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2.
Int J Prison Health ; ahead-of-print(ahead-of-print)2021 05 17.
Article in English | MEDLINE | ID: covidwho-1228628

ABSTRACT

PURPOSE: The purpose of this commentary is to draw upon available literature and practices related to COVID-19 and management of older incarcerated adults in Australia to highlight key matters for better risk management and care of this population during this and future infectious disease pan/epidemics. DESIGN/METHODOLOGY/APPROACH: The present commentary draws on current policies, practices and literature regarding the health, needs and management of older incarcerated adults in Australia to discuss risk, care and early release for this population during the COVID-19 pandemic. FINDINGS: Incarcerated persons experience poorer health and accelerated age-related decline compared to those in the general community. The present situation offers the opportunity to fill knowledge and practice gaps, including policies for staff training, identification of dementia and cognitive decline, assessment of mobility issues, addressing barriers to health-seeking, possibilities of medical or compassionate release, risk assessment and release protocols and post-release needs. PRACTICAL IMPLICATIONS: While Australian prisons have acknowledged the vulnerability of older persons, more focused adaptation of COVID-19-related policies to consider adults as young as 45 years are needed. Appropriate ethical identification and management of cases in this population is needed, as is discussion on issues of decarceration and medical release. Re-conceptualisation of incarcerated adults as "citizens in need of care", rather than as "offenders to be secured", will be beneficial. Robust, local evidence is needed to assist decision-making. ORIGINALITY/VALUE: This is a comprehensive, focused review of relevant evidence, policies and practices for a growing subpopulation of prisoners worldwide with complex needs and particular vulnerability to the COVID-19.


Subject(s)
COVID-19/prevention & control , Prisoners , Prisons , Vulnerable Populations , Aged , Australia/epidemiology , Health Services Needs and Demand , Health Status , Humans , Middle Aged , Public Policy , SARS-CoV-2
3.
Am J Public Health ; 111(6): 1099-1105, 2021 06.
Article in English | MEDLINE | ID: covidwho-1186641

ABSTRACT

COVID-19 is ravaging US prisons. Prison residents and staff must be prioritized for vaccination, but a rapidly mutating virus and high rates of continued spread require an urgent, coordinated public health response.Based on knowledge accumulated from the pandemic thus far, we have identified 10 pressing public health priorities for responding to COVID-19 in prisons: (1) accelerate population reduction coupled with community reentry support, (2) improve prison ventilation systems, (3) ensure appropriate mask use, (4) limit transfers between facilities, (5) strengthen partnerships between public health departments and prison leadership, (6) introduce or maintain effective occupational health programs, (7) ensure access to advance care planning processes for incarcerated patients and delineation of patient health care rights, (8) strengthen partnerships between prison leadership and incarcerated people, (9) provide emergency mental health support for prison residents and staff, and (10) commit to public accountability and transparency.Dedicated prison leaders cannot accomplish these public health priorities alone. We must mobilize prison leaders, staff, and residents; public health departments; community advocates; and policymakers to work together to address the pandemic's outsized impact in US prisons.


Subject(s)
COVID-19 , Health Priorities , Health Services Accessibility , Prisoners/statistics & numerical data , Prisons/statistics & numerical data , COVID-19/epidemiology , COVID-19/transmission , Humans , Mental Health Services , Public Health
4.
Am J Hosp Palliat Care ; 38(6): 731-733, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1076102

ABSTRACT

The COVID-19 pandemic is devastating the health of hundreds of thousands of people who live and work in U.S. jails and prisons. Due to dozens of large outbreaks in correctional facilities, tens of thousands of seriously ill incarcerated people are receiving medical care in the community hospital setting. Yet community clinicians often have little knowledge of the basic rights and ethical principles governing care of seriously ill incarcerated patients. Such patients are legally entitled to make their own medical decisions just like non-incarcerated patients, and retain rights to appoint surrogate decision makers and make advance care plans. Wardens, correctional officers, and prison health care professionals should not make medical decisions for incarcerated patients and should not be asked to do so. Dying incarcerated patients should be offered goodbye visits with their loved ones, and patients from federal prisons are legally entitled to them. Community health care professionals may need to advocate for this medically vulnerable hospitalized patient population to receive ethically appropriate, humane care when under their care in community hospitals. If ethical care is being obstructed, community health care professionals should contact the prison's warden and medical director to explain their concerns and ask questions. If necessary, community clinicians should involve a hospital's ethics committee, leadership, and legal counsel. Correctional medicine experts and legal advocates for incarcerated people can also help community clinicians safeguard the rights of incarcerated patients.


