The
country and the world face a public health emergency in the new coronavirus
causing COVID-19. The media is filled with concerns about how we will respond.
Will we close schools? Cancel sporting events and other large gatherings? Work
from home? Avoid public transportation?
But
little has been said about one of the most vulnerable sectors of our
population: the people in our prisons and jails. Although people often think of
prisons and jails as closed environments, they are not. Medical staff, correctional
staff, and visitors come from the community into the facilities every day and
then return home. People are admitted to and released from prisons and jails,
and they go back and forth to court and to medical appointments. There is ample
opportunity for a virus to enter a prison or jail, and for it to go back out into
the community.
Once
a contagious illness enters, conditions in correctional facilities are highly
conducive to it spreading. People in prisons and jails live in close proximity
to each other. Many are housed in large dormitories, sharing the same space. Even
where people are housed in cells, the ventilation is often inadequate. People
in prisons and jails are often denied adequate soap and cleaning supplies,
making infection control nearly impossible.
Many
people in prisons and jails are in relatively poor health and suffer from
serious chronic conditions due to lack of access to healthcare in the community,
or abysmal healthcare in the correctional system. While people sent to prisons
and jails tend to be young, the harsh sentencing policies of recent decades
mean that the prison population is aging. Medical staff are generally stretched
thin even in the best of times. Though incarcerated people have a
constitutional right to adequate medical and mental health care, the reality is
they too often do not have access to it.
All
this means that prison and jail populations are extremely vulnerable to a
contagious illness like COVID-19. Moreover, prisoners have fewer options for
protecting themselves and others. They don’t have the option to stay away from
other people when they are sick. They can ask for medical attention, but
prisons and jails have few infirmary beds and fewer rooms for medical
isolation.
If
medical staff become ill or have to be quarantined, there will be even fewer
people available to provide care. If correctional staff become ill or need to
be quarantined, there will be fewer officers available to bring sick people to
hospitals, to the infirmary, and even just to keep an eye on who in the
facility is showing signs of illness.
To
limit outbreaks of COVID-19 in jails and prisons, officials must act, and they
must act quickly. They should coordinate with local public health officials to
determine the most appropriate measures to take, given the local conditions and
the peculiarities of the correctional environment. While the plans will differ
from facility to facility, there are points that should be addressed in any
plan:
- How will all people in the facility —
incarcerated people, staff, and visitors — be educated so they can understand
the risks, protect themselves, and protect others? This will ideally be
operationalized and conducted at scale. - Under what circumstances will staff and people
incarcerated in the facilities be tested for the virus? How many tests are
needed? - If people who are incarcerated require
quarantine and/or treatment, how will that be accomplished? - If medical staff must be quarantined or
become ill, how will the facility monitor, quarantine and treat the prison or
jail population? - If correctional staff must be
quarantined or become ill, how will the facility operate, both in terms of
addressing the virus and in terms of simply maintaining necessary services, safety,
and security? - If incarcerated people must be
quarantined or become ill, how will the facility continue necessary operations
that are reliant on the prison or jail population, such as food preparation? - Are there particularly vulnerable
populations, such as the elderly, or immunocompromised, and how can they be
protected? - How will the facility meet the
challenges of COVID-19 without violating the rights of the people in its
custody?
People
in government custody, including in prisons, jails, and civil detention, are
often forgotten in emergencies. This creates unnecessary suffering and loss of
life. We have the opportunity to take steps now to limit the spread of the
virus in prisons, jails, and detention centers. But the time to act for the
health of those incarcerated, and for the broader community, is now.