Background
COVID-19 and mass incarceration are closely intertwined with prisons having COVID-19 case rates much higher than the general population. COVID-19 has highlighted the relationship between incarceration and health, but prior work has not explored how COVID-19 spread in communities have influenced case rates in prisons. Our objective was to understand the relationship between COVID-19 case rates in the general population and prisons located in the same county.
Methods
Using North Carolina’s (NC) Department of Health and Human Services data, this analysis examines all COVID-19 tests conducted in NC from June-August 2020. Using interrupted time series analysis, we assessed the relationship between substantial community spread (50/100,000 detected in the last seven days) and active COVID-19 case rates (cases detected in the past 14 days/100,000) within prisons.
Results
From June-August 2020, NC ordered 29,605 tests from prisons and detected 1,639 cases. The mean case rates were 215 and 427 per 100,000 in the general and incarcerated population, respectively. Once counties reached substantial COVID-19 spread, the COVID-19 prison case rate increased by 118.55 cases per 100,000 (95% CI: -3.71, 240.81).
Conclusions
Community COVID-19 spread contributes to COVID-19 case rates in prisons. In counties with prisons, community spread should be closely monitored. Stringent measures within prisons (e.g., vaccination) and decarceration should be prioritized to prevent COVID-19 outbreaks.
Carceral settings in the United States have been the source of many single site COVID-19 outbreaks. Quarantine is a strategy used to mitigate the spread of COVID-19 in correctional settings, and specific quarantine practices differ state to state. To better understand how states are using quarantine in prisons, we reviewed each state’s definition of quarantine and compared each state’s definition to the Centers for Disease Control’s (CDC) definition and recommendations for quarantine in jails and prisons. Most prison systems, 45 of 53, define quarantine, but definitions vary widely. No state published definitions of quarantine that align with all CDC recommendations, and only 9 states provide quarantine data. In these states, the highest recorded quarantine rate occurred in Ohio in May 2020 at 843 per 1,000. It is necessary for prison systems to standardize their definitions of quarantine and to utilize quarantine practices in accordance with CDC recommendations. In addition, data transparency is needed to better understand the use of quarantine and its effectiveness at mitigating COVID-19 outbreaks in carceral settings.
While infectious diseases (ID) are a well-documented public health issue in carceral settings, research on ID screening and treatment in jails is lacking. A survey was sent to 1,126 jails in the United States to identify the prevalence of health screenings at intake and characteristics of care for ID; 371 surveys were completed correctly and analyzed. Despite conflicting Centers for Disease Control (CDC) guidance, only seven percent of surveyed jails test individuals for HIV at admission. In 46% of jails, non-healthcare personnel perform ID screenings. Jails in less urban areas were more likely to report healthcare screenings performed by correctional officers. Survey findings indicate that HIV, HCV and TB testing during jail admissions and access to PrEP are severely lacking in less urban jails in particular. Recommendations are provided to improve ID surveillance and address the burden of ID in correctional facilities.
Background
COVID-19 shut down trial courts across the country, prolonging case resolution of charged, detained, and incarcerated people. We report on the implementation of rapid COVID-19 testing at Trial Courts in Massachusetts (MA), focusing on the outcomes of adoption and acceptability.
Methods
Guided by the Expert Recommendations in Implementing Change (ERIC) framework, we chose six strategies to guide implementation. After assembling a group of stakeholders, including representatives of the Trial Court, Department of Public Health (DPH) and vendors providing COVID-19 testing, we implemented rapid COVID-19 testing at Trial Court locations in December 2021. We collected data on (1) adoption of COVID-19 testing, (2) number of stakeholders who attended meetings, (3) number of tests performed at Trial Court sites, and (4) acceptability of COVID-19 testing using a QR-code anonymous survey.
Results
There was a high percentage of attendance at stakeholder meetings (> 70% at each meeting). 243 COVID-19 tests were conducted on eight occasions at four Trial Court sites between December 2021 and February 2022. Participants who responded to the QR-code survey reflected favorably on COVID-19 testing at MA Trial Court sites.
Conclusion
COVID-19 testing at Massachusetts Trial Court sites was possible through stakeholder engagement. Several cases of COVID-19 were identified prior to entry into the Trial Court. Funding for rapid COVID-19 testing should be provided to help keep trial courts open as the pandemic continues to evolve.
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