Subject(s)
COVID-19/nursing , Palliative Care/ethics , Prisoners/statistics & numerical data , Prisons/organization & administration , Terminal Care/ethics , Attitude of Health Personnel , Humans , Prisoners/psychology , United States , Vulnerable Populations/statistics & numerical data
5.
Gerontologist ; 61(1): 3-7, 2021 01 21.
Article in English | MEDLINE | ID: covidwho-1043730

ABSTRACT

The large and continued growth of the older adult population within U.S. prisons affects not only criminal justice policy and correctional health practice, but also gerontology. Amidst the unfolding COVID-19 crisis, associated knowledge and skills surrounding older adulthood will be critical to assuring the needs of older adults incarcerated in prisons are met during their detention, while undergoing off-site intervention in community settings, and when preparing for release. We outline several key areas for which gerontologists and associated practitioners are especially well suited in the effort to curtail morbidity and mortality driven by the disease caused by the novel coronavirus. Critical gerontological knowledge and skills needed in prison health care include awareness regarding the unusual clinical presentations of COVID-19 among older adults, deconditioning among older adults due to immobility, challenges in prognostication, and advance care planning with older adults. Specific, targeted opportunities for gerontologists are identified to reduce growing risks for older adults incarcerated in prisons.


Subject(s)
COVID-19 , Geriatrics , Prisoners , Adult , Aged , Delivery of Health Care , Humans , Prisons , SARS-CoV-2
7.
J Gen Intern Med ; 35(9): 2738-2742, 2020 09.
Article in English | MEDLINE | ID: covidwho-649810

ABSTRACT

In the face of the continually worsening COVID-19 pandemic, jails and prisons have become the greatest vectors of community transmission and are a point of heightened crisis and fear within the global crisis. Critical public health tools to mitigate the spread of COVID-19 are medical isolation and quarantine, but use of these tools is complicated in prisons and jails where decades of overuse of punitive solitary confinement is the norm. This has resulted in advocates denouncing the use of any form of isolation and attorneys litigating to end its use. It is essential to clarify the critical differences between punitive solitary confinement and the ethical use of medical isolation and quarantine during a pandemic. By doing so, then all those invested in stopping the spread of COVID-19 in prisons can work together to integrate medically sound, humane forms of medical isolation and quarantine that follow community standards of care rather than punitive forms of solitary confinement to manage COVID-19.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Delivery of Health Care/methods , Patient Isolation/methods , Pneumonia, Viral/epidemiology , Prisons , Social Isolation , COVID-19 , Coronavirus Infections/prevention & control , Coronavirus Infections/psychology , Delivery of Health Care/standards , Humans , Pandemics/prevention & control , Patient Isolation/psychology , Patient Isolation/standards , Pneumonia, Viral/prevention & control , Pneumonia, Viral/psychology , Prisons/standards , Quarantine/methods , Quarantine/psychology , Quarantine/standards , SARS-CoV-2 , Social Isolation/psychology , United States/epidemiology
8.
Health Justice ; 8(1): 17, 2020 Jul 02.
Article in English | MEDLINE | ID: covidwho-621506

ABSTRACT

This editorial describes why surge planning in the community must account for potential infection outbreaks in jails and prisons, and why incarcerated people and those in contact with them, including over 450,000 correctional officers and thousands of healthcare staff working in prisons, are at significant risk of COVID-19 exposure. We then explain how our nation's jails and prisons will continue to serve as breeding grounds for devastating COVID-19 outcomes and offer specific guidance and a call to action for the immediate development of correctional healthcare strategies designed to protect the health and safety of patients and correctional and healthcare staff and the communities in which they are situated. Correctional officers and correctional healthcare professionals need the nation's reassurance during this dire time that they will not be abandoned and further stigmatized for responding to the needs of incarcerated people. Our collective health depends on it.

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