Initial reports said he hung himself. In this context (not being dropped from a height) this means strangulation, not neck snapping. Dying from strangulation takes a long time. 4 minutes minimum if everything "goes right" which means no intervening wheeze. Needless to say if he was shrieking and shouting (this report does not make clear who was
shrieking and shouting)...
CBS News has learned that the morning of Jeffrey Epstein's death there was shouting and shrieking from his jail cell. Guards attempted to revive him while saying "breathe, Epstein, breathe."