More than 600 positive cases and five deaths have been reported just among inmates across state prisons in North Carolina, however the true number is likely much higher.
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Only 4% of the state's 32,000 inmates have been tested and 18 facilities have not performed any testing.
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When widespread testing occurred at facilities, an alarming number of inmates tested positive for COVID-19 but showed no symptoms.
Around 21,000 state employees work at prisons and juvenile facilities but the number of staff who have been tested in unknown.
"This is a personal medical issue between a staff member and their doctor. We ask that the staff tell us if they test positive. They may not. And we have no way of confirming the results of those privately administered tests," said John Bull, a N.C. Department of Public Safety communications officer.
At the county facilities, cases among staff are reported. The data shows 53% of cases at county correctional facilities are linked to staff.
Many have urged the state to offer testing for staff for weeks.
"We never had as big an outcry from our members over anything as we did over this testing and it's because they accept danger for themselves on the job but they were unwilling to accept unnecessary danger for their families," said Ardis Watkins, executive director of the State Employees Association of North Carolina (SEANC).
SEANC advocates for state employees through legislative and grassroots efforts.
Three weeks ago, the association was working with state leaders to enact a plan to test prison workers.
More than 20,000 tests were secured and plans to conveniently test workers right outside facilities after work were in place.
"We wanted to be sure that we were doing everything possible to fill the need of our members who were complaining to the State Health Plan about why they couldn't get tested when they were in this very infectious, hot environment," said N.C. Treasurer Dale Folwell, who was a key figure in putting the plan into action.
That plan never materialized.
"The reasons we were given centered around the short staffing that would get worse if you knew just how many people were carrying the disease who might be asymptomatic but needed to go home for 14 days and quarantine, so they didn't make other people sick," said Watkins, who was working with state leaders on the testing plan.
She said that reason was problematic for her.
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"Short-staffing issues are real but folks getting sick and making more people sick was going to be just as bad of a short staffing issue, just they wouldn't have the information needed to protect their families," she said.
The state maintains a 29% functional vacancy rate across its more than 60 facilities, according to DPS data. Fourteen of the facilities operate with more a more than 40% staffing vacancy.
Jerry Higgins, a spokesperson for the state's Department of Public Safety did not cite staffing as a reason but did say on-site testing was not going to be operationally possible with 21,000 employees dispersed across 100 counties in 250 work sites.
Widespread testing at the Neuse Correctional Institution uncovered 60% of offenders tested positive. More alarmingly 90% of the positive cases were asymptomatic.
'This did not have to be this bad': Inmate at Neuse Correctional discusses COVID-19 outbreak
DPS said 29 of the facility's 250 employees tested positive for COVID-19.
"Other than the staff at Neuse Correctional, who were tested in conjunction with the state Department Health and Human Services and the Wayne County Health Department, we don't know how many staff members have been tested in consultation with their primary care physicians, and, as a result do not how many have tested negative or how many have truly tested positive," Bull said in an email.
Family of prison inmate expresses concern over coronavirus outbreak at Neuse Correctional
As prisons remain a hotspot for the virus across the country, employees and inmates concerns over their safety continue to mount.
"There is no way that they can ensure our safety at this facility. Every day our life is in jeopardy because of the way this facility is set up," said Khateesa McDaniel, an inmate at the Raleigh Correctional Institute for Women.
One inmate died, and 91 others have tested posted at McDaniel's facility.
She said she's been given cleaning supplies, a mask and gloves but there is only so much the staff and inmates can do.
"They are doing everything they can to keep us safe, but they can't possibly do that because the way our facility is," McDaniel said.
COVID-19 has spread through prisons across 40 states killing more than 300 inmates and infecting more than 20,000, according to the Marshall Project, a nonprofit journalism site tracking the virus in prisons.
Crowded dormitory-style living conditions, shared bathrooms and limited medical supplies are just some of the challenges facing facilities across the United States.
"If you have the dormitory style prisons, there is no way to socially distance either the inmates among one another or the staff with the inmates and that is just the way it is when you have the dormitory layout," Watkins said.
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These factors aren't just a concern for inmates and staff but for the community as well.
The virus can easily spread from the staff who go back into the community on a daily basis.
"They might stop at the convenience store and that makes it a very real public health concern. Experts have been saying this since February and we haven't acted. In the opinion of our members, North Carolina has not acted in a manner that shows this is serious," Watkins said.
Medical screening for prison staff has been in place since April and the state has taken other measures to reduce the virus including limiting inmate transfers, providing PPE and allowing some inmates to serve their time outside of prison.
Still, Watkins said more can be done and testing is a key part of the solution.
While many states aren't publicly releasing data on prison staff infected, the data that is available reveals more than 6,000 have tested positive, according to The Marshall Project.
The Center for Disease Control cited testing as an important strategy to minimize the spread of the virus in a recent report that uncovered thousands of staff tested positive for COVID-19.
Now, three weeks after the announcement of the first plan to test employees, DPS is launching a different plan.
Testing will take place at FastMed Urgent Care locations across the state and staff will be told their results through an online portal.
Watkins said the plan "looks like far too little far too late and with far too much on the line."
She said requiring staff to drive a long distance to get tested is not realistic and expressed concerns that prison locations would not be notified if employees test positive.
For staff at the Pasquotank Correctional Institute, the nearest FastMed location is more than an hour away.
Higgins with DPS said the department anticipates a need to be flexible and for additional testing resources.
"DPS and its vendor partner, FastMed, are committed to providing testing sites that are located in close proximity to where our employees live and work. In areas of the state where FastMed does not have a permanent location, such as Hyde and Pasquotank counties, FastMed has committed to identify and provide a testing location in those communities to accommodate the testing needs of our employees," Higgins told ABC 11.