When COVID entered the federal medical prison in Carswell, Texas, it ballooned within weeks — of the 1,288 people tested, 504 were positive. In one housing unit of 300 women, only 26 women tested negative, including 56-year-old Sandra Shoulders.

Shoulders has severe diabetes, respiratory problems, and, since entering prison in 2015, chronic kidney disease, leaving her at only 30 percent kidney function. All of these make her more vulnerable to becoming debilitated, if not dying, from COVID.

Meanwhile, the prison’s practices discourage people from getting tested for COVID. “Even when inmates feel ill now, they are so scared of those conditions to speak up,” Shoulders explained. She described how those who tested positive were treated: “You are held in a room, and expected to wear the same set of clothes for 21+ days, without laundry facilities. Food is dropped by the door and physically kicked into the room by the guards.”

After Congress passed the Coronavirus Aid, Relief and Economic Security (CARES) Act, Attorney General William Barr issued a memo to the Bureau of Prisons (BOP), the agency responsible for federal prisons, expanding the criteria under which to release people to home confinement to stem the spread of COVID. The expanded criteria prioritize people whose age or health makes them vulnerable to COVID, as well as those in low- and medium-security prisons, people whose reentry plans show that they are less likely to contract COVID if not incarcerated, and people with low risk-assessment (or PATTERN) scores.

In August, a prison case manager said that Shoulders qualified for home confinement on September 25. Elated, she began making plans to join her godsister in Chicago. She also planned to reconnect with her three children and her 16 grandchildren, some of whom she only knew through photos and video calls.

Three weeks later, prison administrators told Shoulders that the BOP’s Central Office had denied her release. She was not told why. “I had to call my family and give them this heartbreaking news,” Shoulders told Truthout. The news not only left her reeling, but sent Shoulders — who has bipolar disorder, an anxiety disorder and obsessive-compulsive disorder — into what she calls a “serious mental health crisis and meltdown.”