The impact of the implementation of medication for opioid use disorder and COVID-19 in a statewide correctional system on treatment engagement, postrelease continuation of care, and overdose.

BACKGROUND: People with opioid use disorder (OUD) are overrepresented in US correctional facilities and experience disproportionately high risk for overdose after release. Medications for OUD (MOUD) are highly efficacious but not available to most incarcerated individuals. In 2018, Vermont began providing MOUD for all incarcerated individuals with OUD statewide. In 2020, the COVID-19 state of emergency began. We assessed the impact of both events on MOUD utilization and treatment outcomes. METHODOLOGY: Analyses linked Vermont Department of Corrections administrative data and Medicaid claims data between 07/01/2017 and 03/31/2021. The study used logistic regression to analyze treatment engagement among all incarcerated individuals in Vermont. Multilevel modeling assessed change in clinical outcomes among release episodes that occurred among individuals with an OUD diagnosis Medicaid claim. RESULTS: Prescriptions for MOUD while incarcerated increased from 0.8% to 33.9% of the incarcerated population after MOUD implementation (OR = 67.4) and subsequently decreased with the onset of COVID-19 to 26.6% (OR = 0.7). After MOUD implementation, most prescriptions (63.1%) were to individuals who had not been receiving MOUD prior to incarceration, but this figure decreased to 53.9% with the onset of COVID-19 (OR = 0.7). Prescriptions for MOUD within 30 days after release increased from 33.9% of those with OUD before to 41.0% after MOUD implementation (OR = 1.4) but decreased to 35.6% with the onset of COVID-19 (OR = 0.8). Simultaneously, opioid-related nonfatal overdoses within 30 days after release decreased from 1.2% before to 0.8% after statewide MOUD implementation (OR = 0.3) but increased to 1.9% during COVID-19 (OR = 3.4). Fatal overdoses within 1 year after release decreased from 27 deaths before to ≤10 after statewide MOUD implementation and remained ≤10 during COVID-19. CONCLUSIONS: This longitudinal evaluation demonstrated increased treatment engagement and a decrease in opioid-related overdose following implementation of MOUD in a statewide correctional system. In contrast, these improvements were somewhat attenuated with the onset of COVID-19, which was associated with decreased treatment engagement and an increase in nonfatal overdoses. Considered together, these findings demonstrate the benefits of statewide MOUD for incarcerated individuals as well as the need to identify and address barriers to continuation of care following release from incarceration in the context of COVID-19.

BHIVA Spring Conference 2023

The proceedings contain 159 papers. The topics discussed include: microelimination of hepatitis C among people living with diagnosed HIV in England;laboratory implementation of emergency department blood-borne virus (EDBBV) opt-out screening in a London tertiary center;a review of sexual health and blood-borne virus care provided to inmates at admission into UK prisons and secure facilities;implementation of routine opt-out blood-borne virus (BBV) screening in 34 emergency departments (EDs) in areas of extremely high HIV prevalence in England;impact and experiences of offering HIV testing across the whole city population through primary care clusters and GP surgeries in the texting 4 Testing (T4T) project;'Not PrEPared': barriers to accessing PrEP in England;HIV care during the SARS-COV-2 pandemic for Black people with HIV in the UK;clinical presentation of mpox in people with and without HIV;and 'if you don't know, how can you know?': a qualitative investigation of HIV pre-exposure prophylaxis knowledge and perceptions among women in England.

Micro-eliminating HCV in 8 diverse prisons that serve a general population of 3.7 million in the Yorkshire region of England

Background: National Health Service England (NHSE) plans to eliminate Hepatitis C (HCV) by 2025. With a reported HCV prevalence of about 6% in male prisons, and about 12% in female prisons, secure environments are an essential component of this elimination plan. Yorkshire is a region in England with a general population of about 3.7 M. PPG is the provider of healthcare to 9 prisons in Yorkshire, with approximately 6,000 residents, many of whom are current, or previous, substance users. Description of model of care/intervention: To support NHSE in the elimination of HCV, a partnership between Gilead Sciences, Practice Plus Group (PPG) and the Hepatitis C Trust (HCT) was formed in 2019. This partnership works with prison and hospital teams to optimise test and treat pathways for new prison admissions. In addition, whole prison HCV Intensive Test and Treat events (HITT programmes) were run in targeted prisons to ensure testing of residents who were incarcerated before these optimisations were implemented. Effectiveness: HCV screening, within 7 days of prison entry, increased from 27% in May 2019 to 93% in January 2022. This increase was achieved despite COVID-19 restrictions remaining in place since March 2020 across all English prisons. In addition, HITT programmes were used to test residents who were missed at prison entry. The overall result is that 8/9 prisons have achieved microelimination status, as defined by: >= 95% of prison residents tested within the previous 12 months, >= 90% of RNA positive patients treated or initiated on treatment and presence of a robust system to review ongoing testing and treatment performance to ensure these targets are maintained. Conclusion and next steps: Micro-elimination of HCV will now need to be maintained in these prisons by ensuring the uptake of HCV testing remains>95%. Plans are in place to micro-eliminate the final prison-which is a high-security prison presenting unique challenges to HCV micro-elimination.

