SARS-CoV2 Infection and Comorbidity in Inmates: A Study of Central Italy.

BACKGROUND AND OBJECTIVE: The presence of multiple chronic diseases is associated with an increase in mortality when related to COVID-19 infection. THE AIMS OF OUR STUDY WERE: (i) to evaluate the association between the severity of the COVID-19 disease, defined as symptomatic hospitalized in prison or symptomatic hospitalized out of prison, and the presence of one or more comorbidities in two prisons in central Italy: L'Aquila and Sulmona; (ii) to describe the profiles of inmates using multiple correspondence analysis (MCA). METHODS: A database was created including age, gender and clinical variables. The database containing anonymized data was password-protected. The Kruskal-Wallis test was used to evaluate a possible association between diseases and the severity of COVID-19 stratified by age groups. We used MCA to describe a possible characteristic profile of inmates. RESULTS: Our results show that in the 25-50-year-old age group (COVID-19-negative) in the L'Aquila prison, 19/62 (30.65%) were without comorbidity, 17/62 (27.42%) had 1-2 comorbidities and only 3.23% had >2 diseases. It is interesting to note that in the elderly group, the frequency of 1-2 or >2 pathologies was higher than in the younger group, and only 3/51 (5.88%) inmates did not have comorbidities and were COVID-19 negative (p = 0.008). The MCA identified the following profiles: the prison of L'Aquila showed a group of women over 60 with diabetes, cardiovascular and orthopedic problems, and hospitalized for COVID-19; the Sulmona prison presented a group of males over 60 with diabetes, cardiovascular, respiratory, urological, gastrointestinal and orthopedic problems, and hospitalized or symptomatic due to COVID-19. CONCLUSIONS: our study has demonstrated and confirmed that advanced age and the presence of concomitant pathologies have played a significant role in the severity of the disease: symptomatic hospitalized in the prison; symptomatic hospitalized out of the prison.

COVID-19 Mitigation Compliance and Vaccination Status Among Formerly Incarcerated Individuals in the United States.

BACKGROUND: To examine the relationship between incarceration history and an individual's compliance toward COVID-19 mitigation strategies and vaccination status/intentions. METHOD: Data are from the Crime, Health, and Politics Survey (N = 1,735), a national probability sample of community-dwelling adults aged 18 and above living in the United States. Data were collected from May 10, 2021 to June 1, 2021. Multinomial logistic regression models were used to assess the relationship between incarceration history and COVID-19 mitigation strategies and vaccination status/intentions. RESULTS: Individuals with a history of incarceration reported approximately twice the relative risk of rarely/never using hand sanitizer and rarely/never wearing a mask compared with always/very often. Incarceration history was associated with more than 3 times greater relative risk of reporting not being vaccinated and not planning to get vaccinated compared with currently being vaccinated. CONCLUSION: Formerly incarcerated individuals are less likely to abide by key COVID-19 mitigation protocols and exhibit higher levels of vaccine hesitancy. These findings suggest that formerly incarcerated individuals, as well as their families and communities, may therefore be at greater risk of accelerated spread of COVID-19 because of these factors.

Factors associated with changes in illicit opioid use during the COVID-19 pandemic among incarcerated people who use drugs in Quebec, Canada.

PURPOSE: People who use drugs (PWUD) have been disproportionately affected by the COVID-19 pandemic. This study aims to examine changes in illicit opioid use and related factors among incarcerated PWUD in Quebec, Canada, during the pandemic. DESIGN/METHODOLOGY/APPROACH: The authors conducted an observational, cross-sectional study in three Quebec provincial prisons. Participants completed self-administered questionnaires. The primary outcome, "changes in illicit opioid consumption," was measured using the question "Has your consumption of opioid drugs that were not prescribed to you by a medical professional changed since March 2020?" The association of independent variables and recent changes (past six months) in opioid consumption were examined using mixed-effects Poisson regression models with robust standard errors. Crude and adjusted risk ratios with 95% confidence intervals (95% CIs) were calculated. FINDINGS: A total of 123 participants (median age 37, 76% White) were included from January 19 to September 15, 2021. The majority (72; 59%) reported decreased illicit opioid consumption since March 2020. Individuals over 40 were 11% less likely (95% CI 14-8 vs 18-39) to report a decrease, while those living with others and with a history of opioid overdose were 30% (95% CI 9-55 vs living alone) and 9% (95% CI 0-18 vs not) more likely to report decreased illicit opioid consumption since March 2020, respectively. ORIGINALITY/VALUE: The authors identified possible factors associated with changes in illicit opioid consumption among incarcerated PWUD in Quebec. Irrespective of opioid consumption patterns, increased access to opioid agonist therapy and enhanced discharge planning for incarcerated PWUD are recommended to mitigate the harms from opioids and other drugs.

