The emergence of COVID-19 has again raised the issue of prisons as incubators of infectious diseases and their impact on the community, as well as the havoc a prison outbreak could have on the prisoner population. The World Health Organization (WHO) released guidance on responding to COVID-19 in prisons, recommending custodial and health agencies jointly engage in risk management, prevention and control, treatment, and information sharing. While such guidance is useful, more immediate considerations and responses are required to prevent COVID-19 outbreaks in our prisons. The concept of prison cell spatial density (a measure of crowding) is relevant as it is potentially linked to adverse health outcomes, including the transmission of infectious diseases.
To synthesise the evidence examining associations between prison cell spatial density and infectious disease and assess potential interventions and strategies that might mitigate infectious disease transmission in prisons with high cell spatial density (i.e. mediating factors).
Outcomes of a systematic review of the association between prison cell spatial density and infectious and communicable diseases, and a review of mediating factors were synthesised. Assessment of findings in relation to potential COVID-19 outbreaks and prevention in prisons was undertaken.
Decarceration strategies in the context of COVID-19 are recommended. Mediating factors identified can help inform priority measures within these strategies. Published British Medical Journal: https://doi.org/10.1136/bmj.m1551
This work illustrates that it is essential that citizens held in prisons and other detention facilities are an integral part of the broader public health response to COVID-19, and that responses recognise decarceration measures to increase the spatial separation of prisoners. The outcomes of this work contributed to reports and briefings produced for Corrective Service NSW and Legal AID NSW to inform their respective responses to COVID-19.