ABSTRACT
INTRODUCTION: Previous research has found COVID-19 cases to be disproportionately prevalent among U.S. prisoners. Similar to prisoners, prison staff experience ventilation and social distancing hazards and may have limited access to testing, paid sick leave, personal protective equipment, and other workplace protections. Yet, systematic case surveillance among prison staff remains unexplored. The objective of this study is to document the trends in COVID-19 cases among U.S. correctional staff relative to those among prisoners and the U.S. METHODS: Reports of COVID-19 cases among prisoners and staff were collected from state Departments of Corrections and the Federal Bureau of Prisons from March 31, 2020 to November 4, 2020. In November 2020, this series of aggregated case records was linked to population estimates to calculate COVID-19 period prevalence among prison staff and residents in comparison with the U.S. population trends. RESULTS: Within the prison environment, COVID-19 case burden was initially higher among staff than among prisoners in 89% of jurisdictions. Case prevalence escalated more quickly among prisoners but has remained persistently high among staff. By November 4, 2020, COVID-19 was 3.2 times more prevalent among prison staff than among the U.S. CONCLUSIONS: Prison staff experienced substantially higher COVID-19 case prevalence than the U.S. population overall. Across prison staff and resident populations, cases were rapidly rising in November 2020, indicating poor outbreak containment within the prison environment. An Emergency Temporary Standard, issued by federal and state Occupational Safety and Health Administrations, and priority vaccination are urgently needed to reduce COVID-19 occupational risk. Reduced occupational transmission of COVID-19 will benefit workers, incarcerated people, and community members alike.