In the Journals

IDSA: Interventions are ‘urgently needed’ to limit spread of COVID-19 in jails

Alysse Wurcel

The Infectious Diseases Society of America and the HIV Medicine Association have issued policy recommendations to address the “alarmingly high rates” of COVID-19 in detention settings.

“There are outbreaks of COVID-19 in jails and prisons across the country. Depending on the layout of the jail or prison and the intended capacity, implementation of social distancing policies can be challenging,” Alysse Wurcel, MD, MS, IDSA member, attending physician in the division of geographic medicine and infectious diseases at Tufts Medical Center and assistant professor at Tufts University School of Medicine, told Healio. “People in the community, both people who are arrested and people who work in jails, can bring the infection inside the corrections setting, often during asymptomatic or presymptomatic infection. By the time the first case is identified, COVID-19 has often already spread widely.”

The call for a strengthened response in the brief from IDSA highlights data from Ohio correctional facilities showing that 80% of more than 3,000 incarcerated people tested were infected with COVID-19. More than 1,800 of the inmates with COVID-19 were at one facility and six incarcerated individuals were confirmed to have died from COVID-19, with an additional individual “likely” dying from COVID-19.

“The news is sobering but not surprising, given the close quarters and other conditions that hinder physical distancing and the limited availability of appropriate hygiene supplies,” the brief states.

The brief also outlines an outbreak at the Chicago Cook County jail, where testing for COVID-19 demonstrated that nearly half of incarcerated individuals (47%; n = 486) and 371 employees who were tested were positive for the illness; six inmates and one employee had died from COVID-19 as of April 29. As of April 30, according to data from the Federal Bureau of Prisons that is outlined by IDSA, 1,692 of the 141,933 people incarcerated in the federal system nationwide and 343 Bureau of Prisons staff members had tested positive for COVID-19 and 31 individuals incarcerated in the federal system have died.

Although not all states were reporting data on COVID-19 in jails at the time this article was published, covidprisonproject.com, a website Wurcel is working on to make prison data more accessible, has reported 23,753 COVID-19 cases among incarcerated people and 6,454 cases among staff, including 23 deaths among staff, as of May 13.

To support prevention, testing and care as well as the physical and mental health of incarcerated populations, IDSA is urging federal and state policymakers to:

  • Support adherence to CDC guidance for managing COVID-19 in correctional facilities through routine symptom screening for incarcerated individuals and staff, regular cleaning and disinfecting practices and appropriate isolation of confirmed or suspected COVID-19 cases in a safe, medically appropriate, nonpunitive manner.
  • Ensuring a stable supply chain for swabs, transport media and testing reagents, allowing for adequate testing in facilities and for personal protective equipment for correctional facility health care worker staff.
  • Provide necessary resources to correctional health and other public health services to implement testing and CDC guidance.
  • Cover COVID-19 testing and care for individuals who are incarcerated or detained at no cost to them.
  • Ensure individuals who are incarcerated with severe illness are given equitable access to care, including opportunities to receive experimental care such as plasma therapy, to the extent available in hospitals where individuals are transferred.
  • Provide individuals in the criminal justice system with sufficient supplies of appropriate and safe cleaners and personal protective equipment, including face coverings, at no charge to them and eliminate barriers to hand-washing or hand-sanitizing.
  • Provide personal protective equipment for all staff.
  • Provide for the enhanced mental health needs of individuals who are incarcerated and allow more phone calls at no cost and enable video visitation with family.
  • Prepare for the availability of verified antibody tests for monitoring surveillance and provide resources to support their distribution.
  • Prepare for the availability of a protective vaccine and effective treatment and plan for their distribution.
  • Support suitable shelter for newly released individuals.
  • Support re-entry services including medical and behavioral health care, substance use disorder treatment, housing, food support and workforce development.

Wurcel noted that there should be a low threshold for testing and that screening should be implemented for both staff and new detainees on intake by asking about previous symptoms such as diarrhea and loss of smell. She also said that people in jail may be concerned about the loss of privileges, such as phone calls, if they report symptoms and test positive for COVID-19, which can deter them from reporting symptoms.

“Unfortunately, when jails or prisons start testing and are transparent about outbreaks, they are often the target of criticism,” Wurcel said. “In order to encourage prisons and jail administration to feel comfortable partnering with local academic and public health centers, we should be applauding those that are testing frequently and identifying cases.” – by Caitlyn Stulpin

Reference:

IDSA. Strengthening the response to COVID-19 in correctional facilities. https://www.idsociety.org/globalassets/idsa/public-health/covid-19/covid-19-in-correctional-facilities.pdf. Accessed on May 6, 2020.

Disclosure: Wurcel reports that her salary is being paid in part by the Massachusetts Sheriff’s Association.

