This story originally published online at NC Health News. 

As the Omicron variant begins to spread across the country, it is inevitable that it will end up in North Carolina’s prison system—if it isn’t there already.

It is unclear whether the more contagious Omicron is driving COVID-19 cases across North Carolina’s prison system, but if the variant is behind bars now, it’s not a question of if but when, experts say.

COVID-19 cases have already been surging in some carceral facilities across the country, with city jails in New York reporting “crisis level” risk to the people incarcerated there.

“All indications suggest that our jail population faces an equal or greater level of risk from COVID now as it did at the start of the pandemic,” New York City Department of Correction Commissioner Vincent Schiraldi wrote in a letter to public defenders December 21.

The North Carolina Department of Public Safety announced Monday via press release that an unnamed inmate from Greene Correctional Institution died over the weekend, the first COVID death since May.

“The offender tested positive for COVID-19 on December 21 and was hospitalized on December 24. His condition worsened, and he died on January 1, 2022. He was unvaccinated for COVID-19,” the statement read. It also said that the inmate was in his late 70s and had pre-existing conditions. 

According to DPS spokesman John Bull, the department does not perform genetic sequencing, so it’s unknown whether that person was infected with Omicron or Delta. 

“We don’t have the capabilities,” Bull said. “We will never know which variants this is that impacts the prison population. We just don’t have that equipment, we don’t do that work.” 

Bull also said that North Carolina’s carceral system is starting to see outbreaks again, that are likely Omicron. He confirmed that there were three positive tests at the North Carolina Correctional Institution for Women over the weekend.

It is likely that other facilities across the country will face similar challenges, said Wanda Bertram, communications specialist for the Prison Policy Initiative.

“I think the worst-case scenario is that a lot of people get sick with the Omicron variant,” Bertram said. “And it overwhelms the medical unit in the prison, such that people who have other chronic illnesses are not able to get treated and a lot of folks in prison get long COVID. 

“I think that’s basically the worst-case scenario. I think it’s also almost inevitable.”

Vulnerable population

Scientists are still learning more about the Omicron variant, but early indications are that it appears to spread more easily than the Delta variant, and vaccines are estimated to be less effective at preventing infections and only 70 percent effective at preventing severe disease.

People given a booster vaccine, however, tend to have better outcomes if infected.

Public health experts have moved to protect immunocompromised and elderly people from severe disease due to COVID-19, but incarcerated people—who disproportionately suffer from chronic conditions and include the elderly—are often left behind. This can lead to deadly consequences, both for people inside and outside prison systems. One study found that the Cook County Jail in Illinois was linked to 15.7 percent of COVID cases in the state.

“As long as there are outbreaks behind bars, those epidemic outbreaks spill into our communities,” said Amanda Klonsky, a research and policy fellow at the UCLA Law COVID Behind Bars Project. “People who work in jails and prisons carry the virus into these confined settings, where they spread rapidly– and they carry the virus from these institutions back home to their families and communities.” 

DPS has reported that 56 incarcerated people have died in its prison facilities since the beginning of the pandemic. The COVID Behind Bars Project estimates that the mortality rate for people incarcerated in North Carolina’s prisons increased about 36 percent from 2019 to 2020.

In May, vaccinations started to be given widely inside the walls of North Carolina’s correctional institutions.

But as vaccines’ ability to prevent COVID infection appears to have waned with the new variant, it is a cause for concern for incarcerated people, who are housed in close-quarter dorms, and many of whom have chronic health conditions, Bertram said.

At a press conference addressing COVID-19 in the state on December 20, North Carolina Department of Health and Human Services Sec. Mandy Cohen and Gov. Roy Cooper urged North Carolinians to get their vaccinations and booster shots to prevent severe illness, hospitalization and death.

“This is not … a moment to throw up our arms in the air,” Cohen said. “It is a moment to act.” 

At that press conference, Cohen recommended North Carolinians fight the upcoming surge with vaccination, booster shots, testing and masking up. For people incarcerated in the state’s prisons, whose safety the state is responsible for, some of those recommendations are a tall order.