SARS-CoV-2 WASTEWATER SURVEILLANCE IN A US JAIL: CORRELATION, FEASIBILITY, NEXT STEPS

Background: Jails house vulnerable persons. Crowded conditions, restricted access to medical care, and limited resources facilitate infectious disease outbreaks, particularly for airborne, highly transmissible diseases like COVID-19 (C19). Wastewater-Based Surveillance (WBS) is a low-cost, highly sensitive, non-invasive method that can provide an early warning of C19 surges in communities. We examined the value of SARS-CoV-2 WBS for a mega-jail. Method(s): 28-week study period: 10/20/21- 5/5/22. Wastewater samples were collected x 25 weeks;SARS-CoV-2 RNA was measured using RT-qPCR. We sampled one manhole serving multiple housing units. C19 rapid test data on jail entrants were summarized daily by the jail;16 mass PCR screenings using selfcollected nasal swabs were conducted by the study team. Individual diagnostic tests were collated and analyzed on a weekly basis. Data were summarized by % of the tested jailed individuals found infected. The Spearman correlation coefficient between weekly SARS-CoV-2 RNA in wastewater and % of positive (pos) C19 diagnostic tests were calculated;we also used linear regression to assess the predictability between paired Ct values and weekly % of pos diagnostic tests. Result(s): Weekly WBS coupled with periodic mass testing of jailed individuals was feasible. The efficiency of gathering individual nasal swabs increased to 3 tests collected per minute through a CQI process. PCR signal strength for SARSCoV- 2 RNA in jail wastewater correlated with the % of jail residents tested who had C19. The mean RT-qPCR Cycle threshold (Ct) value was 35.2. Overall, 3.4% of nasal swabs were pos. A strong inverse correlation was observed between % nasal swab pos and WBS Ct value (Figure.) The Spearman correlation coefficient was r= 0.628;linear regression likewise showed a similar correlation. Conclusion(s): Weekly WBS results for C19 correlated with the proportion of C19 individual test results. WBS proved to be a practical strategy to surveil for C19 in this jail setting. We are developing means to identify exact source, by housing unit, of wastewater with positive signal. Future studies will explore WBS for Mpox and HIV in correctional facilities. HIV RNA can be found in wastewater specimens;whether WBS for HIV in congregate facilities is feasible remains an open question.

How COVID-19 worsened the mental health problems of incarcerated youth

The COVID-19 pandemic of 2020 transformed daily life worldwide. To minimize the spread of the virus, many governments imposed a lockdown and physical distancing measures. Schools, universities, restaurants, shops, and businesses all closed. Research has shown that the mandatory stay-at-home orders associated with the COVID-19 pandemic adversely affected the mental health of parents, children, and youth. This chapter considers how the COVID-19 pandemic has affected the mental health of youth behind bars in the United States and in other countries. The longstanding impression of prisons is that the people in custody are violent, dangerous, and deserve to be incarcerated. Even incarcerated youth are viewed by many in society as super-predators. Most incarcerated youth have significant mental health needs. Incarcerated youth often suffer from a variety of mental health conditions including anxiety, depression, Post Traumatic Stress Disorder, substance abuse, and suicidal ideation. When incarcerated youth show symptoms of COVID-19 or are diagnosed with it, juvenile correctional facilities are faced with few options for quarantine that do not resemble solitary confinement. Because of concern regarding the high transmissibility of COVID-19 in juvenile prisons, most prison administrators suspend visitors or greatly restrict the number of people entering the facilities. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Problem-solving Covid-19: A qualitative inquiry into how correctional officers and administrators have responded to the dynamic problems of the coronavirus pandemic

