Health Management in Italian Prisons during COVID-19 Outbreak: A Focus on the Second and Third Wave

Vella, Raimondo; Giuga, Gabriele; Piizzi, Giorgia; Fegatelli, Danilo Alunni; Petroni, Giulia; Tavone, Alessandro Mauro; Potenza, Saverio; Cammarano, Andrea; Mandarelli, Gabriele; Marella, Gian Luca

doi:10.3390/healthcare10020282

Cited by 9 publications

(15 citation statements)

References 20 publications

(22 reference statements)

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“…In March 2021, about two months after the COVID-19 vaccines became available in Italy, by decree of the Italian Ministry of Health, prisoners as well as prison workers were included among the priority targets of the vaccination campaign due to the complexity of this population and their high risk of infection, severe disease, and death [ 19 ]. Unlike many other countries, this led to an immediate implementation of vaccinations within those categories in the Italian population [ 20 ]. At the time of the outbreak, the reported COVID-19 vaccination coverage in the investigated prisons showed 84.2% of inmates receiving at least one dose of mRNA vaccine, and 76.3% fully vaccinated, comparable to the coverage observed among Italian adults overall (83.1% and 76.3%, respectively), and the general Italian prison population at that time [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Outbreak and BNT162b2 mRNA Vaccination Coverage in a Correctional Facility during Circulation of the SARS-CoV-2 Omicron BA.1 Variant in Italy

Stufano

Buonvino²,

Trombetta

et al. 2022

Vaccines

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Background. The recent spread of the highly mutated SARS-CoV-2 Omicron variant (B.1.1.529) has raised concerns about protection against COVID-19 in congregate settings such as prisons, characterized by a high risk of transmission and possible difficulties in obtaining adequate vaccination coverage. The present study aims to investigate the spread of an outbreak of COVID-19 in an Italian correctional facility during the dominant circulation of the Omicron BA.1 variant, and also considers BNT162b2 mRNA vaccination coverage among inmates. A COVID-19 screening campaign by RT-PCR was performed on 515 detainees from 4–30 January 2022, in response to an outbreak that began in the correctional facility. Furthermore, 101 serum samples collected from healthy inmates 21 days after having received the second dose of the BNT162b2 vaccine were tested for neutralizing antibodies against both the wild-type SARS-CoV-2 strain and the Omicron BA.1 variant. The global attack rate during the study period was 43.6% (RR 0.8), progressively reducing from unvaccinated inmates (62.7%, RR 1.8) to those who had one dose (52.3%, RR 1.5), two doses (full cycle) (45.0%, RR 1.3), and the third dose (booster) vaccinated group (31.4%, RR 0.7). The percentage of SARS-CoV-2 positive subjects among unvaccinated inmates was significantly higher than in the other groups (p < 0.001), while no significant difference was observed between inmates with one or two vaccine doses. Only two of the positive inmates were hospitalized for COVID-19. The geometric mean titer of neutralizing antibodies in the tested sub-group after two doses of vaccine was lower than in previous studies against the wild-type virus, and showed a complete lack of neutralization against the Omicron variant in 92.1% of individuals. The findings support the need to prioritize vaccination in correctional facilities, as a public health measure to increase the protection of inmates and consequently of prison workers and the community against COVID-19, in coordination with the other prevention strategies.

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Section: Discussionmentioning

confidence: 99%

COVID-19 Outbreak and BNT162b2 mRNA Vaccination Coverage in a Correctional Facility during Circulation of the SARS-CoV-2 Omicron BA.1 Variant in Italy

Stufano

Buonvino²,

Trombetta

et al. 2022

Vaccines

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“…Measures taken in such situations are legally enforceable at each national level. For example, related to the COVID-19 pandemic context, the study by Vella et al in Italy found a lower number of COVID- positive cases among detainees than among the general population, which reflected the effectiveness of the measures taken, including vaccination [ 45 ]. In the same sense, Pagano et al found that measures such as screening and safe isolation of COVID-positive or COVID-suspect detainees prevented the spread of the virus [ 46 ].…”

