Social Distancing and Incarceration: Policy and Management Strategies to Reduce COVID-19 Transmission and Promote Health Equity Through Decarceration

Abstract

Incarcerated people are at disproportionately high risk of contracting COVID-19. Prisons are epicenters for COVID-19 transmission, including to the community. High rates of preexisting health conditions, limited access to quality health care, and inability to social distance make it impossible to reduce the impact of COVID-19 in prisons. Due to a history of compounded social determinants, incarcerated populations are disproportionately composed of people of color and people with stigmatized behavioral health disorders. Rapid decarceration is needed to promote health equity. Historical mass decarceration events demonstrate feasibility to rapidly release large groups of people while maintaining public safety. Iran and Ireland have released substantial portions of their prison populations by transitioning people to home confinement. In the United States and Uganda, some jurisdictions have reduced new incarcerations through policies that decrease arrests. These policies must be globally expanded to contain the epidemic, and its potential health consequences, while addressing health equity.

Decarceration and community re-entry in the COVID-19 era

“…There is no effective method to predict whether future epidemics and pandemics will affect marginalised groups (such as people who are incarcerated); however, there is an urgent need to minimise that vulnerability through social improvements that include permanent reductions in jail and prison populations 60 Personal View populations in half since reaching peak population levels. 73 Notably, during their periods of decarceration, these states have had less crime than the national average.…”

“…18,49 The growing number of COVID19 related deaths in jails and prisons 39 highlights the inability of incarcerated people to shield from the effect of this pandemic inside crowded and unsanitary environments where physical distancing is unattainable and they are unable to seek timely and adequate medical care. 6,31,60 People older than 55 years, who are incarcarated, are especially at risk of severe COVID19 and they often pose little public safety risk. 58,59 Yet, political leaders have often neglected this population in prison depopulation efforts.…”

“…47,62 Reducing population density in correctional facilities could lead to more effective physical distancing interventions and infection prevention protocols being implemented. 18,60…”

British Columbia Provincial Corrections’ Response to the COVID-19 Pandemic: A Case Study of Correctional Policy and Practice

“…Decarceration promotes the health of individuals diverted and released from custody by keeping them out of prisons, "epicentres for infectious diseases" (Kinner et al, 2020, p. E188), and in some jurisdictions, allows them to access higher quality health-care resources in the community than they could access in custody (Henry, 2020).…”

“…Decarceration allows both those who remain incarcerated (e.g., individuals with higher risk profiles) and staff greater ability to practice social distancing, access existing health-care resources, and quarantine when necessary while also providing opportunities for enhanced cleaning procedures (Henry, 2020;Oladeru et al, 2020;Vose et al, 2020). BC Corrections' ability to implement diverse strategies (e.g., induction units) and to practice physical distancing, including single-bunking, in response to COVID-19 has been largely influenced by external factors.…”