Association of Jail Decarceration and Anticontagion Policies With COVID-19 Case Growth Rates in US Counties

Abstract

IMPORTANCE Mass incarceration is known to foster infectious disease outbreaks, amplification of infectious diseases in surrounding communities, and exacerbation of health disparities in disproportionately policed communities. To date, however, policy interventions intended to achieve epidemic mitigation in US communities have neglected to account for decarceration as a possible means of protecting public health and safety.OBJECTIVE To evaluate the association of jail decarceration and government anticontagion policies with reductions in the spread of SARS-CoV-2. DESIGN, SETTING, AND PARTICIPANTS This cohort study used county-level data from January toNovember 2020 to analyze COVID-19 cases, jail populations, and anticontagion policies in a panel regression model to estimate the association of jail decarceration and anticontagion policies with COVID-19 growth rates. A total of 1605 counties with data available on both jail population and COVID-19 cases were included in the analysis. This sample represents approximately 51% of US counties, 72% of the US population, and 60% of the US jail population.EXPOSURES Changes to jail populations and implementation of 10 anticontagion policies: nursing home visitation bans, school closures, mask mandates, prison visitation bans, stay-at-home orders, and closure of nonessential businesses, gyms, bars, movie theaters, and restaurants. MAIN OUTCOMES AND MEASURESDaily COVID-19 case growth rates. RESULTSIn the 1605 counties included in this study, the mean (SD) prison population was 283.38 (657.78) individuals, and the mean (SD) population was 315.24 (2151.01) persons per square mile. An estimated 80% reduction in US jail populations, achievable through noncarceral management of nonviolent alleged offenses and in line with average international incarceration rates, would have been associated with a 2.0% (95% CI, 0.8%-3.1%) reduction in daily COVID-19 case growth rates. Jail decarceration was associated with 8 times larger reductions in COVID-19 growth rates in counties with above-median population density (4.6%; 95% CI, 2.2%-7.1%) relative to those below this median (0.5%; 95% CI, 0.1%-0.9%). Nursing home visitation bans were associated with a 7.3% (95% CI, 5.8%-8.9%) reduction in COVID-19 case growth rates, followed by school closures (4.3%; 95% CI, 2.0%-6.6%), mask mandates (2.5%; 95% CI, 1.7%-3.3%), prison visitation bans (1.2%; 95% CI, 0.2%-2.2%), and stay-at-home orders (0.8%; 95% CI, 0.1%-1.6%). CONCLUSIONS AND RELEVANCEAlthough many studies have documented that high incarceration rates are associated with communitywide health harms, this study is, to date, the first to show that decarceration is associated with population-level public health benefits. Its findings suggest that, among other anticontagion interventions, large-scale decarceration and changes to pretrial (continued) Key Points Question Were jail decarceration and government implementation of anticontagion policies associated with the spread of SARS-CoV-2 in US counties? Findings In this cohort study of 1605 cou...

The Risk of COVID-19 Infection in Prisons and Prevention Strategies: A Systematic Review and a New Strategic Protocol of Prevention

“…Regulated release worked best in overcrowded prisons to reduce the risk of infection. Reinhart, E. et al [35] claimed that controlled decarceration reduced the infection rate by eight times in overcrowded prisons, while the use of masks reduced the infection rate by…”

“…Regulated release worked best in overcrowded prisons to reduce the risk of infection. Reinhart, E. et al [ 35 ] claimed that controlled decarceration reduced the infection rate by eight times in overcrowded prisons, while the use of masks reduced the infection rate by 2.5%, while the visit ban reduced the infection rate by 1.2%. Brinkley-Rubinstein, L. et al [ 30 ] concluded that inter-prison transfers reduced the risk of COVID-19 infection.…”

“…Controlled decarceration was a very useful element in reducing the incidence of COVID-19 in prisons. Reinhart et al [ 35 ] stated that controlled decarceration reduced the infection rate by eight times in overcrowded prisons. The use of masks reduced the infection rate by 2.5%, while the visit ban reduced the infection rate by 1.2%.…”

“…A total of 1250 articles did not meet the inclusion criteria. Therefore, 21 articles were included in the present systematic review ( Figure 1 ) [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ].…”

The policy lessons learned from the criminal justice system response to COVID‐19

“… 13 In a recent analysis, Reinhart and Chen ( 2021 , p. 1) found that “anticontagion policies, including jail decarceration to minimize carceral outbreaks and their spillover to surrounding communities, appear to be necessary for epidemic control, public health, and mitigation of racial health disparities.” …”