by Mike Fitzgerald, originally published by the Riverfront Times

Derrick Howard was tough — prison tough.

Howard grew up in the St. Louis suburb of Normandy. In his late teens, before his first stretch in prison, he acquired the street name of “The Black Italian Snake.”

Proud of the moniker, Howard wore it through his long and ultimately deadly journey through the nation’s prison system.

In January 2007, a jury in St. Louis convicted Howard of orchestrating an elaborate murder-for-hire scheme while he was locked up in jail awaiting trial on a gun charge. The federal judge presiding over Howard’s case sentenced him to 60 years in prison.

By late 2019, Howard had racked up a string of disciplinary violations while incarcerated, landing him at one of the Federal Bureau of Prisons’ toughest lockups, the high-security U.S. Penitentiary Tucson in Arizona.

Then COVID-19 hit. The coronavirus surged through the densely packed prison like wildfire, turning it into a world haunted by sickness and death.

Howard feared for his life.

The 51-year-old suffered from a series of underlying conditions, including obesity, hypertension, asthma and a chronic lung disease.

Inside the prison, face masks and hand sanitizer were in short supply, and social distancing was nearly impossible to maintain. Howard knew he had little chance of survival if he caught the coronavirus, according to Diane Dragan, his St. Louis-based federal public defender.

“He did say if he got COVID he’d die because he had lung issues,” Dragan says. On October 22, Howard tested positive for the coronavirus.

Four days later, an ambulance took him to a nearby Tucson hospital for further treatment. On October 31, hospital staff placed him on a ventilator, according to BOP reports.

But the chain of events of the following weeks, culminating in Howard’s death on December 3, remains a mystery to his family.

Did he die from COVID-19? The death certificate issued by Pima County, Arizona, indicates that he did.

Or did his death stem from something else, such as the fall he suffered — as medical records show — while recuperating at a Tucson rehab facility shortly after he was taken off the ventilator?

Medical records also indicate he was conscious but hallucinating, writing notes to hospital staff until shortly before he stopped breathing early on the morning of December 3.

“We don’t know why our brother died,” says Pam Howard, his older sister. “He was able to fight his way off the ventilator, and he’s conscious, and the next day he’s dead? We just want to know why.”

What’s more, Howard’s family could not contact him during the six weeks between when he tested positive and when he died, his sister says.

“I just don’t understand why we couldn’t see him, or get any information from the hospital,” Pam Howard says, adding that she feels “very angry and heartbroken because our brother was in the hospital that long, and we didn’t get a chance to contact him, to write him a letter.”

It was not until this past Halloween, nearly a week after Howard was sent to the hospital, that Howard’s family was even notified that he was seriously sick with COVID-19.

Soon after that initial notification, a hospital staff member called Howard’s family to ask if they wanted to say goodbye to him before he died. But Pam Howard says the offer came with a condition — they could only talk to him if they agreed to take him off the ventilator.

The family refused the deal.

The next day, Derrick Howard was taken off the ventilator anyway. Medical records indicate he took a turn for the better and was sent to a nearby rehabilitation center to recover.

The improvement in his condition was fleeting. A few days later, without explanation, Howard’s heart stopped beating. An ambulance took him to a nearby hospital emergency room, where he was pronounced dead.

Derrick Howard’sdeath has opened a rare window into a prison medical-care system that is widely criticized for its lack of transparency and systemwide failures to protect inmates and staff from COVID-19 — conditions that public health experts say pose a catastrophic health menace both inside and outside the nation’s jail and prison walls.

The BOP’s failures and shortcomings echo similar problems in state prison and local jail systems nationwide. And even though prisons and jails are some of the worst coronavirus hot spots in the nation, the effort to roll out vaccines to inmates has become mired in partisan politics and bad science. The problems are exacerbated by a punitive philosophy that sorely contradicts the warnings of public health experts.

“There is a general attitude of, ‘If you don’t want to be exposed to those things, then you should never have done whatever criminal activity you did,’“ says Maria Morris, director of the American Civil Liberties Union’s National Prison Project.

From a human rights perspective, the governments that run prisons have a duty to protect people in their care and to provide adequate medical care. But even aside from that obligation, public health experts point out it just makes sense from a medical perspective to take an especially aggressive approach to treating COVID-19 in prison, including the rollout of vaccines, because doing so does a great deal to prevent the spread of the virus and protect communities outside jails and prisons.

People moving in and out of prisons and jails serve as highly efficient vectors for infectious diseases of all kinds, especially a virus and its variants that have so far killed more than 540,000 Americans.

Prisoners live in crowded conditions, have little control over what precautions they can take, and share the same toilets and personal spaces. In low-security settings, those spaces are usually open bays, with no barriers separating dozens of people sleeping in the same rooms.

