COVID-19 in Correctional and Detention Facilities — United States, February–April 2020

Wallace, Megan; Hagan, Liesl M.; Curran, Kathryn; Williams, Samantha; Handanagić, Senad; Bjork, Adam; Davidson, Sherri; Lawrence, Robert; McLaughlin, Joseph; Butterfield, Marilee; James, Allison; Patil, Naveen; Lucas, Kimberley D.; Hutchinson, Justine; Sosa, Lynn; Jara, Amanda; Griffin, Phillip T.; Simonson, Sean; Brown, Catherine; Smoyer, Stephanie; Weinberg, Meghan Pearce; Pattee, Brittany; Howell, Molly; Donahue, Matthew; Hesham, Soliman; Shelley, E. I.; Philips, Grace; Selvage, David; Staley, Elizabeth M.; Lee, Anthony; Mannell, Mike; McCotter, Orion; Villalobos, Raúl; Bell, Linda; Diedhiou, Abdoulaye; Ortbahn, Dustin; Clayton, Joshua; Sanders, Kelsey; Cranford, Hannah M.; Barbeau, Bree; McCombs, Katherine; Holsinger, Caroline; Kwit, Natalie; Pringle, Julia C.; Kariko, Sara; Strick, Lara; Allord, Matt; Tillman, Courtney; Morrison, Andrea; Rowe, Devin; Marlow, Mariel

doi:10.15585/mmwr.mm6919e1

Cited by 139 publications

(120 citation statements)

References 2 publications

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“…This is critical, because asymptomatic and presymptomatic infections have led to significant transmission events in other high-density congregate living facilities with highrisk residents. 1,4 Similar to other congregate environments like cruise ships, correctional institutions, and long-term care facilities, [20][21][22] SNFs are an environment where introduction of one case may lead to rapid transmission. We did not assess for routes of disease transmission during the study period, and transmission of SARS-CoV-2 to SNF residents could have occurred from contact between residents, infected employees, or other outside contacts, such as exposure to dialysis centers outside of the SNF.…”

Section: Discussionmentioning

confidence: 99%

Cross-Sectional Prevalence of SARS-CoV-2 Among Skilled Nursing Facility Employees and Residents Across Facilities in Seattle

et al. 2020

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BACKGROUND: Skilled nursing facilities (SNFs) are highrisk settings for SARS-CoV-2 transmission. Infection rates among employees are infrequently described. OBJECTIVE: To describe SARS-CoV-2 rates among SNF employees and residents during a non-outbreak time period, we measured cross-sectional SARS-CoV-2 prevalence across multiple sites in the Seattle area. DESIGN: SARS-CoV-2 testing was performed for SNF employees and residents using quantitative real-time reverse transcription polymerase chain reaction. A subset of employees completed a sociodemographic and symptom questionnaire. PARTICIPANTS: Between March 29 and May 13, 2020, we tested 1583 employees and 1208 residents at 16 SNFs for SARS-CoV-2. MAIN MEASURE: SARS-CoV-2 testing results and symptom report among employees and residents. KEY RESULTS: Eleven of the 16 SNFs had one or more resident or employee test positive. Overall, 46 (2.9%) employees had positive or inconclusive testing for SARS-CoV-2, and among those who completed surveys, most were asymptomatic and involved in direct patient care. The majority of employees tested were female (934, 73%), and most employees were Asian (392, 30%), Black (360, 28%), or white (360, 28%). Among the 1208 residents tested, 110 (9.1%) had positive or inconclusive results. There was no association between the presence of positive residents and positive employees within a SNF (p = 0.62, McNemar's test). CONCLUSIONS: In the largest study of SNFs to date, SARS-CoV-2 infections were detected among both employees and residents. Employees testing positive were often asymptomatic and involved in direct patient care. Surveillance testing is needed for SNF employees and residents during the pandemic response.

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Section: Discussionmentioning

confidence: 99%

Cross-Sectional Prevalence of SARS-CoV-2 Among Skilled Nursing Facility Employees and Residents Across Facilities in Seattle

et al. 2020

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“…[53] These were implemented to consider the impact of community-initiated, coordinated efforts across response pillars for identifying and supporting cases and their high-risk contacts in order to suppress the epidemic curve without population-level lockdown. The adaptations reflected in this framework have relevance for ongoing transmission in settings with overcrowding and resource constraints--such as with the recent introduction of SARS-CoV-2 into UN camps in South Sudan [54] and ongoing reports of outbreaks in prisons [55] homeless shelters, and underresourced aged care homes [56], globally. They also are pertinent to settings with socioeconomic disparity, with the goal of promoting consideration of approaches that engender local agency and facilitate adoption of transmission-reducing practices in complex settings.…”

Section: Discussionmentioning

confidence: 99%

Coordinated support for local action: A modeling study of strategies to facilitate behavior adoption in urban poor communities of Liberia for sustained COVID-19 suppression

