Decarcerating Correctional Facilities during COVID-19

Wang, E. A.; Western, Bruce; Backes, Emily P.; Schuck, J.

doi:10.17226/25945

Cited by 46 publications

(38 citation statements)

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“…Specifically, our results suggest that the globally unparalleled system of mass incarceration in the US, which is known to incubate infectious diseases and to spread them to broader communities, puts the entire country at distinctive epidemiologic risk. This study is thus consistent with existing expert consensus 16 that public investment in a national program of large-scale decarceration and reentry support is an essential policy priority for reducing racial inequality and improving US public health and safety, pandemic preparedness, and biosecurity.…”

Section: Discussionsupporting

confidence: 88%

“…16,25 COVID-19 outbreaks in jails, prisons, and immigrant detention facilities do not only pose risks to incarcerated people, they also appear to spread to surrounding communities. [16][17][18][19][20] This carries particularly pronounced consequences for Black and Latinx communities that are subjected to disproportionately high rates of arrest and incarceration, which may partially explain the disproportionate burden of COVID-19 that has been borne by racialized groups in the US. 18 Carceral-community epidemiologic relationships, that is, connections between carceral conditions and disease spread in broader communities, have long been observed worldwide in relation to, for example, HIV, tuberculosis, influenza, and viral hepatitis.…”

Section: Introductionmentioning

confidence: 99%

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

Reinhart

Chen

2021

JAMA Netw Open

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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...

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

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

Reinhart

Chen

2021

JAMA Netw Open

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“…Our study shows that thousands of vulnerable incarcerated people continue to be housed in settings where their risk of COVID-19 infection is high. Protective measures such as decarceration, testing, vaccination, and efforts to enhance vaccine uptake remain vital (24,25). Residents at greatest risk of transmission and infection, such as those living dormitories and participating in labor, should be prioritized.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors

et al. 2021

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BACKGROUND: Correctional institutions nationwide are seeking to mitigate COVID-19-related risks. OBJECTIVE: To quantify changes to California's prison population since the pandemic began and identify risk factors for COVID-19 infection. DESIGN: For California state prisons (March 1-October 10, 2020), we described residents' demographic characteristics, health status, COVID-19 risk scores, room occupancy, and labor participation. We used Cox proportional hazard models to estimate the association between rates of COVID-19 infection and room occupancy and out-of-room labor, respectively. PARTICIPANTS: Residents of California state prisons. MAIN MEASURES: Changes in the incarcerated population's size, composition, housing, and activities. For the risk factor analysis, the exposure variables were room type (cells vs. dormitories) and labor participation (any room occupant participating in the prior 2 weeks) and the outcome variable was incident COVID-19 case rates. KEY RESULTS: The incarcerated population decreased 19.1% (119,401 to 96,623) during the study period. On October 10, 2020, 11.5% of residents were aged ≥60, 18.3% had high COVID-19 risk scores, 31.0% participated in out-of-room labor, and 14.8% lived in rooms with ≥10 occupants. Nearly 40% of residents with high COVID-19 risk scores lived in dormitories. In 9 prisons with major outbreaks (6,928 rooms; 21,750 residents), dormitory residents had higher infection rates than cell residents (adjusted hazard ratio [AHR], 2.51 95% CI, 2.25-2.80) and residents of rooms with labor participation had higher rates than residents of other rooms (AHR, 1.56; 95% CI, 1.39-1.74). CONCLUSION: Despite reductions in room occupancy and mixing, California prisons still house many medically vulnerable residents in risky settings. Reducing risks further requires a combination of strategies, including rehousing, decarceration, and vaccination.

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“…To elaborate, in the early days of the pandemic, many policymakers quickly adopted quarantine and early release policies to achieve greater social distancing within correctional facilities (16) . The populations of jails and prisons have declined by 20% and 5%, respectively (17) . Of course, these policies are more difficult to enact in some facilities than others, which stresses that adopting one policy is not likely the most effective strategy to reduce virus spread.…”

Section: Resultsmentioning

confidence: 99%

Inclusive Health: Modeling Covid-19 in Correctional Facilities and Communities

Greenhalgh

Provencher

2021

Preprint

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Mass incarceration, commonly associated with overcrowding and inadequate health resources for incarcerated people, creates a fertile environment for the spread of the coronavirus disease 2019 (COVID-19) in U.S. correctional facilities. The exact role that correctional facilities play in enhancing COVID-19 spread and enabling community re-emergence of COVID-19 is unknown. We constructed a novel stochastic model of COVID-19 transmission to estimate the impact of correctional facilities, specifically jails and state prisons, for enhancing disease transmission and enabling disease re-emergence in local communities. Using our model, we evaluated scenarios of testing and quarantining infected incarcerated people at 0.0, 0.5, and 1.0 times the rate that occurs for infected people in the local community for population sizes of 5, 10, and 20 thousand people. Our results illustrate testing and quarantining an incarcerated population of 800 would reduce the probability of a major community outbreak by 6% and also prevent between 250 to 730 incidences of COVID-19 per year, depending on local community size. These findings illustrate that managing COVID-19 in correctional facilities is essential to mitigate risks to community health, and thereby stresses the importance of improving the health standards of incarcerated people.

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Decarcerating Correctional Facilities during COVID-19

Cited by 46 publications

References 0 publications

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

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

COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors

Inclusive Health: Modeling Covid-19 in Correctional Facilities and Communities

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