Outbreak of COVID-19 and interventions in a large jail — Cook County, IL, United States, 2020

Abstract

Background: Correctional and detention facilities are disproportionately affected by COVID-19 due to shared space, contact between staff and detained persons, and movement within facilities. On March 18, 2020, Cook County Jail, one of the United States' largest, identified its first suspected case of COVID-19 in a detained person. Methods: This analysis includes SARS-CoV-2 cases confirmed by molecular detection among detained persons and Cook County Sheriff's Office staff. We examined occurrence of symptomatic cases in each building and proportions of asymptomatic detained persons testing positive, and timing of interventions including social distancing, mask use, and expanded testing and show outbreak trajectory in the jail compared to case counts in Chicago. Results: During March 1-April 30, 907 symptomatic and asymptomatic cases of SARS-CoV-2 infection were detected among detained persons (n = 628) and staff (n = 279). Among asymptomatic detained persons in quarantine, 23.6% tested positive. Programmatic activity and visitation stopped March 9, cells were converted into single occupancy beginning March 26, and universal masking was implemented for staff (April 2) and detained persons (April 13). Cases at the jail declined while cases in Chicago increased. Discussion/Conclusions: Aggressive intervention strategies coupled with widespread diagnostic testing of detained and staff populations can limit introduction and mitigate transmission of SARS-CoV-2 infection in correctional and detention facilities.Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.

Accounting for partisanship and politicization: Employing Benford's Law to examine misreporting of COVID-19 infection cases and deaths in the United States

“…The treatment of COVID-19 in prison systems provides an illustrative example of inconsistent reporting behavior that highlights how political actions could have affected the accuracy of COVID-19 infection case data through the avenues described above. In the early stages of the pandemic, authorities in prison systems utilized the tools at their disposal to protect prison inmates ( Tsoungui et al, 2021 ; Zawitz et al, 2021 ). Still, state governments suffered from a dire lack of resources necessary to adequately stymy COVID-19 outbreaks in prison systems—including robust testing capabilities.…”

“…While leaders held the authority to enforce testing requirements for both prisoners and staff ( LeMasters et al, 2020 ; Maxmen, 2020 ), prisons initially only tested symptomatic inmates as well as those at high risk for developing severe diseases. As resources became more readily available, some prisons began testing all detainees entering the respective systems ( Zawitz et al, 2021 ); however, differences in protocol persisted—resulting in disparate testing and reporting. As a consequence, reports indicate that Republican-led Texas demonstrated one of the lowest rates in the country for inmate testing ( McCullough, 2020a ) while the four states conducting the most inmate tests were led by Democratic governors ( Brand-Williams, 2021 ).…”

Implementation of Rapid COVID-19 Testing in Criminal Justice Residential Re-entry Sites

“…Early in the pandemic, jails and prisons were epicenters of COVID-19 transmission and death. 1,2 Mitigation strategies effectively reduced transmission and mortality from COVID-19, including but not limited to decarceration, 3 increased testing, 4 improved ventilation, 5 and vaccination. 3,6 Carceral systems' distribution of vaccines effective at decreasing the risk of severe illness from COVID-19 led to decreases in clinically signi cant infections.…”

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“…Several studies described the proportion of cases that were symptomatic and the proportion of cases with specific symptoms. The proportion of cases identified as symptomatic was 89.8% (510/568) in New York City, USA jails from March to April 2020 [59], 76.3% (479/628) in an outbreak in an Illinois, USA jail in March and April 2020 [50], 4% (3/71) in a Louisiana, USA correctional facility in outbreak in April to May 2020 [52], 18.8% in a men's correctional facility in Arkansas, USA in April and May 2020 [49], 43% (48/111) in a Louisiana, USA detention facility outbreak in May and June 2020 [53], 37% (12/19) in a correctional facility in Illinois, USA in May 2020 [56], and 53.5% (68/127) for people aged 60 and older in an outbreak in a penitentiary in Brazil from April to October 2020 [23].…”