Data from prisons and detention facilities shows that COVID-19 has negatively affected the health of thousands of prisoners, officers and staff, and threatened the health of their families, communities, and networks furthermore, threatening the billions invested in ‘flattening the curve’. Prisons across the globe are experiencing ageing populations and individuals with multiple co-morbidities. COVID-19 has an increased rate of mortality amongst senior citizens and people with pre-existing and chronic conditions. The spread of COVID-19 in prison clusters has been documented across the world. Contributory factors encompass societal, economic and structural factors, including institutionalised stigma, racism and poverty, which ultimately influence ministerial budget decisions and violate fundamental human rights. Globally, governments have committed to curtailing risk and reducing rates of COVID-19, yet there has been a lack of comprehensive screening and testing for prisoners and staff in prisons.
With inadequate intervention toolkits and populations that are highly susceptible to severe infection, incarcerated settings are akin to incubators for infectious diseases – as learned with the tuberculosis and HIV epidemics. Furthermore, many incarcerated settings lack adequate screening programmes, deploy fragmentary harm reduction and infectious disease treatment initiations, and operate with insufficient medical personnel. Unavoidable close contact, poor ventilation, unsanitary facilities, and poor access to healthcare lead to severely aggravated health risks. The exacerbated risks posed by the pandemic in detention facilities are clear: prisons across the world are severely overcrowded, making social distancing unfeasible, and placing prisoners at a higher risk for virus infection and transmission. Prisons, detention centres, and other custodial settings are important locations that need to be included in any national public health response to the COVID-19 pandemic.
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