(Photo via The Philadelphia Tribune)
By Joseph Amon
We are in extraordinary times, navigating an unprecedented pandemic.
Public health officials have recommended measures that just months ago would have been unthinkable in order to combat the spread of COVID-19.
Schools, courts, collegiate and professional sports, theater and other congregate settings have been closed to help mitigate the spread of the virus. In each of these settings, where people are crowded together, individuals become especially vulnerable.
But in one congregate setting – jails and prisons – facilities also provide limited medical care.
This is the recipe for a disaster, and one we are starting to see nationally as more than 20,000 people in detention facilities have been infected with the coronavirus that causes COVID-19, and more than 300 have died from their infection.
From the first report of this disease at the end of December, it’s been clear that detention facilities – like cruise ships and nursing homes – were going to face a huge challenge to control the spread of the disease.
Yet, the response by counties, states and the federal government has been slow.
For example, it wasn’t until March 23 that the U.S. Centers for Disease Control and Prevention issued “interim” guidance on how to address COVID in detention facilities/ And counties and states have often been acting like a thermal screening and a quick questionnaire is enough to ensure that the infection does not get inside their institutions.
That’s madness. And what we have seen as a result is far higher rates of COVID-19 infection in detention facilities than in the general population. We need urgent solutions.
The answer starts with universal testing in these facilities.
We need not look further than Montgomery County to find the reason for the urgency around testing in detention facilities.
In late April, Montgomery County tested every single person being held in detention in the county’s jail. The results were disheartening, to say the least.
The infection rate among people in the jail was 18 percent of the total population, about 30 times higher than the county’s previous assessment. What’s more, of the people who tested positive, the overwhelming majority were asymptomatic – they weren’t showing any signs of being sick at the time of testing, but they could still transmit the virus to other incarcerated people and staff. And from there into the surrounding community.
Detention facilities have even greater risk of COVID-19 transmission than other enclosed environments because of crowding within the facility and limited access to personal hygiene products. People in detention are housed in crowded spaces of limited size and are subjected to security measures that force them into close contact with correctional officers.
They cannot practice the “social distancing” necessary to effectively prevent the spread of COVID-19. Bathroom facilities—toilets, showers, and sinks—and other common areas are shared, without adequate surface disinfection between users. Food preparation and distribution without proper precautions also present further opportunities for the virus to spread.
Some federal and state officials have recently suggested that universal testing inside detention facilities is unnecessary because conditions are improving and contact tracing can help identify those people who should be quarantined.
But Montgomery County is evidence that contact tracing is impossible without universal testing. Waiting for symptomatic cases and trying to play ‘catch up’ via contact tracing is not realistic in detention settings where social distancing isn’t being effectively implemented.
The city of Philadelphia recently released a statement saying “until we have the ability to test everyone who may have been exposed to COVID-19 coronavirus, we won’t know how safe it will be to re-open Philadelphia.”
If universal testing is required to re-open Philadelphia and keep everyone safe, why is the same logic not applied to detention facilities?
Society is defined by how we treat the most vulnerable among us. People in detention centers deserve the same safety and dignity as anyone else.
If detention facilities do not release large swaths of vulnerable people, as many advocates and public health experts have urged, universal testing must be implemented in these institutions to keep staff and people in detention safe and healthy.
This is not just about the people locked up; the virus doesn’t respect prison walls or metal gates. Widespread infection inside will inevitably spread into the surrounding communities.
The stakes have never been higher. Administrators of our jails and prisons must act now.
Dr. Joseph Amon is the director of Global Health and Clinical Professor of Community Health and Prevention at the Dornsife School of Public Health at Drexel University.
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