Jail administrators and officers have been confronted with a number of workplace problems as a result of the coronavirus pandemic. Ever since its emergence, they have been required to contain outbreaks of the virus, manage a correctional population that has grown increasingly frustrated over restrictions imposed on their movements, and contend with health protocols that have been in a constant state of fluctuation. This article commences the literature on how exactly jail staff have responded to these serious problems. Semistructured interview data collected from administrators and officers employed in a county-level jail located in the southeastern United States (N = 21) revealed how, to contain viral spread, respondents received the vaccine and wore masks at all times while working. Trauma-informed leadership was embraced by superiors to help their line-staff deal with the confusion created by constant health policy changes, while gentle communication styles were adopted to de-escalate potentially hostile interactions with detainees. Implications for correctional policy and practice are discussed in light of these findings. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Clinician Perspectives for Mental Health Delivery Following COVID-19 in Carceral Settings: A Pilot Study.

We aimed to understand clinician perspectives on mental healthcare delivery during COVID-19 and the utility of tele-mental health services in carceral settings. A survey was administered in November 2022 through the American College of Correctional Physicians listserv. A nationwide sample of 55 respondents included 78.2% male (n = 43) and 21.8% female (n = 12), 49.1% active clinicians (n = 27) and 50.9% medical directors (n = 28), with a median of 12 and mean of 14.5 years working in carceral settings. Most agreed that mental telehealth services could serve as a stopgap amid infection prevention measures and resource-limited settings with an increasing role moving forward (80.0%, n = 44) but may not be sufficient to replace in-person services completely. Access to mental healthcare is vital in helping achieve optimal health during incarceration. Most clinicians in a nationwide survey report an essential role of mental telehealth in the future, although they vary in beliefs on the present implementation. Future efforts should further identify facilitators and barriers and bolster delivery models, particularly via e-health.

COVID-19 Burden in Adult Correctional or Detention Facilities and the Surrounding Communities, January 1, 2020-July 20, 2021.

We estimated the COVID-19 burden in adult correctional or detention facilities and associated counties by state, facility jurisdiction, and county urbanicity. COVID-19 cumulative incidence (cases per 1,000 persons) for each U.S. correctional or detention facility and people ages 18 years and older in the associated county was estimated between January 1, 2020 and July 20, 2021. Across 46 U.S. states, 1,083 correctional or detention facilities in 718 counties were included. The median COVID-19 incidence rate was higher in facilities than in associated counties for 42 of 46 states and for all facility jurisdictions and county urbanicity categories. COVID-19 burden was higher in most facilities than in associated counties. Implementing COVID-19 mitigation measures in correctional settings is needed to prevent SARS-CoV-2 transmission in facilities and associated counties.

Investing in Community Care Is an Important Goal and Need for Eliminating Hepatitis C in the United States: An Abolitionist Perspective.

Recent nationwide racial justice uprisings following ongoing police violence against Black communities juxtaposed with the COVID-19 pandemic have increased the urgency for a reckoning around the ineffectiveness and harm caused by the carceral apparatus. It is well documented that the correctional system was founded upon and continues the legacy of slavery and white supremacy. Research has shown that incarceration directly contributes to many negative health outcomes, including increased risk and spread of hepatitis C virus (HCV) infections, especially among people who inject drugs. This high burden of HCV disproportionately impacts low-income communities of color, who not only report higher rates of substance use due to pervasive discrimination but are also over-incarcerated as a result of structural racism and the War on Drugs. The COVID-19 pandemic further underscores that correctional facilities are fundamentally structured to promote health inequities. Minoritized communities who are overrepresented in corrections continue to be put at increased risk of COVID-19 in overcrowded facilities, are isolated from social support and medical care, and have been ignored in vaccination strategies. In this perspective, we argue that HCV interventions within the carceral apparatus will remain largely ineffective due to the negative health impacts of incarceration. Instead, we propose adopting abolitionist principles for HCV elimination-divesting from the carceral apparatus to prioritize community-based efforts on promoting HCV screening, treatment, and prevention. In doing so, the nation will have not only the capacity to meaningfully eliminate HCV but also the potential to improve overall societal outcomes.

Public Health and Prisons: Priorities in the Age of Mass Incarceration.