Section: Particular Scenarios Physician–inmate Patientmentioning

confidence: 99%

Malpractice Claims and Ethical Issues in Prison Health Care Related to Consent and Confidentiality

Isailă

Hostiuc

2022

Healthcare

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Respecting the consent and confidentiality of a patient is an underlying element in establishing the patient’s trust in the physician and, implicitly, obtaining the patient’s compliance. In particular, cases of inmate patients require increased attention in order to fulfill this goal against a background of institutional interferences, which, in certain situations, may endanger the autonomy of the physician and their respect for the inmate’s dignity. The purpose of this article is to depict the characteristics of consent and confidentiality in a prison environment, in special cases, such as hunger strikes, violent acts, HIV testing, COVID-19 measures, and drug use, bringing into focus the physician and the inmate in the context of the particular situation where the target is disciplining someone in order for them to conform to social and juridical norms. Respecting the dignity of the inmate patient requires an adequate approach of informed consent and confidentiality, depending on each case, considering the potential unspoken aspects of the inmate’s account, which can be key elements in obtaining their compliance and avoiding malpractice claims.

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“…Italy was among the first countries in Europe to be affected by the COVID-19 pandemic [ 4 , 5 , 6 , 7 ]. This required the definition and implementation, in the shortest possible time, of management and prevention protocols, both for the Italian and prison populations.…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV2 Infection and Comorbidity in Inmates: A Study of Central Italy

Altobelli

Galassi

Mastrodomenico

et al. 2023

IJERPH

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Background and Objective: The presence of multiple chronic diseases is associated with an increase in mortality when related to COVID-19 infection. The aims of our study were: (i) to evaluate the association between the severity of the COVID-19 disease, defined as symptomatic hospitalized in prison or symptomatic hospitalized out of prison, and the presence of one or more comorbidities in two prisons in central Italy: L’Aquila and Sulmona; (ii) to describe the profiles of inmates using multiple correspondence analysis (MCA). Methods: A database was created including age, gender and clinical variables. The database containing anonymized data was password-protected. The Kruskal–Wallis test was used to evaluate a possible association between diseases and the severity of COVID-19 stratified by age groups. We used MCA to describe a possible characteristic profile of inmates. Results: Our results show that in the 25–50-year-old age group (COVID-19-negative) in the L’Aquila prison, 19/62 (30.65%) were without comorbidity, 17/62 (27.42%) had 1–2 comorbidities and only 3.23% had >2 diseases. It is interesting to note that in the elderly group, the frequency of 1–2 or >2 pathologies was higher than in the younger group, and only 3/51 (5.88%) inmates did not have comorbidities and were COVID-19 negative (p = 0.008). The MCA identified the following profiles: the prison of L’Aquila showed a group of women over 60 with diabetes, cardiovascular and orthopedic problems, and hospitalized for COVID-19; the Sulmona prison presented a group of males over 60 with diabetes, cardiovascular, respiratory, urological, gastrointestinal and orthopedic problems, and hospitalized or symptomatic due to COVID-19. Conclusions: our study has demonstrated and confirmed that advanced age and the presence of concomitant pathologies have played a significant role in the severity of the disease: symptomatic hospitalized in the prison; symptomatic hospitalized out of the prison.

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Health Management in Italian Prisons during COVID-19 Outbreak: A Focus on the Second and Third Wave

Cited by 9 publications

References 20 publications

COVID-19 Outbreak and BNT162b2 mRNA Vaccination Coverage in a Correctional Facility during Circulation of the SARS-CoV-2 Omicron BA.1 Variant in Italy

COVID-19 Outbreak and BNT162b2 mRNA Vaccination Coverage in a Correctional Facility during Circulation of the SARS-CoV-2 Omicron BA.1 Variant in Italy

Malpractice Claims and Ethical Issues in Prison Health Care Related to Consent and Confidentiality

SARS-CoV2 Infection and Comorbidity in Inmates: A Study of Central Italy

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