‘High-risk settings’ in our jails means prisoners must get priority for coronavirus vaccines

Researchers have recommended prisoners be prioritised for the coronavirus (Covid-19) vaccine, after finding it’s difficult to manage outbreaks.

Academics from the University of Oxford conducted a review of how prisons manage outbreaks of contagious diseases. They found that several factors, including higher rates of other health problems, fear of quarantine, and overcrowding, make it more difficult to control virus transmission.

The researchers concluded that vaccinating prisoners early would help to solve these problems.

Professor Seena Fazel, one of the researchers, said:

Prisons are high-risk settings for the transmission of contagious diseases and there are considerable challenges in managing outbreaks in them. Our research suggests that people in prison should be among the first groups to receive any COVID-19 vaccine to protect against infection and to prevent further spread of the disease.

The prison population is generally at higher risk of complications from infection because of the increased prevalence of underlying health conditions, and the overrepresentation of marginalised groups that have been disproportionately affected by COVID-19. A public health approach to managing COVID-19 in prisons is important now and for any future infectious disease outbreaks.

The research

The study analysed 28 different investigations of disease outbreaks such as influenza. All of the research included was conducted in high-income countries.

Analysis found that contact tracing was difficult in prisons due to the stigma associated with disclosing symptoms. Furthermore, prisoners feared being isolated in quarantine if they showed symptoms. Many prisons studied were overcrowded, with poor sanitation and ventilation, making quarantine measures difficult.

Additionally, prisoners are more likely to have mental and physical health problems that compound virus vulnerability.

As a result, the researchers recommended weighing costs and benefits of preventative strategies up and keeping prisoners and staff more informed about health measures. They also said released prisoners should have access to safe housing so they are less likely to pass on the virus.

Coronavirus in prisons

There have been several outbreaks of coronavirus in prisons across the world. According to the New York Times, 250,000 people in US jails and prisons have contracted coronavirus. This has led to 1,450 deaths among inmates and correctional officers.

After mass outbreaks in California, prisoners told the Guardian that basic preventative measures had been ignored. Some said they didn’t have access to medicine, masks, or doctors.

In the UK, the Ministry of Justice (MoJ) has reported 55 coronavirus-related deaths, and 1,529 positive tests.

Sheppey Isle in Kent recently saw “a number of positive cases” in its three prisons, HMP Elmley, Swaleside, and Standford Hill, which hold about 2,500 prisoners. The MoJ has not disclosed the specific amount of positive cases. But on 20 November, Kent Live reported that “more than 100 coronavirus cases have been confirmed across all three of Swale’s prisons this week”.

Conditions on the inside

Speaking to The Canary in March, prison campaigners said they were concerned for the safety and wellbeing of inmates.

Prisoners were in strict lockdown measures, spending 23-hours a day in their cells and with loved ones unable to visit.  Several campaigners said they didn’t think many prisons had the capacity for social distancing or strict hygiene measures.

In October, the Prison Reform Trust and the Howard League wrote to lord chancellor Robert Buckland about coronavirus prison outbreaks. They asked for more transparency on prison health policy, as well as releasing prisoners earlier to create space.

In the letter, heads Peter Dawson and Frances Crook said:

We recognise and applaud the effort that so many within the prison service have made to keep people safe from the virus over the last 6 months. But the fact remains that they are having to make that effort in a system which is needlessly overcrowded, denying prisons the physical and operational space which would otherwise allow for regimes that were both safe and humane.

We are very concerned that even the modest relief afforded by the interruption to normal court activity will soon be eroded, and that you have no plan of which we are aware to deal with that predictable change.

Featured image via Flickr/Dave Nakayama