Mass incarceration is a sociostructural driver of profound health inequalities in the United States. The political and economic forces underpinning mass incarceration are deeply rooted in centuries of the enslavement of people of African descent and the genocide and displacement of Indigenous people and is inextricably connected to labor exploitation, racial discrimination, the criminalization of immigration, and behavioral health problems such as mental illness and substance use disorders. This article focuses on major public health crises and advances in state and federal prisons and discusses a range of practical strategies for health scholars, practitioners, and activists to promote the health and dignity of incarcerated people. It begins by summarizing the historical and sociostructural factors that have led to mass incarceration in the United States. It then describes the ways in which prison conditions create or worsen chronic, communicable, and behavioral health conditions, while highlighting priority areas for public health research and intervention to improve the health of incarcerated people, including decarceral solutions that can profoundly minimize-and perhaps one day help abolish-the use of prisons.

COVID-19 Fears and Preventive Behaviors among Prison Staff

This study focused on COVID-19 preventive behaviors and fears among prison staff members after the first wave of the pandemic. Cross-sectional data from 171 participants were collected in Switzerland. The level of fears (58.5%) and protective behaviors (100%) were high. Correctional officers adhered less to preventive measures than other staff members (p = .001). Fears were related to a reduction of social contacts (p = .006) and worries about physical health was related to preventive behaviors in general (p = .006). There is a need to raise prison staff awareness regarding their vulnerability to the SARS-CoV-2 in order to improve the effectiveness of health campaigns in prison settings. Special attention should be given to correctional officers.

COVID-19 dynamics in an Ohio prison.

Incarcerated individuals are a highly vulnerable population for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Understanding the transmission of respiratory infections within prisons and between prisons and surrounding communities is a crucial component of pandemic preparedness and response. Here, we use mathematical and statistical models to analyze publicly available data on the spread of SARS-CoV-2 reported by the Ohio Department of Rehabilitation and Corrections (ODRC). Results from mass testing conducted on April 16, 2020 were analyzed together with time of first reported SARS-CoV-2 infection among Marion Correctional Institution (MCI) inmates. Extremely rapid, widespread infection of MCI inmates was reported, with nearly 80% of inmates infected within 3 weeks of the first reported inmate case. The dynamical survival analysis (DSA) framework that we use allows the derivation of explicit likelihoods based on mathematical models of transmission. We find that these data are consistent with three non-exclusive possibilities: (i) a basic reproduction number >14 with a single initially infected inmate, (ii) an initial superspreading event resulting in several hundred initially infected inmates with a reproduction number of approximately three, or (iii) earlier undetected circulation of virus among inmates prior to April. All three scenarios attest to the vulnerabilities of prisoners to COVID-19, and the inability to distinguish among these possibilities highlights the need for improved infection surveillance and reporting in prisons.

Social media use and juvenile incarceration: Perspectives from mental health professionals and staff of juvenile correctional facilities

Social media has become pervasive in the lives of modern adolescents. Although social media may provide individuals with many positive opportunities for communication and learning, social media sites also may provide an outlet for youth conduct problems, such as bullying, harassment, and intentional hostility and aggression toward others. In recent years, more and more research has shown that overuse of social media can lead to negative mental health outcomes( Khine et al., 2020;Andreassen, 2015;Lin et al., 2016). Research also suggests that more childhood conduct disorder symptoms are significantly associated with greater daily social media use during emerging adulthood (Galica, 2017). Yet, the relationship between social media use and adolescent delinquent behavior has remained clear. At the same time, according to a 2016 nationwide study, U.S. law enforcement arrested around 1.3 million adolescents each year (Puzzanchera, 2014). To this end, countless juvenile detention counselors, probation officers, unit counselors and other staff have treated and rehabilitated youths who were criminal offenders in an effort to prevent future crimes. This study aimed to better understand how these professionals considered and potentially addressed social media use in their everyday work with adolescents within the juvenile justice system. This researcher developed a brief survey which explored correctional staff's perspectives on the impact of social media use on the adolescents with whom they worked;and ways in which they could intervene. Data was collected from February 2021 to October 2021, which was longer than expected as it occurred amid the COVID-19 pandemic. The study sample consisted of 28 juvenile correctional facilities staff members (ages 18 or older), primarily mental health counselors, who were currently working with or previously worked with juveniles within the criminal justice system. Participants were acquired through multiple outreach attempts via phone and email to various juvenile correctional facilities throughout California. A majority of participants agreed that social media played a pertinent role in juvenile delinquency where it acted as a facilitator or platform for criminal behavior, and many disclosed a willingness to intervene or had previously attempted to intervene around social media use in some capacity. This included (a) directly communicating with adolescents, (b) communicating with their parents/caregivers about social media use, (c) recommending social media restrictions as a condition of probation, or (d) simply monitoring or limiting social media use in their general recommendations. This study offered a modest preliminary effort to explore and highlight the need to better understand the connection between social media use and juvenile criminal behavior as well as to develop and enhance ways to intervene with respect to this connection. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Towards family preservation: A systematic jurisdiction analysis of prison visitation policies during the COVID-19 pandemic