Prisoners' experiences and coping strategies during the COVID-19 pandemic response - an ethnographic study conducted mid-pandemic.

PURPOSE: This paper aims to report findings about how prisoners experience and cope with COVID-19 restrictions, which can contribute to an understanding of how pandemic responses, and specifically the COVID-19 response, affect prisoners. DESIGN/METHODOLOGY/APPROACH: Data was collected through ethnographic fieldwork involving days of observations (N = 24) and the conduction of semi-structured interviews with prisoners (N = 30) in closed prisons and detentions in Denmark between May and December 2021. The transcribed interviews and field notes were processed and coded by using the software programme NVivo. FINDINGS: The data analysis reveals that the pains of imprisonment have been exacerbated to people incarcerated during the COVID-19 pandemic. To relieve pains of imprisonment, prisoners turn to censoriousness as an informal coping strategy, where they complain about inconsistency and injustice in the prison's COVID-19 prevention strategy to reveal the prison system itself as a rule-breaking institution. The prisoners criticise the prison management for using COVID-19 as an excuse, treating prisoners unjustly or not upholding the COVID-19 rules and human rights. Furthermore, principles of justice and equality are also alleged by some prisoners who contemplate the difficulty in treating all prisoners the same. RESEARCH LIMITATIONS/IMPLICATIONS: More research will be needed to create a full picture of how prisoners cope with pandemic responses. Further research could include interviews with people working inside prisons. ORIGINALITY/VALUE: In a Scandinavian context, to the best of the author's knowledge, this study is the first of its kind to apply an ethnographic approach in exploring prison life during the COVID-19 pandemic.

"Prison life is very hard and it's made harder if you're isolated": COVID-19 risk mitigation strategies and the mental health of incarcerated women in California.

PURPOSE: This study aims to describe the COVID-19 risk mitigation strategies implemented in California prisons and the impact of these policies on the mental health of incarcerated women. DESIGN/METHODOLOGY/APPROACH: The authors conducted semi-structured qualitative interviews with ten women who were over the age of 50 and/or had a chronic illness and had been incarcerated in California prisons during the COVID-19 pandemic. The authors also interviewed ten health-care providers working in California jails or prisons during the pandemic. Interviews were analyzed using a grounded theory coding framework and triangulated with fieldnotes from ethnographic observations of medical and legal advocacy efforts during the pandemic. FINDINGS: Participants described being locked in their cells for 23 hours per day or more, often for days, weeks or even months at a time in an effort to reduce the spread of COVID-19. For many participants, these lockdowns and the resulting isolation from loved ones both inside and outside of the prison were detrimental to both their physical and mental health. Participants reported that access to mental health care for those in the general population was limited prior to the pandemic, and that COVID-19 risk mitigation strategies, including the cessation of group programs and shift to cell-front mental health services, created further barriers. ORIGINALITY/VALUE: There has been little qualitative research on the mental health effects of the COVID-19 pandemic on incarcerated populations. This paper provides insight into the mental health effects of both the COVID-19 pandemic and COVID-19 risk mitigation strategies for the structurally vulnerable older women incarcerated in California prisons.

Determinants of SARS-CoV-2 vaccine willingness among people incarcerated in 3 Canadian federal prisons: a cross-sectional study.

