Seroprevalence and Risk Factors for Severe Acute Respiratory Syndrome Coronavirus 2 Among Incarcerated Adult Men in Quebec, Canada, 2021

Kronfli, Nadine; Dussault, Camille; Maheu‐Giroux, Mathieu; Halavrezos, Alexandros; Chalifoux, Sylvie; Sherman, Jessica; Park, Hyejin; Balso, Lina Del; Cheng, Matthew P.; Poulin, Sébastien; Cox, Joseph

doi:10.1093/cid/ciac031

Cited by 13 publications

(19 citation statements)

References 25 publications

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“…In concordance with previous accounts of under-testing in prisons and jails ( 25 – 28 ), this study revealed substantial undetected COVID-19 infection among both residents and staff. These results are consistent with other studies employing antibody testing in carceral ( 31 ) and non-carceral settings ( 30 , 59 ). We also found a significant association between antibody positivity and perceived likelihood of prior infection among residents without a prior COVID-19 diagnosis, suggesting that the hidden burden of infection was concentrated among individuals who were aware of exposure or infection but had not been tested.…”

Section: Discussionsupporting

confidence: 92%

“…Antibody testing, which can identify prior infection by detecting antibodies to SARS-CoV-2 in the blood, is one strategy to assess the extent of undetected infection in a population and to determine factors associated with risk of prior infection ( 29 , 30 ). However, to our knowledge few studies–none in the U.S.–have employed antibody testing in a carceral setting ( 31 – 35 ).…”

Section: Introductionmentioning

confidence: 99%

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COVID-19 Preventive Measures in Northern California Jails: Perceived Deficiencies, Barriers, and Unintended Harms

Liu

LeBoa

Rodriguez

et al. 2022

Front. Public Health

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BackgroundCarceral facilities are high-risk settings for COVID-19 transmission. Little is known about the hidden burden of infection or practical barriers to infection control in these settings, especially in jails. There is also limited research on the mental health impacts of the pandemic among people living and working in carceral facilities.MethodsBetween July 8, 2020 and April 30, 2021, we performed SARS-CoV-2 rapid antibody testing and administered a questionnaire among residents and staff of four Northern California jails. We utilized multivariable logistic regression, adjusting for demographic and carceral characteristics, to analyze factors associated with prior infection, including perceived likelihood of prior infection and access to new masks. We additionally assessed the implementation of, perceptions toward, and impacts of COVID-19 policies in practice. We engaged stakeholder representatives, including incarcerated individuals, to guide study design, procedures, and results interpretation.ResultsWe enrolled 788 jail residents and 380 jail staff. Nearly half of residents and two-thirds of staff who were antibody-positive had not previously tested positive for COVID-19. Among residents without a prior COVID-19 diagnosis, antibody positivity was significantly associated with perceived likelihood of prior infection (adjusted OR = 8.9; 95% CI, 3.6–22.0). Residents who had flu-like illness in jail cited inadequate responses to reported illness and deterrents to symptom reporting, including fears of medical isolation and perceptions of medical neglect. Residents also disclosed deficient access to face masks, which was associated with antibody positivity (adjusted OR = 13.8, 95% CI, 1.8–107.0). Worsened mental health was pervasive among residents, attributed not only to fear of COVID-19 and unsanitary jail conditions but also to intensified isolation and deprivation due to pandemic restrictions on in-person visitation, programs, and recreation time.ConclusionCarceral settings present significant challenges to maintaining infection control and human rights. Custody officials should work diligently to transform the conditions of medical isolation, which could mitigate deterrents to symptom reporting. Furthermore, they should minimize use of restrictive measures like lockdowns and suspension of visitation that exacerbate the mental health harms of incarceration. Instead, custody officials should ensure comprehensive implementation of other preventive strategies like masking, testing, and vaccination, in conjunction with multisector efforts to advance decarceration.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

COVID-19 Preventive Measures in Northern California Jails: Perceived Deficiencies, Barriers, and Unintended Harms

Liu

LeBoa

Rodriguez

et al. 2022

Front. Public Health

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“…Finally, each prison has a variable number of correctional workers and incarcerated individuals, and is different in size and spatial organization, further impacting differences in seroprevalence. This variability was also observed during our preceding seroprevalence study among incarcerated individuals at the same three sites (27% at EDM, 19% at EDSJ, and 15% at EDRDP) (3). Very few studies exploring the risk of infectious diseases in correctional settings have focused on correctional workers despite having shared health and safety hazards as those incarcerated (36).…”

