Throughout the spring and summer of 2021, the COVID-19 outbreak in corrections has been more than five times higher than in the general population. The vast majority (75+%) of COVID deaths in jails were of people who were not convicted. The concentration of disease in corrections is higher even than nursing homes.

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. They were central in the 2009 H1N1 influenza, and remain a persistent location for tuberculosis. Spread is predictable in these and other congregate settings because of the limited ability to move away from the source of the disease: other human beings.

In recent weeks, there have been new reports from Maine to California, Texas to Michigan and Hawaii of new outbreaks in jails and prisons. This is predictable and preventable as the number of vaccinated inmates and corrections staff remained lower than goals set by public health officials for “herd immunity.” There are also encouraging signs in some place: 89% of Washington state corrections staff were vaccinated as of early October.

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 improved HVAC and negative-pressure air flow medical quarantine inside buildings with large and sick restricted populations was proven again and again in this pandemic. The coming flu and new COVID variant seasons will provide the same evidence. These are needs in nursing homes and corrections.

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. The incarcerated populations are getting sicker and older (the over-50s rose by 400% between 1993 and 2013) in recent years.

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. Let’s not waste another crisis, let’s prevent the next predictable outbreaks in out jails and prisons. For information on the author and his biography, and if you would like additional information on books published by the author.