BACKGROUND: Maximizing uptake of SARS-CoV-2 vaccines among people in prison is essential in mitigating future outbreaks. We aimed to determine factors associated with willingness to receive SARS-CoV-2 vaccination before vaccine availability. METHODS: We chose 3 Canadian federal prisons based on their low uptake of influenza vaccines in 2019-2020. Participants completed a self-administered questionnaire on knowledge, attitude and beliefs toward vaccines. The primary outcome was participant willingness to receive a SARS-CoV-2 vaccine, measured using a 5-point Likert scale to the question, "If a safe and effective COVID-19 vaccine becomes available in prison, how likely are you to get vaccinated?" We calculated the association of independent variables (age, ethnicity, chronic health conditions, 2019-2020 influenza vaccine uptake and prison security level), identified a priori, with vaccine willingness using logistic regression and crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: We recruited 240 participants from Mar. 31 to Apr. 19, 2021 (median age 46 years; 19.2% female, 25.8% Indigenous). Of these, 178 (74.2%) were very willing to receive a SARS-CoV-2 vaccine. Participants who received the 2019-2020 influenza vaccine (adjusted OR 5.20, 95% CI 2.43-12.00) had higher odds of vaccine willingness than those who did not; those who self-identified as Indigenous (adjusted OR 0.27, 95% CI 0.11-0.60) and in medium- or maximum-security prisons (adjusted OR 0.36, 95% CI 0.12-0.92) had lower odds of vaccine willingness than those who identified as white or those in minimum-security prisons, respectively. INTERPRETATION: Most participants were very willing to receive vaccination against SARS-CoV-2 before vaccine roll-out. Vaccine promotion campaigns should target groups with low vaccine willingness (i.e., those who have declined influenza vaccine, identify as Indigenous or reside in high-security prisons).

Protection against Omicron from Vaccination and Previous Infection in a Prison System.

BACKGROUND: Information regarding the protection conferred by vaccination and previous infection against infection with the B.1.1.529 (omicron) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is limited. METHODS: We evaluated the protection conferred by mRNA vaccines and previous infection against infection with the omicron variant in two high-risk populations: residents and staff in the California state prison system. We used a retrospective cohort design to analyze the risk of infection during the omicron wave using data collected from December 24, 2021, through April 14, 2022. Weighted Cox models were used to compare the effectiveness (measured as 1 minus the hazard ratio) of vaccination and previous infection across combinations of vaccination history (stratified according to the number of mRNA doses received) and infection history (none or infection before or during the period of B.1.617.2 [delta]-variant predominance). A secondary analysis used a rolling matched-cohort design to evaluate the effectiveness of three vaccine doses as compared with two doses. RESULTS: Among 59,794 residents and 16,572 staff, the estimated effectiveness of previous infection against omicron infection among unvaccinated persons who had been infected before or during the period of delta predominance ranged from 16.3% (95% confidence interval [CI], 8.1 to 23.7) to 48.9% (95% CI, 41.6 to 55.3). Depending on previous infection status, the estimated effectiveness of vaccination (relative to being unvaccinated and without previous documented infection) ranged from 18.6% (95% CI, 7.7 to 28.1) to 83.2% (95% CI, 77.7 to 87.4) with two vaccine doses and from 40.9% (95% CI, 31.9 to 48.7) to 87.9% (95% CI, 76.0 to 93.9) with three vaccine doses. Incremental effectiveness estimates of a third (booster) dose (relative to two doses) ranged from 25.0% (95% CI, 16.6 to 32.5) to 57.9% (95% CI, 48.4 to 65.7) among persons who either had not had previous documented infection or had been infected before the period of delta predominance. CONCLUSIONS: Our findings in two high-risk populations suggest that mRNA vaccination and previous infection were effective against omicron infection, with lower estimates among those infected before the period of delta predominance. Three vaccine doses offered significantly more protection than two doses, including among previously infected persons.

COVID-19 in prisons: what telejournalism (not) showed - a study on the criteria for newsworthiness during the pandemic. / COVID-19 nas prisões: o que o telejornalismo (não) mostrou - um estudo sobre os critérios de noticiabilidade na pandemia.

To analyze the news coverage of the COVID-19 pandemic in Brazilian prisons and its visibility, 213 articles broadcast between March and December 2020 were examined, found in the search service of the digital streaming video platform Globoplay. Most aired in March, April and July, with the theme almost disappearing in subsequent months. The reports, on numbers of deaths or infections, prevention measures and house arrest or freedom for groups at risk of COVID-19 were mainly published in local telejournals. Health agencies were barely heard. Of the 19 news items presented nationally, 12 address "famous prisoners" and the legibility of house arrest or freedom for groups at risk of COVID-19 unfavorable outcome. The health guidelines and the guarantee of the right to health of persons deprived of liberty were limited to the difficulties in implementing protection measures in prisons and to sustaining the need for restrictive measures to move inside prisons and in exchanges with the outside, to limit the circulation of the virus. In general, the form and visibility given to the topic do not contribute to broadening the viewers' perception of the sanitary conditions in prisons and the fact that health is a right for all, without any distinction.