Alysse Wurcel

The Infectious Diseases Society of America and the HIV Medicine Association have issued policy recommendations to address the “alarmingly high rates” of COVID-19 in detention settings.

“There are outbreaks of COVID-19 in jails and prisons across the country. Depending on the layout of the jail or prison and the intended capacity, implementation of social distancing policies can be challenging,” Alysse Wurcel, MD, MS, IDSA member, attending physician in the division of geographic medicine and infectious diseases at Tufts Medical Center and assistant professor at Tufts University School of Medicine, told Healio. “People in the community, both people who are arrested and people who work in jails, can bring the infection inside the corrections setting, often during asymptomatic or presymptomatic infection. By the time the first case is identified, COVID-19 has often already spread widely.”

The call for a strengthened response in the brief from IDSA highlights data from Ohio correctional facilities showing that 80% of more than 3,000 incarcerated people tested were infected with COVID-19. More than 1,800 of the inmates with COVID-19 were at one facility and six incarcerated individuals were confirmed to have died from COVID-19, with an additional individual “likely” dying from COVID-19.

“The news is sobering but not surprising, given the close quarters and other conditions that hinder physical distancing and the limited availability of appropriate hygiene supplies,” the brief states.

The brief also outlines an outbreak at the Chicago Cook County jail, where testing for COVID-19 demonstrated that nearly half of incarcerated individuals (47%; n = 486) and 371 employees who were tested were positive for the illness; six inmates and one employee had died from COVID-19 as of April 29. As of April 30, according to data from the Federal Bureau of Prisons that is outlined by IDSA, 1,692 of the 141,933 people incarcerated in the federal system nationwide and 343 Bureau of Prisons staff members had tested positive for COVID-19 and 31 individuals incarcerated in the federal system have died.

Although not all states were reporting data on COVID-19 in jails at the time this article was published, covidprisonproject.com, a website Wurcel is working on to make prison data more accessible, has reported 23,753 COVID-19 cases among incarcerated people and 6,454 cases among staff, including 23 deaths among staff, as of May 13.

To support prevention, testing and care as well as the physical and mental health of incarcerated populations, IDSA is urging federal and state policymakers to:

PAGE BREAK
  • Support adherence to CDC guidance for managing COVID-19 in correctional facilities through routine symptom screening for incarcerated individuals and staff, regular cleaning and disinfecting practices and appropriate isolation of confirmed or suspected COVID-19 cases in a safe, medically appropriate, nonpunitive manner.
  • Ensuring a stable supply chain for swabs, transport media and testing reagents, allowing for adequate testing in facilities and for personal protective equipment for correctional facility health care worker staff.
  • Provide necessary resources to correctional health and other public health services to implement testing and CDC guidance.
  • Cover COVID-19 testing and care for individuals who are incarcerated or detained at no cost to them.
  • Ensure individuals who are incarcerated with severe illness are given equitable access to care, including opportunities to receive experimental care such as plasma therapy, to the extent available in hospitals where individuals are transferred.
  • Provide individuals in the criminal justice system with sufficient supplies of appropriate and safe cleaners and personal protective equipment, including face coverings, at no charge to them and eliminate barriers to hand-washing or hand-sanitizing.
  • Provide personal protective equipment for all staff.
  • Provide for the enhanced mental health needs of individuals who are incarcerated and allow more phone calls at no cost and enable video visitation with family.
  • Prepare for the availability of verified antibody tests for monitoring surveillance and provide resources to support their distribution.
  • Prepare for the availability of a protective vaccine and effective treatment and plan for their distribution.
  • Support suitable shelter for newly released individuals.
  • Support re-entry services including medical and behavioral health care, substance use disorder treatment, housing, food support and workforce development.

Wurcel noted that there should be a low threshold for testing and that screening should be implemented for both staff and new detainees on intake by asking about previous symptoms such as diarrhea and loss of smell. She also said that people in jail may be concerned about the loss of privileges, such as phone calls, if they report symptoms and test positive for COVID-19, which can deter them from reporting symptoms.

“Unfortunately, when jails or prisons start testing and are transparent about outbreaks, they are often the target of criticism,” Wurcel said. “In order to encourage prisons and jail administration to feel comfortable partnering with local academic and public health centers, we should be applauding those that are testing frequently and identifying cases.” – by Caitlyn Stulpin

Reference:

IDSA. Strengthening the response to COVID-19 in correctional facilities. https://www.idsociety.org/globalassets/idsa/public-health/covid-19/covid-19-in-correctional-facilities.pdf. Accessed on May 6, 2020.

Disclosure: Wurcel reports that her salary is being paid in part by the Massachusetts Sheriff’s Association.

    See more from COVID-19 Resource Center