JACKSON, Miss. (AP) — All inmates and employees in Mississippi prisons have been given masks to try to slow the spread of the new coronavirus, the state Department of Corrections said Monday.

Advocates have repeatedly raised concerns that the highly contagious virus is difficult to control in prisons, where inmates have little chance to keep distance from one another even when they're told to do so. They have also pushed for wider testing for COVID-19 in prisons.

The corrections department said four Mississippi inmates had tested positive for the highly contagious virus by Monday — two at the State Penitentiary at Parchman and two in the Winston-Choctaw County Regional Correctional Facility. The department has previously said one of the Parchman cases was an inmate who died.

The department said 21 inmates had tested negative for COVID-19 as of Monday. Two were waiting for test results; one was at the Marshall County Correctional Facility and one was at Delta Correctional Facility.

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough. But for others, especially older adults and people with existing health problems, the highly contagious virus can cause severe symptoms and be fatal.

In court papers filed earlier this month, the Department of Corrections said and inmates in crowded spaces are being encouraged to sleep face-to-feet with each other rather than face-to-face. Prisoners’ rights attorneys said in a separate court filing that in some areas of Parchman, more than 100 inmates were sleeping about 18 inches (46 centimeters) apart from each other.

More than 18,500 people are in custody in Mississippi prisons. Long before the pandemic, multiple health inspections showed sanitation problems including broken sinks and toilets in cells and widespread mold in showers.

The Department of Corrections said gloves and additional soap are being provided in prisons. A news release said hand sanitizer is available in “strategic locations,” including dining areas. In court papers filed in mid-April, the Department of Corrections said hand sanitizer with 60% or more alcohol is a security concern, and distributing it to all inmates is not feasible.

“Running a prison in the midst of the COVID-19 pandemic is all the more difficult, as corrections systems are neither infallible nor immune from the virus’s spread,” the department said in the court papers. Those came in response to demands made by attorneys who sued the state early this year over conditions at the Mississippi State Penitentiary at Parchman.

The Mississippi Emergency Management Agency and Mississippi Prison Industries Corporation have provided many of the masks being used by inmates and prison employees. The news release said Parchman inmates are using 5,000 masks donated by REFORM Alliance, affiliated with entertainment mogul Jay-Z.

Mississippi prisons were hit by outburst of violence in late December and early January that left several inmates dead or injured. The Justice Department announced Feb. 5 that its civil rights division would investigate Mississippi prisons that have also struggled with tight budgets, short staffing and poor living conditions.

Mississippi prison officials have told state budget writers for years that the department has trouble hiring guards because the jobs are dangerous and the pay is low. Despite the requests, budgets were cut.

Two federal lawsuits have been filed on behalf of prisoners since January, saying Parchman is dangerous, vermin-infested and unfit for human habitation. Attorneys in both lawsuits are being paid by Jay-Z, rapper Yo Gotti and Team Roc, the philanthropic arm of Jay-Z’s Roc Nation.