Through May 2020, none of the 3,500 people incarcerated in San Quentin State Prison had tested positive for COVID-19. Six weeks later, 40 percent of the population was infected, making it the worst COVID hotspot in the country. Sickness in the System shows the San Quentin outbreak from the inside by combining phone interviews with incarcerated people with performances by actors and hand-drawn illustrations. Through two men’s stories, we see how the virus came to San Quentin from a botched prisoner transfer and quickly spread through open-air cells, packed showers and poor management. As the pandemic rages, both men fear for their lives, but they meet very different fates when the California Department of Corrections begins releasing inmates to combat the crisis.