Protections against Omicron

North Carolina’s prison system is reporting that close to 80 percent of incarcerated people are “fully vaccinated,” along with roughly 61 percent of staff. 

“We know we want vaccines as many places as we possibly can,” Cooper said at the press conference. “One of the things I know we’ve done is offer incentives for corrections officers to get vaccinated. So it’s critically important that we get vaccines and boosters all across the state.”

As of Christmas, Bull said about 4,000 of the 29,218 incarcerated people in the state had gotten their booster shots. Just under 75 percent, or 21,770, of those incarcerated in NC prisons have opted to get a vaccine at all. Almost all of those vaccinated received the Moderna vaccine.

“We’re working on boosting everybody who’s willing to get boosted,” he said on Monday. 

The prison system is offering incentives to incarcerated people to get booster shots, Bull said, including “extended television time, extended visits, extended time to use the tablets for offenders in the seven prisons that are tablet-capable at this point.” He also noted that currently, he didn’t have facility-by-facility information on how many inmates have received boosters.

Incarcerated people who get booster shots are also prioritized for job assignment and program placements in work release programs, Bull said. Part of the incentive is requiring anyone working outside prison walls to receive a booster by February 1. 

“There are no staff booster incentives at this point,” Bull said.

However, staff who are fully vaccinated are eligible for a $500 bonus. The state is using CARES Act money to pay for these incentives, CBS 17 reported.

“Anybody on the staff who was fully vaccinated or becomes fully vaccinated at any point between now and April will get the $500 incentive,” Bull said on Monday.

To prevent spread, Cohen recommended North Carolinians to wear a “medical grade” mask in public indoor settings, if possible. These include surgical masks and N95 masks.

Still, medical grade masks are not distributed to incarcerated people, Bull said. Incarcerated people have cloth masks, many of which are worn and do not fit their faces tightly, said one person incarcerated at North Carolina Correctional Institution for Women, Bridgette Mabry.

Medical grade masks are available to “any staff who asks for one” and distributed to staff who work with incarcerated people who have tested positive for COVID-19.

The prison’s protocols for testing have proven to be confusing for incarcerated people, North Carolina Health News previously reported. Although the Centers for Disease Control and Prevention recommend that vaccinated incarcerated people be tested for COVID-19 after potential exposure to the virus or if they are experiencing symptoms, women incarcerated at NCCIW said it seemed like no one was being tested.

Staffing in Omicron

The Omicron surge is also likely to sicken carceral staff, Bertram said.

“Just getting boosted is not going to prevent staff from bringing the Omicron variant in and out of the facilities,” Bertram said. “And it’s not going to prevent staff from getting sick and having to be out sick.”

Without adequate staffing, carceral facilities will be less able to test and care for incarcerated people, Klonsky said. 

“All the critical public health functions, such as COVID monitoring through testing and reporting, are impossible without staff on hand to carry out those tasks,” Klonsky said. “When prisons are unable to maintain basic safety for people inside, we see huge increases in violence behind bars and reports of people getting sick and dying because they are being neglected.”

In anticipation of an increase in COVID-19 cases, prisoners will now get their medications three times a day instead of four times a day, in order to “free up nursing staff who may be needed to provide patient care for any increase in COVID-19-positive cases in the weeks and months to come,” Bull said in December.

As the Omicron variant looms, Bertram argued that it’s time to think about lowering the population in carceral facilities as an option for decreasing harm.

“I just think those are the situations where prison systems really need to take seriously their power to let people go home,” Bertram said.

Outbreaks in prisons, while seemingly confined within those institutions, put the rest of the public at risk, Klonsky argued.

“That’s why it is so very important that people who work in jails and prisons get vaccinated. Rates of vaccination among people who work in jails and prisons in North Carolina are still too low.”

North Carolina Health News is an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at

Support independent local journalism. Join the INDY Press Club to help us keep fearless watchdog reporting and essential arts and culture coverage viable in the Triangle. 

Comment on this story at