, Stirling said. SCDC spokeswoman Chrysti Shain said she hasn't been able to verify any periods of more than four days that inmates couldn't shower.
Prisoner Alan Burns isn’t taking any showers, period. Incarcerated at Broad River for a series of child sex convictions, Burns has several health conditions and is so desperate to stay healthy that he keeps to his cell, bathing with sink water.
Burns said an officer coughed on him as a joke when he reminded staff to put on their masks, and he’s still trying to get someone at the department to help enforce the rules laid out at the beginning of the pandemic. He’s filed complaints and talked to staff, he said, and officers have begun wearing masks more consistently. Shain said the department investigated his claims and determined there was no need to discipline the corrections officer.
But Burns fears the mask wearing is too late. From his cell, Burns has seen inmates' bodies pulled from their cell floors across the hall. One man was on his way to the hospital when he died in the hallway, Burns said. Afterward, workers sanitized the cell and common areas, but Burns said neighboring cells weren't cleaned or tested.
So far, over 400 inmates at his facility have tested positive for COVID-19, and half of the cases are still active — making it SCDC's largest current outbreak. Nine have died. It would take little more than an unsanitized doorknob or too-close cellmate to give Burns the virus, he said, and he’s already resigned himself to the likelihood of infection.
Clarification: This report has been updated to clarify that prisoner Mark Trammell died July 6 and that the SCDC investigated claims a corrections officer coughed on inmate Alan Burns and found there was no need to discipline the officer.