What’s more, inmates are constantly back and forth into their communities as sentences begin and end, or they are transferred to county and city jails awaiting trial, or moved to new facilities across the country, as was Howard’s fate.

And of course inmates come into close contact with prison staff and corrections staff, who go home after their shifts end and can spread COVID-19 to family and friends.

For these reasons, a December editorial in the newsletter of the Harvard T.H. Chan School of Health called for the federal and state prison systems to make inmates a priority when it comes to administering the new COVID-19 vaccines.

“Prioritizing incarcerated and detained individuals with COVID-19 vaccinations is the smart public health strategy,” according to the editorial’s authors.

In the meantime, inmates must try to survive a prison health-care system that is erratic at best, according to Dave Fields.

Fields spent 22 years in federal prisons after being convicted on charges of possessing and selling crack cocaine.

“They don’t deal with people’s health problems at all,” Fields says of BOP medical care.

The 48-year-old served part of his sentence with Howard at a federal prison in Florida before successfully appealing his conviction and winning release in 2017. He credits Howard with helping him regain his freedom, describing Howard as a good friend with a strong sense of humor and a sharp mind.

When Fields was working on the research to challenge his drug conviction, Howard’s knowledge of the legal system proved invaluable, Fields recalls.

“He’d say, ‘I happened to come across this case. Check it out,’” Fields says. “Nine times out of ten, he’d be on point.”

Howard also possessed a keen sense of humor, which is an essential trait for surviving in prison, according to Fields.

“If you were standing in line, he’d be the one to tell you a story to make you laugh,” Fields says. “He’d always be telling you a story about his family. I learned a lot from him.”

Fields was saddened to hear of his old friend’s death, but he was not shocked when he learned that Howard had gotten sick from COVID-19.

“If you get seriously sick in prison,” he says, “you’re not going to make it.”

So far nearly 400,000 people behind bars in federal, state and local facilities have tested positive for COVID-19, with more than 2,400 deaths documented, according to the COVID Prison Project.

The true death toll is likely much higher, however, because of jails’ and prisons’ culture of secrecy and their tendency to define COVID-19 deaths very narrowly.

Since the pandemic began more than a year ago, some of the nation’s worst outbreaks of the virus have occurred among incarcerated populations, who are especially vulnerable because of overcrowding, stress, poor health care and nutrition, and shoddy sanitation — conditions that have sent coronavirus mortality soaring.

Officially, the prison death rate is twice as high as it is in the general population, with four times as many positive cases as overall, according to a report published in December by the National Commission on COVID-19 and Criminal Justice.

What remains unclear, however, is the full scope of COVID’s impact on the federal prison system, which is responsible for more than 150,000 inmates in dozens of penitentiaries, prison camps and halfway houses nationwide.

The ACLU, in a lawsuit filed in October, accused the BOP of concealing information and “stonewalling” efforts by the nonprofit and lawmakers to find out how the prison bureau is handling the pandemic.

“In the face of that failure the BOP has offered rosy assessments of its own performance and stonewalling in response to requests for public disclosure and congressional oversight,” according to the lawsuit.

The lawsuit further notes that BOP’s own data indicate that more than one-third of federal inmates tested for COVID-19 tested positive for it.

At some federal prisons, the positivity rate is much worse. More than 90 percent of the 997 inmates tested at the federal prison in Lompoc, California, came back positive, according to the suit.

A separate class-action lawsuit the ACLU filed in May against the BOP and the Lompoc prison described the situation there as a humanitarian crisis of “horrific proportions.”

The ACLU and other prison watchdog groups contend the BOP’s testing procedures are woefully inadequate, according to Sharon Dolovich, the director of the UCLA Law COVID-19 Behind Bars Data Project.

“We know that those are under-counts because there are many facilities that are reporting zero, or under ten or under twenty infections,” Dolovich says. “And both because of what we know from COVID, and from what we’ve seen in countless facilities a year into the pandemic, we know that if you’re a prison with twenty infections, you have many more than twenty people who are infected.”

Morris, of the ACLU, agreed that BOP officials are motivated to under-test and therefore to under-count infections.

“And then they can say COVID isn’t a problem in our facilities. ‘Look at how low our numbers are,’“ she says.

Emery Nelson, a BOP spokesperson, declined an interview request from the Riverfront Times.

But in a written statement, he stated the BOP “has taken swift and effective action in response to the Coronavirus Disease 2019 (COVID-19) and has emerged as a correctional leader in the pandemic. As with any type of emergency situation, we carefully assess how to best ensure the safety of staff, inmates and the public. All of our facilities are implementing the BOP’s guidance on mitigating the spread of COVID-19.”

