Gift supports COVID-19 testing, prevention, and research for California’s prison population

Horowitz Family Foundation’s $1 million gift aims to reduce the spread of COVID-19 among the incarcerated and inform mitigation strategies in other high-density living situations

As the world’s greatest minds focus their energies and resources on combating COVID-19, there is a growing population of victims that has remained somewhat ignored—the men and women incarcerated in overcrowded prisons and local jails. Among the more than 116,000 individuals currently imprisoned in California state institutions, outbreaks of COVID-19 infection have continued to escalate in some facilities. With an average prison cell measuring just six by eight feet, and often shared by more than one adult, social distancing and careful hygiene practices—the very prevention strategies needed to curb the spread of the disease—are difficult to maintain.

Through a $1 million gift from the Horowitz Family Foundation, Stanford Medicine established a COVID-19 Emergency Response Fund to support research and prevention strategies to slow and eventually stop the spread of COVID-19 infection in California prisons and jails where infection rates greatly outpace those in the general public. Learnings from these efforts can be applied to help reduce transmission in other high-density living situations such as nursing homes, dormitories, and group homes.

Felicia Horowitz

“It’s impossible for us to stop this pandemic anywhere until we stop it everywhere,” says Felicia Horowitz, founder of the Horowitz Family Foundation. Horowitz has a long history of supporting marginalized populations through philanthropic giving and volunteering. For her, intervening in prisons is critical to stopping the spread of COVID-19. “This is an opportunity to shine a bright light on people who are just unseen. Every death represents a heart ache. It doesn’t matter if it’s someone who lives in your home or someone you love who is incarcerated. If we can save one life with this program, it will have been worth every cent.”

During the civil unrest over the death of George Floyd, which has brought out hundreds of thousands of people across the world to protests and vigils, more than 4,000 people in the U.S. alone were arrested during the weekend of May 29. “The need for COVID research in prisons is more important than ever,” says Horowitz. Even a brief, 24- to 48-hour stay in a crowded jail could significantly increase a person’s chances of contracting COVID-19 and unknowingly bring it back to their communities. “The work we are doing with Stanford to bring more testing to prisons is vital to curbing the spread of this disease among an already vulnerable population.”

Beginning in June, a project team from Stanford will begin working with medical teams inside the prisons and jails in Santa Clara and San Mateo counties to map out the best strategies to help prevent the transmission of COVID-19 among inmates. This effort will include COVID-19 testing of all men and women at the time of incarceration, in addition to screening a portion of those already incarcerated, with periodic retesting to assess new infections. The study team will also conduct mathematical modeling of the rates and patterns of transmission in correctional facilities to inform policies for containment.

Jason Andrews, MD

“We have seen large outbreaks of COVID-19 in jails and prisons across the country, with staggering rates of infection as the virus spreads unabated through facilities. The goal of our research is to evaluate a model for screening and monitoring COVID-19 in correctional facilities that could be scalable,” says Jason Andrews, MD, associate professor of medicine (infectious diseases) at Stanford Medicine, who has studied the high rates of tuberculosis (TB) in prisons in Brazil for the past seven years. “The epidemic of tuberculosis in prisons in many ways foreshadowed what we could expect with COVID-19 in jails and prisons. In nearly every country in the world, rates of TB in prisons are orders of magnitude higher than that of the general population. The reasons for this—crowding, medical comorbidities, inadequate health-care infrastructure, and highly socio-demographically vulnerable populations—also explain why we have seen so much COVID-19 in correctional facilities.”

In addition to Dr. Andrews, the Stanford team includes Jeremy Goldhaber-Fiebert, PhD, associate professor of medicine (primary care and outcomes research), and by courtesy, of health research and policy; Lisa Goldman Rosas, PhD, assistant professor of health research and policy (epidemiology) and of medicine (primary care and population health); and David Studdert, LLB, ScD, professor of medicine and law, specializing in public health law, epidemiology, and the justice system.

Also advising this work will be Shaka Senghor, a former inmate who spent 19 years in prison, seven of which were in solitary confinement. Today, Senghor is a best-selling author and an advisor on prison reform.

“We all know that conditions in prison are extreme, but Shaka understands the psychology of the prisoner and he can help us find a solution that is not only the most effective, but that is also humane,” says Horowitz. “Shaka’s intimate knowledge of the prison system will help Stanford navigate the administrative and cultural complexities as we fight to make prison safer for everyone. I know that with testing, and with the experts at Stanford combined with Shaka Senghor, we can make a difference.”

In selecting Stanford Medicine to lead this effort, Horowitz sought an ally that would be a good steward of her foundation’s gift. “I know Stanford will do what is right for this population and I know they will do it in the right way,” she says. “Stanford can serve as a model for other large institutions nationwide and other philanthropists nationwide because it’s going to take more than just Stanford and more than this one gift to solve this problem.”

To help reduce and prevent the spread of COVID-19 among California's incarcerated populations, click the button below, and in the field “Special Instructions/Other Designation,” write COVID-19 Incarcerated Assistance Fund.