Vaccination plus Decarceration — Stopping Covid-19 in Jails and Prisons

Barsky, Benjamin A.; Reinhart, Eric; Farmer, Paul; Keshavjee, Salmaan

doi:10.1056/nejmp2100609

Cited by 54 publications

(69 citation statements)

References 2 publications

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“…This study's conclusion that decarceration should be "a primary strategy for COVID-19 mitigation in jails" is shared by a consensus policy report by The National Academies of Science, Engineering, and Medicine and was further buttressed by a recent study of transmission dynamics in Texas prisons (21,90). Evidence-based policy should insist that priority vaccination of incarcerated people be paired with large-scale decarceration in order to maximize vaccination effectiveness, disrupt the high risk for the development of new SARS-CoV-2 variants posed by current carceral conditions, and break viral transmission chains extending well beyond carceral facilities (103).…”

Section: Resultsmentioning

confidence: 99%

Carceral-community epidemiology, structural racism, and COVID-19 disparities

Reinhart

Chen

2021

Proc. Natl. Acad. Sci. U.S.A.

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Black and Hispanic communities are disproportionately affected by both incarceration and COVID-19. The epidemiological relationship between carceral facilities and community health during the COVID-19 pandemic, however, remains largely unexamined. Using data from Cook County Jail, we examine temporal patterns in the relationship between jail cycling (i.e., arrest and processing of individuals through jails before release) and community cases of COVID-19 in Chicago ZIP codes. We use multivariate regression analyses and a machine-learning tool, elastic regression, with 1,706 demographic control variables. We find that for each arrested individual cycled through Cook County Jail in March 2020, five additional cases of COVID-19 in their ZIP code of residence are independently attributable to the jail as of August. A total 86% of this additional disease burden is borne by majority-Black and/or -Hispanic ZIPs, accounting for 17% of cumulative COVID-19 cases in these ZIPs, 6% in majority-White ZIPs, and 13% across all ZIPs. Jail cycling in March alone can independently account for 21% of racial COVID-19 disparities in Chicago as of August 2020. Relative to all demographic variables in our analysis, jail cycling is the strongest predictor of COVID-19 rates, considerably exceeding poverty, race, and population density, for example. Arrest and incarceration policies appear to be increasing COVID-19 incidence in communities. Our data suggest that jails function as infectious disease multipliers and epidemiological pumps that are especially affecting marginalized communities. Given disproportionate policing and incarceration of racialized residents nationally, the criminal punishment system may explain a large proportion of racial COVID-19 disparities noted across the United States.

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Section: Resultsmentioning

confidence: 99%

Carceral-community epidemiology, structural racism, and COVID-19 disparities

Reinhart

Chen

2021

Proc. Natl. Acad. Sci. U.S.A.

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“…Our findings thus support existing consensus among public health experts that large-scale decarceration is needed not only to mitigate the spread of SARS-CoV-2 but also, in the longer-term, to assist in remedying US racial health inequities and to improve national public health, pandemic preparedness, and international biosecurity. 16 , 18 , 24 , 71 , 78 , 79 , 80 …”

Section: Discussionmentioning

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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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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“…Due to the disproportionate criminalization and incarceration of those who are poor, Black, Latinx, Indigenous, and/or disabled, formerly incarcerated individuals often return to communities that bear a high burden of COVID-19. Therefore, coupling early vaccination in carceral settings with significantly reducing jail and prison populations is a key strategy to reduce both health inequities and viral spread in vulnerable communities [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 vaccine prioritization of incarcerated people relative to other vulnerable groups: An analysis of state plans

Strodel¹,

Dayton

Garrison-Desany

et al. 2021

PLoS ONE

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Background Carceral facilities are epicenters of the COVID-19 pandemic, placing incarcerated people at an elevated risk of COVID-19 infection. Due to the initial limited availability of COVID-19 vaccines in the United States, all states have developed allocation plans that outline a phased distribution. This study uses document analysis to compare the relative prioritization of incarcerated people, correctional staff, and other groups at increased risk of COVID-19 infection and morbidity. Methods and findings We conducted a document analysis of the vaccine dissemination plans of all 50 US states and the District of Columbia using a triple-coding method. Documents included state COVID-19 vaccination plans and supplemental materials on vaccine prioritization from state health department websites as of December 31, 2020. We found that 22% of states prioritized incarcerated people in Phase 1, 29% of states in Phase 2, and 2% in Phase 3, while 47% of states did not explicitly specify in which phase people who are incarcerated will be eligible for vaccination. Incarcerated people were consistently not prioritized in Phase 1, while other vulnerable groups who shared similar environmental risk received this early prioritization. States’ plans prioritized in Phase 1: prison and jail workers (49%), law enforcement (63%), seniors (65+ years, 59%), and long-term care facility residents (100%). Conclusions This study demonstrates that states’ COVID-19 vaccine allocation plans do not prioritize incarcerated people and provide little to no guidance on vaccination protocols if they fall under other high-risk categories that receive earlier priority. Deprioritizing incarcerated people for vaccination misses a crucial opportunity for COVID-19 mitigation. It also raises ethical and equity concerns. As states move forward with their vaccine distribution, further work must be done to prioritize ethical allocation and distribution of COVID-19 vaccines to incarcerated people.

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Vaccination plus Decarceration — Stopping Covid-19 in Jails and Prisons

Cited by 54 publications

References 2 publications

Carceral-community epidemiology, structural racism, and COVID-19 disparities

Carceral-community epidemiology, structural racism, and COVID-19 disparities

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

COVID-19 vaccine prioritization of incarcerated people relative to other vulnerable groups: An analysis of state plans

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