Nobody knows how the ­novel coronavirus sneaked through the barbed wire and imposing gates of Ohio’s Pickaway Correctional Institution, where visitors and volunteers were barred from entering in March. But the first case showed up April 4.

Within a week, 23 inmates and 17 staff members were found to be infected. One inmate, Charles Viney Jr., a 66-year-old with a collapsed lung, died hours after testing positive. Within a month, more than three-quarters of Pickaway’s roughly 2,000 inmates were confirmed positive. By the end of May, 35 were dead.

Pickaway, where officials acknowledged that efforts to control viral spread were hectic and hindered by imperfect testing, exemplifies the broad challenges facing the nation’s jail and prison systems in the grip of the pandemic. Conditions long considered degrading — including overcrowded, unsanitary housing and inadequate inmate health care — have, in many places, become deadly.

“A prison is now a public health threat,” said Armen Henderson, an assistant professor of medicine at the University of Miami. He and other criminal justice reform advocates have called for massive reductions in incarceration because of the pandemic. They argue that measures such as distributing masks or allowing access to hand sanitizer do little to stop the spread of the virus in facilities where people live so close together.

More than 173,000 inmates nationwide have contracted the coronavirus, and almost 1,300 have died, according to the UCLA Law Covid-19 Behind Bars Data Project. At least 37,000 corrections workers have tested positive and 78 have died. A study prepared for the National Commission on Covid-19 and Criminal Justice reports that the rate of coronavirus cases in federal and state prisons is more than four times the national rate. When adjusted for age, sex and ethnicity, the mortality rate in federal prisons is twice that of the general population.

In at least 39 states and D.C., governors, local officials or ­sheriff’s departments have taken steps to reduce prison and jail populations since the beginning of the pandemic. The measures varied widely, from releasing some nonviolent inmates or those who are medically vulnerable to accepting only the most-violent offenders.

Between March and May, prison populations dropped an average of 8 percent and jail populations decreased about 30 percent, according to data reviewed by Sharon Dolovich, a UCLA law professor who directs the Behind Bars Data Project. The American Civil Liberties Union has filed more than 50 cases aimed at freeing people from prisons, jails and immigration detention facilities, with limited success largely because a 1996 law limits inmates’ ability to sue.

Now, advocates say, those gains are being eroded, leading to fears about additional outbreaks and mounting death tolls. A recent overview by the Covid, Corrections, and Oversight Project at the University of Texas at Austin found that the death curve in Texas prisons remains “stubbornly high”; in one East Texas prison, the Duncan Unit, nearly 6 percent of inmates have died.

“The truth is, there is really only one way to meaningfully reduce the risk of spread, and that is to release enough people to make it possible for those who remain to socially distance,” Dolovich said.

In some cases, courts or governments are intervening to reduce prison and jail populations.

After an outbreak at San Quentin State Prison, a California appellate court ruled in October that the facility must halve its inmate population by releasing or moving nearly 1,500 people. Infections erupted at San Quentin in May after officials transferred 121 inmates from a facility in Chino, Calif. Though the Chino prison was suffering its own outbreak, officials took no steps to keep the new arrivals separate from the existing population.

Since then, more than 2,200 prisoners have tested positive in San Quentin, along with 298 staff members. Twenty-eight inmates and one worker have died in what the court called the “worst epidemiological disaster in California correctional history.”

The prison’s failure to adopt and implement measures to protect prisoners is “morally indefensible and constitutionally untenable,” the court wrote. A San Quentin representative did not respond to requests for comment.

Across California, Gov. Gavin Newsom (D) has released nearly 6,000 inmates in four months, bringing the state’s prison population to its lowest level in three decades. Thousands of additional inmates are deemed vulnerable and eligible for release.

In New Jersey, which has recorded more virus-related prison deaths than almost any state in the nation, Gov. Phil Murphy (D) signed legislation last month that could free about 20 percent of state inmates, primarily people within a year of release. The first 2,200 were freed last week.

New Jersey is an outlier. Dolovich said about half the reduction in jail population has been erased since May. Prison numbers have shown less change. And while there is too little public testing information to determine whether infections have ramped up as a result of the slow in releases, Dolovich said spikes have been found in places that have conducted mass testing.

The Centers for Disease Control and Prevention, which provides regularly updated guidelines for how to manage outbreaks in correctional and detention facilities, published a report in August showing that mass testing in 16 U.S. prisons and jails found a 12-fold increase over the number of cases identified through symptoms alone.

The study also found three times as many cases in dorm-based housing as in cell-based housing.

One modeling study, released before peer review, found that housing more prisoners alone in single cells could sharply reduce infections and hospitalizations.

“We are very far from the ideal, and there are no signs of any meaningful political will to try to get us closer,” Dolovich said.

'I don't want you touching me'

In many ways, Pickaway,a ­minimum-security prison about 15 miles from Columbus,is a microcosm of those national trends: Inmates lived in overcrowded conditions. Some were housed in a medical unit for long-term care.

Within three weeks of the first known infection, more than three-quarters of the prisoners had tested positive for the virus. Early efforts to separate infected prisoners fell short.

Annette Chambers-Smith, director of Ohio’s prison system, acknowledged that attempts to control the virus at Pickaway have been hectic.

“When you test several thousand people at one time, and have the results rolling in all day and all night long, you’re going to make the best decisions at the time,” she said. To keep the infected and noninfected apart, “you’re literally talking about moving literally hundreds of people every day.”

Since the outbreaks, “we’ve completely changed our testing plan and how we deal with outbreaks,” she said, adding that the facility now tests prisoners at “decision points,” including when an inmate enters or is released from the prison and during contact tracing.