Since the onset of COVID-19, visitation to correctional facilities has been in flux, including periods of nationwide suspensions for all in-person visits. Frequent, high-quality parent-child interactions are critical in preventing recidivism and beneficial for the healthy development of children with incarcerated parents. As more variants arise, prisons must reevaluate their family visitation policies to ensure that families stay connected yet safe. As a follow-up to a previous study, we documented how different jurisdictions, including all 50 states, the District of Columbia (D.C.), and the Federal Bureau of Prisons (BOP), communicated, via their websites, their response to COVID-19 and the changes to prison visitation policies. Using each jurisdiction's website as our primary data source, we gathered publicly available information related to each state's COVID-19 safety protocols and prison visitation policies, with special attention to policies pertaining to minors. Findings suggest that as of November and December 2021, all jurisdictions, except D.C., had resumed in-person family visits (n = 34;65.4%) or had announced their commitment to a phased return (n = 17;32.7%). Additionally, most states and D.C. (n = 35;65.7%) offered video visits to all of their prison residents (incarcerated individuals) and six states (11.5%) offered video visits to some of their residents, whereas 11 states and the Federal BOP (21.2%) did not offer any video visits as an alternative. Despite the continued need for safe, accessible, and family-friendly alternatives to in-person visits, 11 jurisdictions did not offer video visitation to their residents further straining families' ability to stay connected through the ongoing COVID-19 pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The Office of Legal Counsel's Client is the President: Why the Model Rules Demand a Secretive Agency Identify its Boss

This Note argues that the Model Rules of Professional Conduct require the Office of Legal Counsel to identify President Biden as its client. Had the agency done so when Biden first took office, it could have immediately implemented Biden's policy preference: keeping former prisoners home during the coronavirus pandemic.

More of the Same, Only Worse: COVID-19 and the Administrative Burdens Facing Loved Ones of Incarcerated Men

Over the course of the COVID-19 pandemic, officials have introduced measures to preserve the health of incarcerated individuals and prison employees. To understand the impact of COVID-related correctional policies on individuals with incarcerated friends and family members, we conducted 181 longitudinal interviews from April 2020 to January 2021 with 29 such 'loved ones.' Participants emphasized concerns about (1) health and safety;(2) unclear, unpredictable and untrusted communications;and (3) diminished personal intimacy. We analyze these findings using an 'administrative burden' framework and discuss possible reforms. We also suggest a wider applicably of this framework for studying individuals who have diverse encounters with the criminal justice system. [ABSTRACT FROM AUTHOR] Copyright of British Journal of Criminology is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Results of an Automatic Alert System from Microbiology to Link Diagnosis to Treatment in Patients with Chronic Hepatitis C

Introduction and Objectives: Strategies to simplify the care circuit for patients with the hepatitis C virus (HCV) are vital to achieving its eradication. To achieve this aim, we introduced an electronic system of HCV serology detection to link diagnosis with specialized assistance in order to minimize the loss of patients. Material(s) and Method(s): A retrospective single-center study of HCV patients developed by Microbiology Department from February 15th, 2020, to December 15th, 2021. In the event of a positive HCV antibody, the anti-HCV core was directly measured by the electronic system. If positive, an encrypted e-mail with the patient data was automatically sent to HCV specialized physicians, who, after evaluating the benefits of antiviral therapy in each patient, contacted them by phone for an appointment. In the first face-to-face consultation FibroScan, HCV genotype and viral load measurement were performed, and antiviral therapy was prescribed. Patient diagnosis origin and public health characteristics were recorded. We analyzed the association between antiviral therapy prescription and these variables. Statistical significance was set at p<0.005. Result(s): Of 171 patients identified, with a mean age of 59.6 +/- 15.9, 61.5 % of males and 81.2% of Spanish nationals. HCV origin from out-of-hospital settings predominated (50.9%, 87/171), particularly primary care (28.7%), penitentiary (11.6%) and addiction units (8.2%). In all, 43.3% (74/171) were aware of their diagnosis, but 64.9% (48/74) hadn't previously received antiviral therapy. Genotype 1 predominated. We recorded 19.4% (20/103) of patients F3 fibrosis and 27.2% (26/103) F4. Finally, 58.5% (100/171) attended a physician consultation. They were all treated with pangenotypic interferon-free therapy. A 100% rate of sustained viral response was achieved. The main reasons for not being treated were high comorbidity (43.7%,31/71), not located (23.9%, 17/71), patient refusal to treatment (23.9%,17/71) and death (8.5%,6/71). The sole association found between antiviral therapy and patient variables was that of comorbidities with being untreated (OR=7.14, p<0.001). Conclusion(s): Our alert system is simple and easily reproducible. It allows for minimizing the loss of HCV patients, even considering it was performed during the COVID-19 pandemic.Copyright © 2023

