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When Diana Trueblood visited the Wayne County Jail鈥檚 medical unit in Detroit in early March, she encountered a gentle and kind physician, Dr. Angelo Patsalis.

Halfway through her incarceration for a probation violation, Trueblood remembered sitting 鈥渒nee to knee鈥� with Patsalis, who pulled down his face mask to speak to her about a tuberculosis skin test. She and other inmates were not provided with face masks, she said, and they pulled up their T-shirts to shield their mouths.

鈥淗e was blunt, but he was concerned about my health,鈥� Trueblood said. In jail, usually, 鈥渢hey just don鈥檛 care.鈥�

Trueblood and other inmates knew something serious was going on. Cramped in their cluttered cells, they tried to watch the news about the pandemic on 鈥渁 little TV way up high,鈥� she said. 鈥淏ut you could barely hear it 鈥� and we could just see their lips move. Most of what we found out was through our families.鈥�

The jail system, they would learn, was at the center of a coronavirus outbreak.

Within four weeks of Trueblood鈥檚 first appointment with Patsalis, the doctor died of COVID-19. The coronavirus soon claimed another doctor, as well as the commander and a sheriff鈥檚 deputy at the Wayne County Sheriff鈥檚 Office (WCSO), a three-facility maximum-security jail system in the Detroit area for inmates charged with violent and nonviolent crimes.

Amid overcrowding and a shortage of personal protective equipment (PPE), at least 208 employees and 83 inmates have tested positive for COVID-19 at WCSO to date.

Public health experts have for months warned that U.S. jails and prisons face catastrophe. At least 100,000 people in U.S. jails and prisons have been infected, and almost 800 inmates and staffers have died, according to .

Failures at the Detroit-area jails echo those in neighboring Oakland County and across the U.S., including facilities in ; the notorious聽聽in Louisiana; and California鈥檚聽San Quentin State Prison,聽where聽over 2,000聽 have had the coronavirus and 10 have died.

Wayne County jails have long been in disrepair, with issues ranging from hot-water boilers in need of maintenance to black mold, rust, a recent failed fire inspection and reports of rats and . Plans for upgrades have been delayed due to the pandemic.

The problems jails face are clear. First is 鈥渞apid turnover 鈥� of new detainees who could be infected,鈥� said Dr. Fred Rottnek, a professor and the director of community medicine at St. Louis University, who inspected the three jails as part of a lawsuit lodged against WCSO over allegedly inadequate COVID-19 protections. In addition, 鈥渋n both jails and prison settings, officers, medical staff and vendors can act like vectors, bringing the infection into the facility, or back out into the community, with each shift change.鈥�

While touring the medical clinic, Rottnek witnessed two correctional officers sitting side by side without face masks. The officers later put them on once Rottnek introduced himself.

Detroit had its first confirmed case of COVID-19 on March 11. That same day, the WCSO jail commander, Donafay Collins, 63, became ill. He had attended an annual gathering of current and former WCSO employees at Bert鈥檚 Marketplace in Detroit almost a week earlier. A handful of other attendees also developed COVID-19.

Collins, the jail commander, died on March 25 followed by medical deputy on April 3.

The聽deputies鈥� union聽became concerned and criticized the jail system and county officials聽for downplaying the crisis, for lacking proper PPE for inmates and for neglecting social distancing requirements. Inmates even took to聽聽to voice concerns.

鈥淭he union called on everyone to be tested in the sheriff department,鈥� said Reginald Crawford, the president of the Wayne County Deputy Sheriffs鈥� Association. 鈥淭he deputies, the civilian employees, the doctors, the nurses and the inmates. We wanted all to be tested so we knew how to deal with this.鈥�

Patsalis, the doctor, had trouble breathing and developed a terrible cough.

鈥淭he next thing I know [his fianc茅e] called me and said he was on a ventilator in a medically induced coma,鈥� said his cousin John Patsalis.

Born in Detroit, Patsalis graduated from Wayne State University and the University of Ioannina Medical School in Greece. As a child, he often spent summers in Platsa, a village in southern Greece and the birthplace of his father, Nicholas Patsalis. As an adult, he loved to hunt and was dedicated to his Greek Orthodox faith, patients and family.

He had been working at the Wayne County jail system鈥檚 medical department for at least six years and was about to marry. 鈥淗e was a wonderful and irreplaceable person,鈥� his fianc茅e, Denise Bargon, told The Guardian. 鈥淗e just put everything into being a doctor.鈥�

Five days after being intubated, Angelo Patsalis died on April 6. He was three weeks away from celebrating his 64th birthday. His father, 86, died of COVID-19 two days after his only son.

Some inmates particularly vulnerable to COVID-19 because of health issues, or who were accused of nonviolent crimes, were released in order to ease the burden on the jails. Trueblood was one of them. They were not tested for the virus, however, and former inmate Michael Meshinski, who fell ill during his detainment, at home days later from COVID-19.

On April 16, Patsalis鈥� colleague Dr. Richard Miles also died as a result of the coronavirus. Miles had been a doctor for 36 years. Before working in the jail system, he was a physician who helped elderly patients with complex health issues on home visits.

鈥淲ith his knowledge and experience and his understanding of what these older, chronically ill patients were experiencing, he was doing his very best to help them deal with that,鈥� said Michael Flannery, a social worker, recalling a time Miles telephoned him to discuss a patient, which few other doctors did. 鈥淗e had a passion for home care and he had a passion for all his patients.鈥�

Patsalis and Miles were both contract physicians employed by Wellpath, a聽 Nashville-based corporation that provides inmate health care. In an email to The Guardian, Judy Lilley, a Wellpath spokesperson, said the company followed the latest guidance from the Department of Public Health and the Centers for Disease Control and Prevention, 鈥渋ncluding numerous changes to training, policy and practice.鈥�

Widespread testing of WCSO employees, which was essential in order to slow transmission, began on April 21. Testing for inmates began on May聽 7.

Several civil rights groups have sued Wayne County jails to obtain the immediate release of vulnerable inmates, and have alleged the jail is not providing adequate safeguards against the threat of the coronavirus, requesting the release of some unhealthy inmates, who would be fitted with GPS tethers. at the jail system recently spoke out about how staff shortages limit their ability to treat inmates, to the point that not all inmates are receiving their medications.

鈥淚鈥檓 very confident that those allegations that were lodged in that lawsuit will prove to be untrue,鈥� said Robert Dunlap, the chief of jails. 鈥淚t is not indicative of the care, concern, commitment and compassion that the men and women of the Wayne County sheriff department have about the care and custody of human beings.鈥�

Crawford, the head of the deputies鈥� union, said that most of all he wanted to know the full picture.

鈥淎ll we want is transparency and truth. We want to know the truth because we can deal with the truth. Everyone needs to be transparent. And that鈥檚 not only Wayne County, everyone in government needs to tell everyone the truth. What are the real numbers? What are we really dealing with here?鈥