Nelson also noted that BOP personnel work closely with local health departments to ensure priority testing is provided to staff who are in close contact with COVID-19-positive personnel, while the federal prison agency has obtained a national contract to perform all staff testing.

Dolovich, of UCLA Law, evinced skepticism about the BOP’s diligence in following its own rules.

“Whatever policies they have on paper aren’t actually being implemented,” she says. “So they could tell you things that actually sound good in theory. But when you actually talk to people incarcerated in the various facilities, they will tell you that the reality is very different.”

One of the hardest hit federal prisons is located in Springfield, Missouri, at the BOP’s Medical Center for Federal Prisoners, which houses some of the nation’s most medically vulnerable inmates.

The extreme dangers they face were underscored in early February in a scathing opinion written by U.S. District Judge Ronnie L. White, of the Eastern District of Missouri, in St. Louis.

White slammed the BOP for its handling of the case of a diabetic inmate seeking compassionate release from the Springfield facility.

White noted in his order granting the prisoner’s release that, at the time, seventeen MCFP inmates had already died there, while 384 inmates and 212 staff were listed as having recovered from COVID-19 infections.

“These numbers reflect a shocking outbreak of cases and deaths at an institution where the BOP places medically fragile inmates,” White wrote.

To critics of prison medical care, White’s blistering opinion is hardly surprising. Long before the pandemic started, America’s prisons and jails generated voluminous complaints about tardy, substandard and even unethical inmate medical care, including well-documented cases of coerced human experimentation.

“They didn’t get good medical care in good times,” says Dragan, the public defender, whose clients are scattered in lockups across the Midwest. “They’re getting really shitty medical care now because they don’t want to take them out of the facility for any sort of medical care.”

Exacerbating these issues is the fact that federal prison inmates often fail to report their symptoms to prison medical personnel for fear of making things even worse for themselves. Sick inmates are usually quarantined in their prisons’ disciplinary housing, according to the ACLU’s Morris.

“And people don’t want to go there,” she says. “They’re very uncomfortable units. They are not getting close medical monitoring. They tend to be dirty. They tend not to have a lot of water access. And people are afraid to go in there.”

All these factors taken together — the poor testing regimen, the lack of ventilation, the shortages of PPE, the crowding and lack of transparency — draw Dolovich, of UCLA Law, to one conclusion about the federal prison system.

“It’s the most effective COVID transmission system we could come up with,” she says.

So far, at least 240 inmates and four staff members have died from COVID-19 in America’s federal prison system, according to COVID Prison Project data.

Nearly 50,000 federal inmates — about one-third the total federal inmate population — have tested positive, as well as nearly 6,500 staff, BOP data show.

Federal inmates make up a fraction of the total number of inmates locked up across the country in jails and prisons, and they can sometimes be obscured in the statistics. But the federal death toll is significant. If the BOP was a state system, it would rank second only to Texas, which has reported more deaths — 257 — but also has a larger prison population, totaling 163,000. Missouri’s system has registered 48 deaths out of a population of 26,000, according to the prison project website.

The Tucson prison, where Howard died, recorded the third-highest number of positive COVID-19 cases compared to other federal prisons — 895 — surpassed only by the federal prisons at Fort Dix, New Jersey, with 2,014 cases, and Seagoville, Texas, with 1,240 cases, BOP data show.

As far as the deadliest federal prisons, USP Tucson is officially tied for second with two others that have recorded ten deaths each. The deadliest federal prison is the hospital for federal inmates in Springfield which documented eighteen deaths.

Medical records obtained by the RFT show that on the night of October 26, Howard was taken by ambulance from USP Tucson to the nearby Tucson Medical Center after experiencing shortness of breath and respiratory distress.

Howard spent several days at the medical center, where medical personnel inserted a tube in his stomach for nutrition.

“He wasn’t there that long when a doctor called and asked if we wanted to have him removed from the ventilator,” Pam Howard says.

“And I’m like, ‘For what reason?’” she says. “I go, ‘He still has brain activity.’ And she said it’s not up to her. It’s up to the Bureau of Prisons, and the only way we could see him is [if] we chose the end-of-life option. Which I thought was unfair.”

Howard was later transferred to Curahealth, a Tucson rehab center. A day later, he sustained a fall there and went back to the medical center, where he underwent a CT scan, which reported negative results.

An ambulance returned Howard to Curahealth, where, just after midnight on December 3, his heart rate dropped dramatically, according to a physician’s notes.

“Patient’s pulse was not palpable,” wrote Dr. Bijay Sanjeev.