Para analisar a cobertura telejornalística da pandemia de COVID-19 nas prisões brasileiras e sua visibilidade, foram examinadas 213 matérias veiculadas entre março e dezembro de 2020, encontradas no serviço de buscas da plataforma digital de vídeos por streaming Globoplay. A maior parte foi ao ar em março, abril e julho, com importante redução nos meses subsequentes. As reportagens, sobre números de mortes ou infectados, medidas de prevenção e prisão domiciliar ou liberdade para grupos de risco da COVID-19, foram divulgadas principalmente nos jornais locais. Os órgãos de saúde quase não foram ouvidos. Das 19 notícias apresentadas nacionalmente, 12 abordam os "presos famosos" e a legitimidade da prisão domiciliar ou a liberdade para grupos de risco da COVID-19. As pautas sanitárias e de garantia do direito à saúde das pessoas privadas de liberdade ficaram limitadas às dificuldades para a efetivação nos presídios das medidas de proteção e a sustentar a necessidade de medidas restritivas à movimentação no interior das prisões e nos intercâmbios com o exterior para limitar a circulação do vírus. Em geral, a forma e a visibilidade dadas ao tema não contribuem para ampliar a percepção dos telespectadores sobre as condições sanitárias das prisões e o fato de que a saúde é um direito de todos, sem qualquer distinção.

The Impact Of COVID-19 On The Health Of Incarcerated Older Adults In California State Prisons.

The number of older adults (age fifty-five or older) incarcerated in US prisons reached an all-time high just as COVID-19 entered correctional facilities in 2020. However, little is known about COVID-19's impact on incarcerated older adults. We compared COVID-19 outcomes between older and younger adults in California state prisons from March 1, 2020, to October 9, 2021. Adjusted odds ratios (aORs) revealed an increasing risk for adverse COVID-19 outcomes among older age groups (ages 55-64, 65-74, and 75 or older) compared with younger adults, including for documented infection (aOR, 1.3, 1.4, and 1.4, respectively) and hospitalization with COVID-19 (aOR, 4.6, 8.7, and 15.1, respectively). Moreover, although accounting for 17.3 percent of the California state prison population, older adults represented 85.8 percent of this population's COVID-19-related deaths. Yet a smaller percentage of older adults than younger adults were released from prison during the pandemic. The differential rates of morbidity and mortality experienced by incarcerated older adults should be considered in future pandemic response strategies regarding prisons.

A Human Rights Framework for Advancing the Standard of Medical Care for Incarcerated People in the United States in the Time of COVID-19.

The COVID-19 pandemic has underscored the lack of resources and oversight that hinders medical care for incarcerated people in the United States. The US Supreme Court has held that "deliberate indifference" to "serious medical needs" violates the Constitution. But this legal standard does not assure the consistent provision of health care services. This leads the United States to fall behind European nations that define universal standards of care grounded in principles of human rights and the ideal of equivalence that incarcerated and non-incarcerated people are entitled to the same health care. In this paper, we review a diverse legal and policy literature and undertake a conceptual analysis of policy issues related to the standard of care in correctional health; we then describe a framework for moving incrementally closer toward a universal standard. The expansion of Medicaid funding and benefits to corrections facilities, alongside a system of comprehensive and enforceable external oversight, would meaningfully raise the standard of care. Although these changes on their own will not resolve all of the thorny health problems posed by mass incarceration, they present a tangible opportunity to move closer to the human rights ideal.

The health impacts of the COVID-19 pandemic on adults who experience imprisonment globally: A mixed methods systematic review.

