As the Covid-19 pandemic ravages prisoners worse than nearly every other U.S. population cohort, prison reform advocates and public health experts are renewing calls for the medical parole of inmates—especially those at risk for death or serious complications due to pre-existing health conditions. 

“They’ve got us bunched up together. There’s no social distancing at all. We share day rooms, we share showers. We share practically  everything.” 
—Mario Smith, inmate 

According to a recent study by the National Commission on Covid-19 and Criminal Justice, U.S. prisoners are three times more likely to be infected with coronavirus than the general population. The situation is even worse in federal prisons, where one in every five inmates is infected, compared with about one in 20 people on the outside. 

At least 275,000 inmates in U.S. prisons and jails have tested positive for coronavirus, and at least 1,700 have died—although some correctional authorities say the actual number of both infections and deaths is much higher. 

California, which is currently suffering its worst period of the pandemic, is also experiencing an acute Covid-19 crisis in state prisons. The Guardian reports that nearly 9,500 incarcerated people are currently infected, with all 35 of California’s state prisons now experiencing outbreaks—most with more than 100 cases.

Over one-third of California’s more than 38,000 total coronavirus infections have occurred in the past two months, a stunning escalation that has sparked renewed calls for the early release of vulnerable inmates, as well as court rulings ordering such paroles. 

“I don’t think there’s another reason to not release them besides political backlash,” Donald Specter, an attorney who is suing for the release of California inmates, told The Guardian. “Some are sex offenders, some are lifers who were convicted of murder, and there’s general reluctance of politicians to release these people.”

“The bottom line is, there are still thousands of people who are at very high risk of death trapped in a prison system where there’s no way that they can avoid the virus,” he added. 

Jennifer Soble, head of the Illinois Prison Project, recently told the St. Louis Post-Dispatch that “there is no question that [Covid-19] was going to make it into the prisons.”

“The tragedy is the number of people who have become sick and died,” added Soble. “That tragedy was preventable.”

In Pennsylvania, the editorial board of the Philadelphia Inquirer earlier this month wrote that “prison should not carry the risk of an unintentional death sentence.”

“A bill to create medical parole for the release of the sick and elderly was introduced before the pandemic and never received a committee vote” in the state legislature, the editors wrote. “For a state with an ill and aging prison population, having no medical parole makes no sense—in financial or humanitarian terms.”

Accusing California prison officials of “deliberate indifference” to inmate health, a state appeals court in October ordered San Quentin State Prison—where thousands of prisoners have been infected—to release or transfer roughly half its population. 

“By all accounts, the Covid-19 outbreak at San Quentin has been the worst epidemiological disaster in California correctional history,” Presiding Judge Anthony Kline wrote in his decision. “And there is no assurance San Quentin will not experience a second or even third spike.”

“By all accounts, the Covid-19 outbreak at San Quentin has been the worst epidemiological disaster in California correctional history.”
—Judge Anthony Kline

However, California Attorney General Xavier Becerra—who earlier this month was nominated by President-elect Joe Biden for health and human services secretary—appealed the ruling to the state Supreme Court, which will decide by January 25 whether to review the case.

More than 400 elderly and medically vulnerable San Quentin inmates recently petitioned a state Superior Court for release, and KQED reported last week that a Marin County judge may soon order their release or transfer.

However, prisoner advocates strongly oppose the transfer option. 

“My clients are terrified of transferring,” Christine O’Hanlon, the deputy public defender of Marin County, where San Quentin is located, told KQED. “They know the transfer process involves being confined in small spaces with several people for several hours and then getting to a new place where they don’t know what’s there.”

“You can’t just pack them in like sardines somewhere else,” added O’Hanlon. “You have to put them in a place where they can be safely housed, practice social distancing, and avoid dorm settings.”

Mario Smith, a prisoner at the Gus Harrison Correctional Facility in Adrian, Michigan who suffers from asthma, high blood pressure, and obesity, told TIME that he “feared for [his] life” after he fell ill with Covid-19 last month, one of more than 1,400 inmates at the facility to contract the virus. 

“They’ve got us bunched up together,” said Smith. “There’s no social distancing at all. We share day rooms, we share showers. We share practically everything.”

This post was originally published on Radio Free.