Addiction Treatment Facilities under Special Circumstances/Settings

Background: There has been a rampant increase in substance abuse in Kashmir valley for the last few years. Department of Psychiatry SKIMS Medical College Srinagar has extended its services to cater to the needs of the substance users in the valley even during the COVID -19 pandemic. In 2021, de-addiction services were also started among prison inmates of central jail Srinagar. This was the first of its kind of services provided in the valley. The management of substance users with Hepatitis infections had also been challenging. Purpose(s): To describe the management of substance users under special circumstances(COVID-19), special settings(Central Jail Srinagar), high-risk groups(substance users with blood-borne infections). Method(s): Semi-structured proformas were used to collect data from special groups of participants a) those who were seeking treatment during COVID-19 times from the De-addiction center, SKIMS Medical College b) Prison in-mates on treatment for substance-use disorders c) substance users who are hepatitis B and/or positive. This included Socio-demographic details, clinical profile, the pattern of substance use, coping strategies, and treatment seeking. Preliminary Findings: More than 25 percent of the prison in-mates are substance dependent and relapse rate is very high. Psychiatric comorbidity like mood disorders and or personality disorders are present among most of the prison-inmates. During COVID-19 times, 90% patients reported average to very high level of importance and value given to their own health and health of family and friends and focussed on treatment of their illness(85%). Substance users with blood-borne infections were associated with highrisk behavior in the form of needle-sharing. Conclusion(s): The findings provide a voice that there is a need for backup plans that cater to the needs of substance users during in-evitable circumstances like the COVID-19 pandemic. Policymakers should focus on prison mental health for the functioning of a better society. Substance users with blood-borne infections should be rigorously treated to prevent them from taking the shape of an epidemic.

Evaluation of wastewater surveillance for SARS-CoV-2 in Massachusetts correctional facilities, 2020–2022

Introduction: Correctional facilities have environmental, resource, and organizational factors that facilitate SARS-CoV-2 transmission and challenge clinical testing of staff and residents. In Massachusetts, multiple state prisons implemented wastewater surveillance for strategic testing of individuals and isolation of COVID-19 cases early in the course of infection, as recommended by the Centers for Disease Control and Prevention (CDC). Our objective was to quantify the correlation of COVID-19 cases with facility-level wastewater surveillance compared to standard case surveillance in towns in closest geographic proximity to participating correctional facilities. Materials and methods: Available data included number of reported COVID-19 cases in residents from each of eight participating facilities (labeled A-H for anonymity), wastewater viral concentrations at each facility, and COVID-19 cases reported to routine surveillance in towns geographically nearest each facility. We selected data from December 2020-February 2022. Spearman's rank correlation was calculated at each facility to assess agreement between town cases and facility resident cases, and between wastewater concentrations and facility resident cases. We considered a correlation of ≤0.3 as weak and ≥0.6 as strong. Results: Facilities housed a mean of 502 individuals (range 54–1,184) with mean staffing of 341 (range 53–547). In 7/8 facilities, the town/resident cases correlation coefficients (ρ) were statistically significant (range 0.22–0.65);in all facilities, the wastewater/facility resident cases correlations were statistically significant (range 0.57–0.82). Consistently, ρ values were higher for facility-specific wastewater/resident cases than for town/resident cases: A (0.65, 0.80), B (0.59, 0.81), C (0.55, 0.70), D (0.61, 0.82), E (0.46, 0.62), F (0.51, 0.70), and H (0.22, 0.57). Conclusion: We conclude that wastewater surveillance for SARS-CoV-2 can provide an additional signal to objectively supplement existing COVID-19 clinical surveillance for the early detection of cases and infection control efforts at correctional facilities. Copyright © 2023 Klevens, Young, Olesen, Osinski, Church, Muten, Chou, Segal and Cranston.