An ambulance took Howard to the St. Joseph’s Hospital emergency room, where he was pronounced dead, according to his Pima County death certificate.

Derrick Howard died alone and cut off from his family, Dragan says.

“They never set up a phone call,” Dragan says. “They never set up a Zoom visit ... [Howard’s family] didn’t get to be there for him. He didn’t have any idea anyone in the world gave a shit about him.”

Vernado Howard, 81, sits in the living room of his O’Fallon, Missouri, home and ponders some photos spread out on the table before him.

The photos were taken a few years ago, the last time he saw Derrick Howard in person.

One photo shows Howard in the light yellow jumpsuit of the federal prison in Florida where he was being housed at the time. His left arm is draped across his father’s shoulders.

Vernado Howard glances at the photo and nods, his eyes lighting up at the memory of that visit to the Coleman penitentiary in northern Florida.

“A good day,” he says.

But the elder Howard doesn’t shy away from the many bad days that marked the decades before, as his son’s attraction to the criminal lifestyle intensified.

Vernado Howard and his daughter Pam make no excuses for Derrick Howard’s life. But they point out they loved him, and he loved them back, and that his life was worth something.

“He wasn’t a bad person,” Pam Howard says. “He did bad things. But he helped a lot of people in prison.”

But Vernado Howard also acknowledges his son put the family through hell, and the memory hits hard.

There was that time, for example, when Derrick Howard, still in his late teens, had just returned to the family home in Normandy after serving time in a Missouri prison.

Picking up where he had left off, he began dealing crack cocaine out of the house, recalls his father, a retired auto worker.

Vernado Howard knew he had no choice. He obtained a court order to kick his son out of the house.

“He got angry with me,” Vernado Howard says. “But I didn’t care. I got other kids to take care of.”

After more than 80 years on this earth, and helping raise eight children to adulthood, Vernado Howard has learned the great, hard truth that eventually dawns on all parents: You have only so much control over the adult your child becomes.

That cha-cha between nature and nurture, between DNA and environment — that confounding little dance never stops.

And with some kids you will have little say over the finished product no matter how hard you try — or how much you pray.

So it was with Derrick Demetrius Howard, the sixth in line of the family’s eight kids.

“He just wouldn’t listen. He just wanted to do it his way,” Vernado Howard says of his late son. “Everywhere he went, he just wanted to be the boss.”

“He was very bright, very smart,” says Pam Howard, his older sister. “But I think that life of easy money, quick money, got him into trouble.”

More than three months have elapsed since his son’s death, and Vernado Howard says he is still plagued by questions about the circumstances surrounding it.

“We’d like to find out what happened in the last 48 hours,” he says.

As for his son’s death, the elder Howard has adopted a philosophy of stoic realism.

“I just deal with it, because I know stuff happens,” he says. “Sometimes it’s out of our control. But all I can do is try to tie up all the loose ends that I can.”

At Pam Howard’s request, the Tucson hospital where her brother died sent her a four-page report on the external autopsy performed on him a day after his death.

Derrick Howard’s cause of death was due to COVID-19, with sarcoid — an inflammatory lung condition — and hypertension as contributing conditions, according to the report written by Dr. David Winston, a forensic pathologist.

But the pathologist’s report was external only, and it makes no mention of the fall Derrick Howard suffered just before his death or what could’ve caused his heart to stop suddenly, such as a bad drug reaction, Pam Howard says.

“And I was like, that’s very broad. And it doesn’t say his heart stopped,” she says. “Or if he had a heart attack. Nothing.”

Howard also noted that Derrick Howard’s body was not tested for COVID-19 after death to determine if the virus truly played a role.

“You didn’t do an internal autopsy,” she says. “And you didn’t test the body for COVID. And yet you put COVID on the death certificate.”

Winston tells the RFT that he knew of the fall that Derrick Howard suffered before his death but did not note it in his report because he did not believe it contributed to his death.

As for a postmortem testing of Howard for COVID-19, Winston says a test was not performed because of the notation in his medical records of a positive earlier test.

“So he had other lung disease as well,” Winston says. “And so that puts him at higher risk, number one, for getting COVID, number two, for dying of COVID.”

Ultimately, no internal autopsy was performed on Howard “because of his extended hospital stay and the documentation of his medical conditions by the records I reviewed,” Winston says.

Pam Howard says she is still seeking answers about her brother’s death.

“I’m not satisfied with that,” she says. “I won’t be satisfied until we get the last 24 hours of his medical records.” 

 

This article was originally published by the Riverfront Times (riverfronttimes.com), St. Louis’s alternative newsweekly; republished with permission. Copyright, 2021 Riverfront Times

Subscribe today

Already a subscriber? Login