COVID in corrections has been more than five times higher than in the general population. This respiratory disease has profoundly changed the experience of incarceration. Known dangers have not been fully addressed and prevention opportunities missed.
During the holiday period there have been new outbreaks in Massachusetts, Ohio and Illinois, and there are visitation restrictions in Texas and Idaho and numerous other locations. Military doctors have been sent to help provide care in Cuyahoga County, Ohio. Officer retention and employee relations have been strained throughout the pandemic. Wisconsin report a 112% employee turnover in 2019 and 2020. In Philadelphia staffing shortages were at a “tipping point” according to the City Controller in June 2021, and have gone up a further 60% since then.
The jail in Monroe County, New York reports that less than 30% of inmates have taken up the offer a vaccine, and some states report lower levels of officer vaccination than the general population. Unions and corrections management are fighting over vaccine mandates and a federal judge has has ordered all prison staff in California be vaccinated.
The concentration of disease in corrections is higher even than nursing homes, and the comparisons are apposite: the incarcerated populations are getting sicker and older in the United States (the over-50s rose by 400% between 1993 and 2013) has been remarkable in recent years; and New York magazine stated this week “are turning into senior-citizen centers with bars, where sick and aging people, some of whom have genuinely turned their lives around, are dying every few days.”
The vast majority (75+%) of COVID deaths in jails are of people who were not convicted. Our prisons Corrections systems have had serious deficits in medical facilities for a long time. Jails and prisons are the de facto mental health system: 44 states hold more mentally ill individuals than their state psychiatric institutions.
Jails and prisons have many previous outbreaks, being the epicenter of community spread of infectious disease. Corrections continue to be a large component of the spread of HIV. The pandemic crisis is a “terrible thing to waste,” yet is it seems as if systemic changes in corrections design and management will not occur, despite the specificity and severity of the outbreak.
The necessity for expanded mental health screening, expanded policies for protecting the vulnerable from respiratory disease, and improved HVAC and negative-pressure air flow medical quarantine inside buildings with large and sick restricted populations was proven over and again in this pandemic. The next infectious disease and new COVID variant will provide the same evidence. These are the same needs in nursing homes and corrections.
Simple facility upgrades would be part of a larger prevention effort to protect staff and incarcerated from predictable infectious diseases. These simple facility changes are all well within the all larger infrastructure improvements we are developing in this nation (whether it is called Build Back Better or not!). Let’s not waste another crisis, let’s prevent the next predictable outbreaks in out jails and prisons.
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