Author:
Duarte Catherine,Cameron Drew B.,Kwan Ada T.,Bertozzi Stefano M.,Williams Brie A.,McCoy Sandra I.
Abstract
Abstract
Background
People incarcerated in US prisons have been disproportionately harmed by the COVID-19 pandemic. That prisons are such efficient superspreading environments can be attributed to several known factors: small, communal facilities where people are confined for prolonged periods of time; poor ventilation; a lack of non-punitive areas for quarantine/medical isolation; and staggeringly high numbers of people experiencing incarceration, among others. While health organizations have issued guidance on preventing and mitigating COVID-19 infection in carceral settings, little is known about if, when, and how recommendations have been implemented. We examined factors contributing to containment of one of the first California prison COVID-19 outbreaks and remaining vulnerabilities using an adapted multi-level determinants framework to systematically assess infectious disease risk in carceral settings.
Methods
Case study employing administrative data; observation; and informal discussions with: people incarcerated at the prison, staff, and county public health officials.
Results
Outbreak mitigation efforts were characterized by pre-planning (e.g., designation of ventilated, single-occupancy quarantine) and a quickly mobilized inter-institutional response that facilitated systematic, voluntary rapid testing. However, several systemic- and institutional-level vulnerabilities were unaddressed hindering efforts and posing significant risk for future outbreaks, including insufficient decarceration, continued inter-facility transfers, incomplete staff cohorting, and incompatibility between built environment features (e.g., dense living conditions) and public health recommendations.
Conclusions
Our adapted framework facilitates systematically assessing prison-based infectious disease outbreaks and multi-level interventions. We find implementing some recommended public health strategies may have contributed to outbreak containment. However, even with a rapidly mobilized, inter-institutional response, failure to decarcerate created an overreliance on chance conditions. This left the facility vulnerable to future catastrophic outbreaks and may render standard public health strategies - including the introduction of effective vaccines - insufficient to prevent or contain those outbreaks.
Funder
Office of the Federal Receiver
National Institute on Aging, National Institutes of Health
University of California, San Francisco Pepper Center
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference35 articles.
1. Beaudry G, Zhong S, Whiting D, Javid B, Frater J, Fazel S. Managing outbreaks of highly contagious diseases in prisons: a systematic review. BMJ Glob Health. 2020;5:e003201.
2. World Health Organization. Regional Office for Europe. Preparedness, prevention and control of COVID-19 in prisons and other places of detention: interim guidance, 8 February 2021. World Health Organization. Regional Office for Europe; 2021. https://apps.who.int/iris/handle/10665/339830.
3. Saloner B, Parish K, Ward JA, DiLaura G, Dolovich S. COVID-19 cases and deaths in federal and state prisons. JAMA. 2020;324(6):602–3. https://doi.org/10.1001/jama.2020.12528.
4. Wang EA, Western B, Berwick DM. COVID-19, Decarceration, and the Role of Clinicians, Health Systems, and Payers: A Report From the National Academy of Sciences, Engineering, and Medicine. JAMA. 2020.
5. Advancing Public Health Interventions to Address the Harms of the Carceral System. 2020. https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2021/01/14/advancing-public-health-interventions-to-address-the-harms-of-the-carceral-system. Accessed 7 Dec 2020.
Cited by
22 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献