Study focusing on high COVID-19 prevalence in US prisons

A trio of new studies highlights the burden of COVID-19 on the country’s prison population and sheds light on how prisons can reduce infections.

Nationwide, federal and state prisons were among the rally facilities severely hit by the coronavirus. by Marshall ProjectAt least 102,494 inmates were tested positive and 889 died as of August 14, tracking data on AP state and federal prison COVID-19 infections. Corrections staff are not included in these numbers.

Preventing the spread of SARS-CoV-2, the virus that causes COVID-19, in correctional facilities is difficult due to crowded living conditions, isolation or limited ability to practice isolation, and poor hygiene. With such settings, the virus spreads easily. In addition, the virus has been repeatedly brought to prisons from the community by staff, visitors, and new prisoners.

Surprisingly high infection rate

As Investigation Nowadays JAMA Network Open As these show, these factors contribute to a much higher infection rate among imprisoned people than seen in the general public.

The study was conducted by researchers at Harvard University and Brigham and Women’s Hospital in Boston, from 16 Massachusetts Orthodontics (MA DOC) facilities and 13 county-level systems from April 5 to July 8. Surveyed the data. Of the 14,987 prisoners housed in the facility, prisoners (664) and staff (368), or 6.9% of prisoners and staff.

The infection rate for COVID-19 is 4.4% among prisoners and 2.91 (95% confidence interval). [CI], 2.69-3.14) are higher than the population of Massachusetts, and 4.8 (95% CI, 4.45-5.18) are higher than the population of the United States.

The study also found high rates of COVID-19 in prison systems with high inspection rates and high numbers of prisoners released to prevent the spread of the disease. At the MA DOC facility, where the test rate was 1,093 per 1,000 people, the case rate was 5.2%. In county prisons, the inspection rate was 254 per 1,000 and the case rate was 3.6%. However, MA DOC reduced population by 9%, compared to prisons, which released 35% of prisoners and reduced population by 21%.

“The rate of COVID-19 in prisons and prisons in Massachusetts is surprisingly high, and urgent action is needed,” the study authors wrote. “To reduce the harm to people incarcerated from COVID-19 and their communities, we need access to tests without coercion, non-discrimination, and contact tracking.”

Mass test

The role of testing is Investigation US prisons announced today at Centers for Disease Control and Prevention (CDC) Weekly Morbidity and Mortality Report (MMWR).

To better understand the prevalence of SARS-CoV-2 in these settings, a research team headed by the CDC said a large-scale testing event in prisons from 15 US jurisdictions and large-scale testing Requested data on cases previously identified in prison. Six jurisdictions provided data for 16 facilities (11 state prisons, 3 federal prisons, 2 county prisons). All 16 centers had identified at least one case by symptom-based testing prior to large-scale testing.

From April 11th to May 20th, mass testing was conducted at 16 facilities, with a total of 16161 prisoners tested and 7,597 tested positive. At 16 institutions, prevalence of SARS-CoV-2 in prisoners ranged from 0% to 86.8% (median 23.9%). The mass screening increased the total number of known cases from 642 before the mass screening to 8,239, showing a 12.1 fold increase in the median number of known infections.

At 12 out of 16 facilities, mass test data for 85 homes showed that the prevalence of SARS-CoV-2 in dormitory-based units (median, 42.6%) was higher than that in cell-based units (median, 14.6%). %) was more than three times. ).

In two of the federal prisons, prisoners quarantined as negative and in close contact with those who were determined to be positive were re-examined 7 days later, 26.8% positive in one prison and 20.5% in the other. Was positive.

The jurisdiction that provided the bulk test data said it would help isolate positive results and medically isolate prisoners quarantined for intimate contact to prevent continued transmission. In addition, the results have impacted targeted testing strategies in facilities that have not been extensively tested.

“This analysis demonstrates that regardless of symptoms, high-volume testing combined with regular retesting can identify infections and support the prevention of widespread infections in orthodontic and detention settings,” the study said. Wrote the author.

They say the results also indicate that prison staff should be examined regularly, regardless of symptoms, indicating that the housing composition may contribute to the infection.

Intake screening for new prisoners

another paper Nowadays MMWR, Researchers at the CDC and the Department of Health in Puerto Rico suggest that a new protocol for diagnosing and managing COVID-19 in newly imprisoned prisoners may also help reduce coronavirus spread in prisons doing.

As of August 17, there were only two confirmed cases of COVID-19 among those in prison in Puerto Rico and no deaths. This follows the implementation of a wide range of measures by the Ministry of Corrective Rehabilitation of Puerto Rico in mid-March.

Countermeasures include feeding all new prisoners in one place, performing reverse transcription polymerase chain reaction (RT-PCR) on all new prisoners regardless of symptoms, and in groups of 20 people or less. Includes gathering new prisoners in the intake area. Wait for test results. If all in the group are negative and all remain asymptomatic during 14 days of quarantine, they are released into the general population. Prisoners who test positive are quarantined.

The Department of Orthodontics and Rehabilitation also divides the prison population into groups of 40-75 prisoners who do not share a common area. If a group member presents with symptoms, that person is quarantined and the entire group is quarantined until a person with symptoms is judged negative.

A prisoner who has left the prison for some reason has to go through the hospitalization process again.

Of the 1,340 people who entered prisons in Puerto Rico from March 16th to July 31st, only two tested positive for SARS-CoV-2.

“Efforts to mitigate SARS-CoV-2 infections, including strict intake screening and cohorting, probably helped prevent outbreaks in state prisons,” the authors said. “Puerto Rico’s steps to protect those incarcerated from COVID-19 will serve as a case study of the successful implementation of the CDC’s guidelines on correctional facilities, especially preventive practices for those incarcerated or detained. “