“We’ve had very good outcomes, comparatively speaking,” Chambers-Smith said. As of Monday, the Pickaway death toll stood at 35.

Before the virus was detected at Pickaway, inmates worried that guards didn’t take the threat seriously.

For example, Harold Davis III saw Ohio Gov. Mike DeWine (R) on the news telling people to wash their hands, keep surfaces clean and stay six feet apart. So when a corrections officer wearing latex gloves tried to pat Davis down as he was leaving the chow hall, Davis asked to shake out his pockets himself.

“I don’t want you touching me with that pair of gloves that you just touched three or four hundred people with,” said Davis, who is in prison for drug trafficking, theft and vandalism. But he said the officer told him to shut up and patted him down anyway.

After Viney’s death, the Ohio National Guard was deployed to Pickaway to help with testing. Work was suspended at the ­prison-run meatpacking facility, which processes food that is then sold to Kroger and Heinen’s grocery stores.

But prisoners kept getting sick. Inmates described seeing ambulances — sometimes six at a time — outside the prison, and receiving little information about who was infected.

Timothy Bailey, who is serving a 10-year sentence for drug trafficking, recalled being worried about his friend James Webb, 64. Webb, locked up for nearly five years on rape charges, suffered from a bone marrow disease.

“If you touched him, he’d bruise,” Bailey said.

Webb died of covid-19 on April 27.

Another covid victim, Christopher Malone, 68, had been in prison since 1987 for murder and felonious assault. Tavaughn Lewis, 27, remembered Malone as a father figure. In prison for manslaughter since he was 19, Lewis said Malone was the rare older inmate who looked out for him and told him he had value.

Lewis said it fell to him to tell other inmates when Malone died. JoEllen Smith, a spokeswoman for the Ohio Department of Rehabilitation and Correction, confirmed that it is not “routine practice” to tell inmates about deaths behind bars.

Meanwhile, the infirmary filled up. Lewis, who worked there as a janitor, said that the patient count swelled from 17 on an average day to 28, and that others were turned away for lack of space. Prison officials said admission decisions were based on clinical guidance.

A few releases

In early April, DeWine announced a plan to reduce the state prison population by releasing nonviolent offenders who had committed no serious infractions while behind bars and had less than 90 days left to serve.

Out of 50,000 inmates in the Ohio prison system, just 105 were released in the first round.

“There’s a balancing act here between keeping the public safe and keeping the people in the prisons safe,” Chambers-Smith told The Washington Post. “We don’t want to create a problem in the community, and we don’t want to keep these people in prison if we can conceivably let them out.”

She noted that additional inmates have since been freed as they approached their scheduled release date.

By April 19, three-quarters of Pickaway inmates were listed as being in “quarantine,” while 380 were “isolated” — meaning they were actively ill. Inmates said the distinction made little difference, since most were still crammed together in dorms. Two days later, mass test results showed 1,530 inmates had been infected.

The next day, an email told inmates that the prison would segregate those who had tested positive in A, B and D dorms. The few virus-free inmates would be moved to C dorms.

Justin Justice, 41 and serving two years on drug charges, was surprised to learn that he was being transferred to C. Convinced that he had the virus in early April, Justice resisted the move. “I didn’t want their blood on my hands,” he said of the people who had tested negative. “I wasn’t going down there and getting people sick.”

At first, the guards let Justice stay. But they soon came back for him, he said, using pepper spray to force him to move. He was handcuffed and put in a segregation cell with an inmate who had tested positive for the virus. When he was tested again, Justice came up positive as well.

A corrections department spokeswoman declined to comment on Justice’s medical status, but confirmed that he was involved in an incident during which, “due to his physical resistance, pepper spray was deployed to bring him into compliance.”

Despite being in separate dorms, inmates said that the sick cooked for and served the well and that inmates from all dorms stood together in line to receive confidential mail from their attorneys.

Corrections officials said that inmates who tested positive were immediately removed from food service jobs, and that attorney mail was distributed to each quarantined unit separately.

Some inmates who tested negative were moved from C dorms to tents. Among them was Davis, the inmate who asked not to be patted down. His tent had only eight other inmates, he said, and the bunks were well spaced.

“That was the one thing I think that they did right,” he said.

Back in the community

Cory Beaty, who served three years for vehicular assault, was set to be released on May 10. He was sent to quarantine with one other inmate in late April.

Inmates in the segregation cells weren’t allowed to call their loved ones or check email. They were rarely let outside for recreation. “It was horrible,” Beaty said.

When guards tried to add a third man, whose health status they did not know, Beaty and his cellmate refused to let him in.

Days later, frustrated inmates threw garbage from their cells and clogged toilets. Guards moved the quarantined inmates into a single open bay where Beaty said the bunks were about shoulder-width apart and no one knew who was infected.

Smith, the corrections department spokeswoman, confirmed that early in the pandemic, people near their release date were held in a single area, and that infections pushed back early release dates for some.

Now, she said, inmates approaching release are tested, but stay in their bays. If someone up for early release tests positive, she said, they have to stay in prison until they recover.

Though the department can’t legally hold anyone past their full sentence, Chambers-Smith said it can issue an order for the person to quarantine upon release. The prison coordinates with halfway houses, religious leaders and volunteers to help inmates isolate, she said.

In May, Beaty moved from Pickaway to a halfway house with instructions to wear a mask and stay socially distanced, but little else. Many freed inmates get little assistance managing their health — and often have no health insurance.

Lenore Anderson, president of the Alliance for Safety and Justice, said the pandemic is focusing attention on problems of overcrowding and neglect that have long been ignored.

“The fact that the U.S. criminal justice system spreads poor health is something many Americans are seeing for the first time,” she said.

Scott Wilson in San Quentin, Calif., contributed to this report.