Managing outbreaks of highly contagious diseases in prisons: a systematic review

Abstract

BackgroundThere are reports of outbreaks of COVID-19 in prisons in many countries. Responses to date have been highly variable and it is not clear whether public health guidance has been informed by the best available evidence. We conducted a systematic review to synthesise the evidence on outbreaks of highly contagious diseases in prison.MethodsWe searched seven electronic databases for peer-reviewed articles and official reports published between 1 January 2000 and 28 July 2020. We included quantitative primary research that reported an outbreak of a given contagious disease in a correctional facility and examined the effects of interventions. We excluded studies that did not provide detail on interventions. We synthesised common themes using the Synthesis Without Meta-analysis (SWiM) guideline, identified gaps in the literature and critically appraised the effectiveness of various containment approaches.ResultsWe identified 28 relevant studies. Investigations were all based in high-income countries and documented outbreaks of tuberculosis, influenza (types A and B), varicella, measles, mumps, adenovirus and COVID-19. Several themes were common to these reports, including the public health implications of infectious disease outbreaks in prison, and the role of interagency collaboration, health communication, screening for contagious diseases, restriction, isolation and quarantine, contact tracing, immunisation programmes, epidemiological surveillance and prison-specific guidelines in addressing any outbreaks.DiscussionPrisons are high-risk settings for the transmission of contagious diseases and there are considerable challenges in managing outbreaks in them. A public health approach to managing COVID-19 in prisons is required.PROSPERO registration numberCRD42020178827

Incarceration as a Fundamental Social Cause of Health Inequalities: Jails, Prisons and Vulnerability to COVID-19

“…In the community, 70 per cent of adults with internet access rely on it as their primary health information source ( Prestin et al 2015 ). Yet, IP often have little to no access to the internet and other digital technologies ( Reisdorf and Jewkes 2016 ), resulting in reduced abilities to independently learn about COVID-19, its impacts and what is being done to address it ( Beaudry et al 2020 ).…”

“…Experts in many countries have called for people in prisons to be prioritized in COVID-19 vaccination plans ( Siva 2020 ), yet limited data exist on the number of vaccines distributed to incarcerated populations. This is especially concerning considering that diminished access to vaccines among IP was also the case during the 1968 H3N2 and the 2009 H1N1 influenza outbreaks ( Beaudry et al 2020 ; Lee et al 2012 ). In the United States, most state prison systems have not even released plans for vaccinating incarcerated residents ( COVID Prison Project 2021b ).…”

“…Therefore, it is vital that de-carceration be considered as the first avenue for mitigating the spread of COVID-19 among IP and staff. De-carceration can take several forms; however, to both ensure public safety and minimize the mortality rate of IP, there is likely some wisdom in prioritizing de-carceration for older and/or infirm persons, those nearing release and those convicted of non-violent crimes ( Beaudry et al 2020 ; Franco-Paredes et al 2021 ). Such efforts will aid in the practicalities of implementing public health guidelines both pre- and post-release.…”

“…Since early 2020, multiple large outbreaks of COVID-19 have emerged in prisons and jails worldwide ( Beaudry et al 2020 ; Kinner et al 2020 ). The United States, which has the highest prison population rate in the world ( World Prison Brief 2018 ), has confirmed 372,569 COVID-19 cases and 2,296 deaths among imprisoned people alone, as of 29 January 2021 ( COVID Prison Project 2021a ).…”

Prisoner's Dilemma: Ethical questions and mental health concerns about the COVID-19 vaccination and people living in detention

“…The latter concern is especially relevant as the pandemic has reportedly taken hold and ripped through prison systems throughout the globe ( Li & Liu, 2020 ; Montoya-Barthelemy, Lee, Cundiff, & Smith, 2020 ; Steinböck, 2020 ; Циганенко & Великодна, 2020 ). Overcrowding has turned prisons into “incubators” ( UNODC, 2020 ), rendering it extremely difficult to stop the spread of COVID-19 and other communicable diseases ( Beaudry et al., 2020 ; Puglisi, Malloy, Harvey, Brandeau, & Wang, 2020 ). This pattern has been reported internationally in both the developing and developed world ( Gannon, 2020 ; Harsono, 2020 ; Rapisarda & Byrne, 2020 ).…”