Skrip

Fallah

Bedson

et al. 2020

Preprint

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Background: Long-term suppression of SARS-CoV-2 transmission will require context-specific strategies that recognize the heterogeneous capacity of communities to undertake public health recommendations, particularly due to limited access to food, sanitation facilities, and physical space required for self-quarantine or isolation. We highlight the epidemiological impact of barriers to adoption of public health recommendations by urban slum populations in low- and middle-income countries (LMICs) and the potential role of community-based initiatives to coordinate efforts that support cases and high-risk contacts. Methods: Daily case updates published by the National Public Health Institute of Liberia were used to inform a stratified stochastic compartmental model representing transmission of SARS-CoV-2 in two subpopulations (urban poor versus less socioeconomically vulnerable) of Montserrado County, Liberia. Differential transmission was considered at levels of the subpopulation, household versus community, and events (i.e., funerals). Adoption of home-isolation behavior was assumed to be related to the proportion of each subpopulation residing in housing units with multiple rooms, access to sanitation facilities, and access to basic goods like water and food. Percentage reductions in cumulative infection counts, cumulative counts of severe cases, and maximum daily infection counts for each subpopulation were evaluated across intervention scenarios that included symptom-triggered, community-driven efforts to support high-risk contacts and confirmed cases in self-isolation following the scheduled lifting of the state of emergency. Results: Modeled outbreaks for the status quo scenario differed between the two subpopulations, with increased overall infection burden but decreased numbers of severe cases in the urban poor subpopulation relative to the less socioeconomically vulnerable population after 180 days post-introduction into Liberia. With more proactive self-isolation by mildly symptomatic individuals after lifting of the public health emergency, median reductions in cumulative infections, severe cases, and maximum daily incidence were 7.6% (IQR: 2.2%-20.9%), 7.0% (2.0%-18.5%), and 9.9% (2.5%-31.4%) for cumulative infections, severe cases, and maximum daily incidence, respectively, across epidemiological curve simulations in the urban poor subpopulation and 16.8% (5.5%-29.3%), 15.0% (5.0%-26.4%), and 28.1% (IQR: 9.3%-47.8%) in the less socioeconomically vulnerable population. An increase in the maximum attainable percentage of behavior adoption by the urban slum subpopulation, with the provision of support to facilitate self-isolation or quarantine, was associated with median reductions in cumulative infections, severe cases, and maximum daily incidence were 19.2% (IQR: 10.1%-34.0%), 21.1% (IQR: 13.3%-34.2%), and 26.0% (IQR: 11.5%-48.9%), respectively, relative to the status quo scenario. Conclusions: Broadly supported post-lockdown recommendations that prioritize proactively monitoring symptoms, seeking testing and isolating at home by confirmed cases are limited by resource constraints in urban poor communities. Investing in community-based initiatives that determine needs and coordinate needs-based support for self-identified cases and their contacts could provide a more effective, longer-term strategy for suppressing transmission of COVID-19 in settings with prevalent distrust and socioeconomic vulnerabilities.

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“…Many more are detained in compulsory drug detention, asylum seeker and immigration detention, and private drug treatment centres [9]. In the US, COVID-19 outbreaks have been reported in prisons and jails, including in New York, Illinois and Ohio, with both staff and detainees infected [34,35]. Interim guidance by the United Nations OHCHR and the WHO has urged governments to reduce the number of people in detention by finding ways to release those at increased risk of COVID-19, including older detainees and people with underlying health conditions, as well as children and those with low risk profiles and people incarcerated for minor offences [16].…”

Section: Prisoners and Detaineesmentioning

confidence: 99%

COVID‐19, HIV and key populations: cross‐cutting issues and the need for population‐specific responses

Iversen

Sabin

Chang³

et al. 2020

J. Intern. AIDS Soc.

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Introduction Key populations at elevated risk to contract or transmit HIV may also be at higher risk of COVID‐19 complications and adverse outcomes associated with public health prevention measures. However, the conditions faced by specific populations vary according to social, structural and environmental factors, including stigma and discrimination, criminalization, social and economic safety nets and the local epidemiology of HIV and COVID‐19, which determine risk of exposure and vulnerability to adverse health outcomes, as well as the ability to comply with measures such as physical distancing. This commentary identifies common vulnerabilities and cross‐cutting themes in terms of the impacts of COVID‐19 on key populations before addressing issues and concerns specific to particular populations. Discussion Cross‐cutting themes include direct impacts such as disrupted access to essential medicines, commodities and services such as anti‐retroviral treatment, HIV pre‐exposure prophylaxis, opioid agonist treatment, viral load monitoring, HIV and sexually transmitted infections testing, condoms and syringes. Indirect impacts include significant collateral damage arising from prevention measures which restrict human rights, increase or impose criminal penalties, and expand police powers to target vulnerable and criminalized populations. Significant heterogeneity in the COVID‐19 pandemic, the underlying HIV epidemic and the ability of key populations to protect themselves means that people who inject drugs and sex workers face particular challenges, including indirect impacts as a result of police targeting, loss of income and sometimes both. Geographical variations mean that transgender people and men who have sex with men in regions like Africa and the middle east remain criminalized, as well as stigmatized and discriminated against, increasing their vulnerability to adverse outcomes in relation to COVID‐19. Conclusions Disruptions to both licit and illicit supply chains, loss of income and livelihoods and changes in behaviour as a result of lockdowns and physical distancing have the potential to exacerbate the impacts of the COVID‐19 pandemic on key populations. While these impacts will vary significantly, human‐rights approaches to COVID‐19 emergency laws and public health prevention measures that are population‐specific and sensitive, will be key to reducing adverse health outcomes and ensuring that no one is left behind.

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COVID-19 in Correctional and Detention Facilities — United States, February–April 2020

Cited by 139 publications

References 2 publications

Cross-Sectional Prevalence of SARS-CoV-2 Among Skilled Nursing Facility Employees and Residents Across Facilities in Seattle

Cross-Sectional Prevalence of SARS-CoV-2 Among Skilled Nursing Facility Employees and Residents Across Facilities in Seattle

Coordinated support for local action: A modeling study of strategies to facilitate behavior adoption in urban poor communities of Liberia for sustained COVID-19 suppression

COVID‐19, HIV and key populations: cross‐cutting issues and the need for population‐specific responses

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