Section: Discussionsupporting

confidence: 57%

“…Canadian correctional facilities have witnessed many large outbreaks of the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) since the beginning of the pandemic, affecting both incarcerated individuals and correctional workers alike (1,2). Several studies have demonstrated that COVID-19 case rates among incarcerated individuals and correctional workers constantly exceeded those of surrounding communities during the pandemic (3)(4)(5)(6), underscoring the prison environment as particularly conducive to SARS-CoV-2 transmission. Correctional workers have experienced many of the same infrastructural catalysts to SARS-CoV-2 transmission as individuals in prison, including inadequate ventilation, unhygienic conditions, and difficulties in accessing and implementing effective infection prevention and control measures (7)(8)(9)(10)(11) -occupational risks that are further heightened by daily community exposures.…”

Section: Introductionmentioning

confidence: 99%

Importance of occupation for SARS-CoV-2 seroprevalence and COVID-19 vaccination among correctional workers in Quebec, Canada: A cross-sectional study

Kronfli

Dussault

Maheu‐Giroux

et al. 2022

Front. Public Health

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BackgroundCorrectional workers are at increased risk of SARS-CoV-2 infection. We examined the seroprevalence of SARS-CoV-2, determined the effects of carceral and occupational exposures on seropositivity, and explored predictors of COVID-19 vaccine uptake among correctional workers in Quebec, Canada.MethodsWe conducted a cross-sectional seroprevalence study in three provincial prisons. The primary and secondary outcomes were SARS-CoV-2 antibody seropositivity (Roche Elecsys® serology test) and self-reported COVID-19 vaccination status (“fully vaccinated” defined as two doses or prior infection plus one dose), respectively. Poisson regression models with robust standard error were used to examine the effect of occupational variables with SARS-CoV-2 seropositivity and predictors of COVID-19 vaccine uptake. Estimates are presented as crude and adjusted prevalence ratios (aPR) with 95% confidence intervals (95% CI).ResultsFrom 14 July to 15 November 2021, 105/600 (18%) correctional workers tested positive across three prisons (range 11–21%); 76% were fully vaccinated. Seropositivity was affected by prison occupation (aPR 1.59, 95% CI 1.11–2.27 for correctional officers vs. all other occupations) and low perceived concern of SARS-CoV-2 acquisition (aPR 1.62, 95% CI 1.11–2.38 for not/hardly worried vs. somewhat/extremely worried). Predictors of being fully vaccinated included race/ethnicity (aPR 0.86, 95% CI 0.76–0.99 for visible minority vs. White), presence of comorbidities (aPR 1.14, 95% CI 1.02–1.28 for > 2 vs. none), and prison occupation (aPR 0.82, 95% CI 0.73–0.92 for correctional officers vs. all other occupations).ConclusionsCorrectional officers were most likely to have acquired SARS-CoV-2, but least likely to be vaccinated, underscoring the importance of addressing both occupational risks and COVID-19 vaccine hesitancy to mitigate future outbreaks.

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“…This is similar to a seropositivity rate (22%) reported among 1100 incarcerated men in Canada, which was attributed to enhanced daily interactions in a congregate setting. 25 …”

Section: Discussionmentioning

confidence: 99%

Seropositivity and risk factors for SARS-CoV-2 infection in a South Asian community in Ontario: a cross-sectional analysis of a prospective cohort study

Anand

Arnold

Bangdiwala

et al. 2022

cmajo

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Seroprevalence and Risk Factors for Severe Acute Respiratory Syndrome Coronavirus 2 Among Incarcerated Adult Men in Quebec, Canada, 2021

Cited by 13 publications

References 25 publications

COVID-19 Preventive Measures in Northern California Jails: Perceived Deficiencies, Barriers, and Unintended Harms

COVID-19 Preventive Measures in Northern California Jails: Perceived Deficiencies, Barriers, and Unintended Harms

Importance of occupation for SARS-CoV-2 seroprevalence and COVID-19 vaccination among correctional workers in Quebec, Canada: A cross-sectional study

Seropositivity and risk factors for SARS-CoV-2 infection in a South Asian community in Ontario: a cross-sectional analysis of a prospective cohort study

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