Finding that jail officials in Prince George’s County acted with “reckless disregard” of a coronavirus outbreak among inmates last month, a federal judge on Thursday ordered the county’s jail to submit plans to ensure proper testing, improve health care and properly protect medically vulnerable inmates.

“Sick calls ignored, temperature checks inaccurate, and nurses telling symptomatic detainees, ‘If you can walk, then you are OK,’ ” U.S. District Judge Paula Xinis wrote in a 33-page opinion, ticking off what she described as troubling procedures in the jail at the height of the outbreak.

Xinis also credited the jail with steps taken over the past six weeks that helped curb the spread of the novel coronavirus. She noted that no inmates during a recent court-ordered inspection of the jail reported active covid-19 symptoms and that the jail appeared to be complying with detention center guidelines established by the Centers for Disease Control and Prevention.

“The facility’s physical structure, combined with the lockdown measures implemented, worked to contain the spread of covid-19 when staff and detainees began testing positive,” Xinis wrote.

Her order followed a lawsuit filed April 21 on behalf of Prince George’s inmates — 27 of whom wrote statements describing unsanitary conditions and a lack of medical care in the jail. The lawsuit sought immediate operational changes, the release of medically vulnerable inmates and the release of any inmate who tests positive for the coronavirus and is “legally entitled to release.”

Xinis issued more “narrowly drawn,” temporary injunctive relief, training her concerns on testing, medical protocols and protecting medically vulnerable inmates. Xinis specifically ordered Prince George’s Department of Corrections Director Mary Lou McDonough — the singular named defendant in the lawsuit — to file written plans addressing those areas within five days.

A department spokesman on Friday said the county will appeal the judge’s findings and injunction order.

“The injunction didn’t require the department to do anything that wasn’t already being done or in the process of starting,” said the spokesman, Andrew Cephas.

He said the county specifically will seek a stay of the order but “will comply with the court’s order until a stay is granted, if one is granted.”

A total of 18 inmates at the jail have tested positive for the virus, according to Cephas. That was the same total going back to April 23, an indication the spread has been halted. Cephas said the jail has begun widespread testing of inmates.

In the judge’s opinion, she blasted the low total of tests during the outbreak.

“The significant presence of covid-19 at the facility, in combination with the scores of detainees who described experiencing distinct covid-19 symptoms (e.g. fever, chills, shortness of breath, loss of smell and taste) yet were never tested, spoke to substantial under-testing at the facility,” Xinis wrote. “The defendant, however, hailed ‘only 18 confirmed cases’ as proof of victory in stopping the spread of the virus.”

“It was good fortune,” she added, “that none, to date, suffered any serious, sometimes catastrophic, outcomes of the virus.”

Xinis’s opinion also confirmed that the jail has recently “begun more systematized screening and testing.”

Xinis based her order on documents provided by the inmates’ attorneys, documents from the jail’s attorneys and a report by an infectious-disease specialist whom she commissioned to inspect the jail on May 6 and 7.

The judge found an outbreak began at the end of March in a dining room for correctional officers and spread to at least four housing units, which together held about 237 inmates.

“Detainees described medical staff wholly unfamiliar with how the virus presents, ill-equipped to identify covid-19 symptoms, and uninformed as to how to conduct proper contact tracing or isolation procedures to stop the spread of this highly infectious virus,” Xinis wrote. “Most disturbing, each detainee either described himself as having covid-19 symptoms, being directly exposed to detainees with covid-19 symptoms, or both.”

She quoted a declaration in court filings from one of the inmates: “I asked to be tested for the virus, but they said they don’t have any tests. Last night I went to sick call again. I had a fever and a headache. They told me that my fever wasn’t high enough, and that they would only test me if it got higher. They told me to drink water and sent me back to the unit.”

In court documents, jail officials reported conducting twice-daily temperature checks of inmates living near inmates who had tested positive.

“However,” Xinis wrote, “the temperature-check logs submitted to the court heightened, rather than allayed, the court’s concerns. The records were spotty and did not reflect the purported twice daily checks. Even more concerning, the recorded temperatures were consistently and atypically low. A significant cohort of detainees had temperatures as low as 95 and 96 degrees, with some as low as 90, 92, and 94.”

The judge noted that those low extremes were “indicative of hypothermia” and that no temperatures were ever recorded over 99 degrees: “The court found [this] both curious and alarming in light of both the eighteen confirmed covid-19 positive detainees and that the singular most frequent symptom of the virus is fever.”

Quoting Carlos Franco-Paredes, the infectious-disease specialist who inspected the jail, Xinis said there was “likely a much higher number” of infected inmates than the 18 positives.

Going forward, the judge wants the jail to better identify and care for high-risk inmates, those who are at least 65 or may be suffering from lung disease, an immunocompromised status, obesity, heart disease or other ailments.

Xinis praised McDonough and her staff for being “helpful” and “cooperative” during the inspection, as described by Franco-Paredes.

“Without doubt, defendant deserves credit for obtaining additional supplies early, suspending inmate work details, and issuing appropriate personal protective equipment to staff,” the judge wrote. “Similarly, defendant undoubtedly worked to reduce the detainee population and put policies in place specific to covid-19. The court commends these measures.”

And the judge struck a hopeful note that McDonough and her staff would be willing to follow her orders to submit detailed plans.

“Plaintiffs have convinced the court that temporary injunctive relief, narrowly drawn, is proper,” she wrote. “Likewise, the defendant appears willing and able to implement such relief, and the court is encouraged that critical measures are underway to protect the health and safety of the facility’s detainees.”