People confined in jail and prison are especially vulnerable to outbreaks of communicable diseases such as coronavirus disease 2019 (COVID-19). Corrections officials across the country have responded by shifting institutional practices, including suspending visitation and programming, as well as releasing some prisoners early. Missing from leading accounts of COVID-19 in correctional facilities are the perspectives of prisoners. This study examined perceptions of risks and responses among a random sample of 31 high-security male prisoners in Oregon. In-depth interviews were conducted by phone in private attorney rooms between April and May 2020. Mixed method data revealed that respondents felt it was a matter of when, not if, the disease would spread throughout the prison system, due primarily to transmission from correctional officers. Yet prisoners were not highly worried about contracting the disease. This was due, in part, to being physically and socially isolated in restrictive housing, which in this instance they viewed as advantageous. Respondents believed the threat of the virus was being taken seriously by prison officials but lacked confidence in their ability to prevent an outbreak or effectively treat infected prisoners. Strategies are needed to mitigate the spread, fear, and consequences of COVID-19 in correctional facilities, as this disease has the potential to upend the functions and purposes of the American prison.