Epidemiology of Coronavirus Disease 2019 at a County Jail—Alameda County, California, March 2020-March 2021

Abstract

Context: Coronavirus disease 2019 (COVID-19) incidence rates are 2- to 5-fold higher among persons incarcerated in the United States than in the general population. Program or Policy: We describe an outbreak investigation of COVID-19 at a jail (jail A) in Alameda County during March 2020-March 2021. Implementation: To prevent COVID-19 cases among incarcerated persons and employees, staff at jail A and the county public health department worked to develop and recommend infection control measures implemented by jail A including, but not limited to, face covering use among incarcerated persons and staff; cohorting incarcerated persons at a higher risk of severe COVID-19 in dedicated housing units; quarantining all newly detained individuals for 14 days; and offering testing for all symptomatic incarcerated persons, newly incarcerated persons at day 2 and day 10, and all persons who resided in a housing unit where a COVID-19 case was detected. Evaluation: A total of 571 COVID-19 cases were detected among incarcerated persons at jail A during March 2020-March 2021, which represented a total incidence of 280 per 1000 population, 5 times higher than the rate in Alameda County. Of the 571 cases among incarcerated persons, 557 (98%) were male; 415 (73%) were aged 18 to 40 years; 249 (44%) were Latino; and 180 (32%) were African American; 354 (62%) were not symptomatic; and 220 (39%) had no comorbidities. Less than 2% of infected incarcerated persons were hospitalized, and no deaths were reported. Discussion: COVID-19 disproportionately impacted persons incarcerated at jail A, with higher numbers among Latinos and African Americans. Implementation of COVID-19 infection control and testing measures, and collaboration between public health, law enforcement, and health care providers may have, in part, led to reductions in morbidity and mortality associated with COVID-19 at jail A.

Effects of the COVID-19 pandemic on people experiencing incarceration: a systematic review

“…Incidence of COVID-19/SARS-CoV-2 varied significantly across countries and prison facilities. Crude incidence rates were mostly higher in prisons than in the general population 26–36. Relative risk of COVID-19 positivity versus the general population was increased by 4.32 times37 and 5.29 times 36.…”

“…Although the incidence of COVID-19 was greater among PEI than in the community, some subgroups of incarcerated residents were at greater risk of seropositivity and COVID-19 incidence. Risk factors for contracting COVID-19 in PEI included Hispanic ethnicity,36 45–47 being of non-Hispanic black ethnicity,36 38 44 46–48 Asian ethnicity,38 partaking in prison labour,44 49 being in high occupancy prisons,32 unstable housing prior to incarceration44 shared meal consumption44 and older age 47 50. Higher security prisons had lower per capita rates of infection 37.…”

“…Crude incidence rates were mostly higher in prisons than in the general population. [26][27][28][29][30][31][32][33][34][35][36] Relative risk of COVID-19 positivity versus the general population was increased by 4.32 times 37 and 5.29 times. 36 However, a UK study documented a crude incidence rate in prisons which was not statistically different to the general population 38 and four studies, from the UK, USA, Italy and Denmark, respectively, showed a lower incidence rate in the incarcerated population.…”

“…[26][27][28][29][30][31][32][33][34][35][36] Relative risk of COVID-19 positivity versus the general population was increased by 4.32 times 37 and 5.29 times. 36 However, a UK study documented a crude incidence rate in prisons which was not statistically different to the general population 38 and four studies, from the UK, USA, Italy and Denmark, respectively, showed a lower incidence rate in the incarcerated population. [39][40][41][42] Testing strategies were not clearly documented in these studies, so results must be interpreted with care.…”

Correlation of SARS-CoV-2 in Wastewater and Individual Testing Results in a Jail, Atlanta, Georgia, USA

“…In 2020, 7% of US jails were operating over capacity, despite total admissions decreasing from 10.3 million in 2019 to 8.7 million in 2020 (16%) ( 3 ). Although the Centers for Disease Control and Prevention published guidelines for COVID-19 management in carceral settings ( 4 ), COVID-19 incidence exceeded that of surrounding communities up to 5-fold ( 5 – 7 ). In addition, there are logistical challenges to regularly screening jail residents for asymptomatic disease, especially in large jails that house thousands of persons ( 5 , 8 – 12 ).…”