A VICE News investigation in partnership with North Carolina Health News found that in the first seven months of the pandemic, North Carolina failed to report all of the prisoners in its custody who died of COVID-19-related causes.
Bingham’s medical investigation, obtained by a public records request from the North Carolina Department of Health and Human Services, states he returned to Albemarle prison on July 30; it makes no mention of whether he received a test that came back negative before his transfer. Regardless, a negative test is not used to determine whether someone’s death was COVID-19-related, according to Campbell. Bingham was placed in “sick ward segregation,” an isolated cell used to quarantine prisoners upon arrival.He insisted his nephew never mentioned previously testing positive for COVID-19.
Using full names and offender data of every prisoner who died in 2020 obtained from the state agency by a freedom of information request, VICE News and NC Health News cross-referenced these press releases with each prisoner’s date of death, age, and location to identify incarcerated people who had likely died of the virus and whose COVID-19-related deaths were announced to the public. Reporters then obtained the death certificates of every prisoner who had died between February 29 and September 20, 2020, from COVID-19 or otherwise, from the register of deeds offices in the counties in which they died through public information requests, as well as medical examiner investigations, and autopsies when available. In North Carolina, incarcerated people’s death certificates must be completed by county medical examiners. The certificates then go to the state vital records office, where they receive final review and are coded into a vital statistics database before being sent to the CDC’s National Center for Health Statistics, which codes each cause of death that occurred within the U.S. using the International Classification of Diseases, a global diagnostic tool maintained by the WHO.“I think it just speaks to a reluctance on the part of the state agency and state leadership to really be accountable and transparent about what is happening to folks who are incarcerated during this pandemic.”
Littman said there are different ways incarcerated people who die due to COVID-19-related causes may be undercounted this year. “There’s people who are tested and confirmed to have had and died of COVID-19, who are not being reported as such,” he said. “That's sort of the clearest case.”That doesn’t include incarcerated people who were not tested before they died, particularly in the earlier months of the pandemic when states didn’t have the capacity to test everyone. Nor does it include people who were released from custody but died of COVID-19 they may have contracted while inside a prison or jail.“Every state is undercounting.”
So does Texas, the country’s deadliest state for prisoners during the pandemic. “For us, it’s a transparency issue. Not all elements of HIPAA expire after death, but the name of an offender does,” said Desel of the Texas Department of Criminal Justice.When prisoner cause-of-death determinations are made, exactly who gets counted—and why—is often opaque.
In 2018, Washington was the first to create such an oversight body. Known as the Office of Corrections Ombuds, it has provided independent reports on state prison conditions and data throughout the pandemic.“You want to get as much information about any death available in one single spot,” said Deitch, who co-chairs ABA's Subcommittee on Correctional Oversight. “As long as the circumstances of the deaths are listed there, it's not really a matter of how the prison is counting it. They can have rules about the way they count, whatever. But you as a researcher could look at the data that's in that database directly and decide.“And it also allows you to look at that data and go back to the prison system and ask, ‘Why not this one?’” she added. “That's how you have accountability in government.” The sheer presence of these oversight bodies may also lead to more accurate internal reporting by prison agencies, Deitch said.“This is not just a COVID issue. This is an all-data issue—we need more transparency when it comes to the data about what's going on in prisons and jails. Deaths are one piece of it.”
But at least 20 states, including North Carolina, do not vet their decisions alongside external death documents. This decision about whether a prisoner’s death is COVID-19-related is made internally, by the prison system’s chief medical officer, according to Bull. The prison doctor reviews all medical records from within the prison system and outside medical facilities to see if “COVID-19 infection played a role in the offender’s death.” Only 11 states, of the 32 respondents to nationwide public information requests, said they adjust COVID-19 counts upon receipt of outside death records such as death certificates, medical examiner investigations, or autopsies.Exactly what broke down between the North Carolina prison system’s criteria and the one medical examiners use to fill out death certificates and investigations is unclear. Regardless, it has led to a discrepancy between what families saw and the public was told.
Both Eddie and Jay Bingham, Billy Bingham’s brother, said they called the Albemarle prison after learning of his death. Both alleged they were told their brother hadn’t had the coronavirus by prison officials. “I contacted the prison camp, and they said he didn’t have COVID-19, because they checked him when he came back and he didn't have the symptoms,” said Jay Bingham.“And then later, once the doctor says it’s COVID on the death certificate, there’s no denying what the documentation says,” Jay Bingham added. “I don’t know if they just weren’t sure, or didn’t want me to know at that time – but my approximation was that they were trying to be low key to not blow it up, because of the concern of the inmates and families, and what kind of repercussions would come as a result of that, you know?”Bingham’s family is trying to move forward, but it’s difficult when they still don’t understand the circumstances of his death, Jay Bingham said. “That was my brother, you know,” he said. “I know my brother was very tough and it would have took a lot to kill him, I can tell you that.”He wishes Billy had tried to call him that weekend, and still wonders what his brother knew in his final moments, what he was thinking. “If I had got to talk to him, he could have told me so much,” Jay said. “I would have been the one to get him to elaborate, to get him to talk about what all was going on in that prison camp – how they were handling things, and his whole diagnosis.”Most of all, as prisoners across the country continue to die of the virus, he wants clarity.“Did he die of pneumonia strictly, or was it COVID-related? I still don't know,” he said. “The families of the inmates—some of these people will never know or find out what the deal is.”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 www.northcarolinahealthnews.org.“I contacted the prison camp, and they said he didn’t have COVID-19.”