BACKGROUND: The prison setting and health status of people who experience imprisonment increase the risks of COVID-19 infection and sequelae, and other health impacts of the COVID-19 pandemic. OBJECTIVES: To conduct a mixed methods systematic review on the impacts of the COVID-19 pandemic on the health of people who experience imprisonment. DATA SOURCES: We searched Medline, PsycINFO, Embase, the Cochrane Library, Social Sciences Abstracts, CINAHL, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Sociology Database, Coronavirus Research Database, ERIC, Proquest Dissertations and Theses, Web of Science, and Scopus in October 2021. We reviewed reference lists for included studies. STUDY ELIGIBILITY CRITERIA: Original research conducted in or after December 2019 on health impacts of the COVID-19 pandemic on adults in prisons or within three months of release. STUDY APPRAISAL AND SYNTHESIS METHODS: We used the Joanna Briggs Institute's Critical Appraisal Checklist for Qualitative Research for qualitative studies and the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data for quantitative studies. We qualitized quantitative data and extracted qualitative data, coded data, and collated similar data into categories. RESULTS: We identified 62 studies. People in prisons had disproportionately high rates of COVID-19 infection and COVID-19 mortality. During the pandemic, all-cause mortality worsened, access to health care and other services worsened, and there were major impacts on mental wellbeing and on relationships with family and staff. There was limited evidence regarding key primary and secondary prevention strategies. LIMITATIONS: Our search was limited to databases. As the COVID-19 pandemic is ongoing, more evidence will emerge. CONCLUSIONS: Prisons and people who experience imprisonment should be prioritized for COVID-19 response and recovery efforts, and an explicit focus on prisons is needed for ongoing public health work including emergency preparedness. PROSPERO REGISTRATION NUMBER: 239324.

COVID-19 and the reimaging of compassionate release.

PURPOSE: The purpose of this paper is to provide a historical overview of compassionate release policies in the USA and describe how these policies have been used during the COVID-19 pandemic. The authors then describe how these programs have been shaped by COVID-19 and could be reimagined to address the structural conditions that make prisons potentially life limiting for older adults and those with chronic illness. DESIGN/METHODOLOGY/APPROACH: This paper is primarily descriptive, offering an overview of the history of compassionate release policies before and during the COVID-19 pandemic. The authors augmented this description by surveying state Departments of Corrections about their utilization of compassionate release during 2019 and 2020. The findings from this survey were combined with data collected via Freedom of Information Act Requests sent to state Departments of Corrections about the same topic. FINDINGS: The findings demonstrate that while the US federal prison system saw a multifold increase in the number of individuals released under compassionate release policies in 2020 compared to 2019, most US states had modest change, with many states maintaining the same number, or even fewer, releases in 2020 compared with 2019. ORIGINALITY/VALUE: This paper provides both new data and new insight into compassionate release utilization during the COVID-19 pandemic and offers new possibilities for how compassionate release might be considered in the future.

Age and COVID-19 mortality in the United States: a comparison of the prison and general population.

PURPOSE: The USA has a rapidly aging prison population that, combined with their poorer health and living conditions, is at extreme risk for COVID-19. The purpose of this paper is to compare COVID-19 mortality trends in the US prison population and the general population to see how mortality risk changed over the course of the pandemic. The authors first provide a national overview of trends in COVID-19 mortality; then, the authors assess COVID-19 deaths among older populations using more detailed data from one US state. DESIGN/METHODOLOGY/APPROACH: The authors used multiple publicly available data sets (e.g. Centers for Disease Control and prevention, COVID Prison Project) and indirect and direct standardization to estimate standardized mortality rates covering the period from April 2020 to June 2021 for the US and for the State of Texas. FINDINGS: While 921 COVID-19-related deaths among people in US prisons were expected as of June 5, 2021, 2,664 were observed, corresponding to a standardized mortality ratio of 2.89 (95%CI 2.78, 3.00). The observed number of COVID-19-related deaths exceeded the expected number of COVID-19-related deaths among people in prison for most of the pandemic, with a substantially widening gap leading to a plateau about four weeks after the COVID-19 vaccine was introduced in the USA. In the state population, the older population in prison is dying at younger ages compared with the general population, with the highest percentage of deaths among people aged 50-64 years. RESEARCH LIMITATIONS/IMPLICATIONS: People who are incarcerated are dying of COVID-19 at a rate that far outpaces the general population and are dying at younger ages. ORIGINALITY/VALUE: This descriptive analysis serves as a first step in understanding the dynamic trends in COVID-19 mortality and the association between age and COVID-19 death in US prisons.

COVID-19 Vaccination Of People Experiencing Homelessness And Incarceration In Minnesota.

We used data from a statewide public health-health system collaboration to describe trends in COVID-19 vaccination rates by racial and ethnic groups among people experiencing homelessness or incarceration in Minnesota. Vaccination completion rates among the general population and people incarcerated in state prisons were substantially higher than those among people experiencing homelessness or jail incarceration.