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To help stop the spread of COVID-19, stop packing a major hot spot: prisons and jails

Social distancing is not possible in packed jails, and biological networks do not respect prison walls.

COVID-19 outbreaks are surging again in jails and prisons across the country as the delta variant takes advantage of persistent local and federal government policy failures to control the pandemic. The recent cases and violence at New York's Rikers Island show – in deadly ways – why emptying these institutions is vital for the protection of incarcerated populations, staff and surrounding communities.    

Rikers Island's spike in COVID-19 infections, combined with unsafe and unsanitary living conditions, have worsened an already shocking environment. About a dozen detained individuals have died there this year – one of the latest on Sunday after reportedly contracting COVID when he was reincarcerated for a simple parole violation (something that, during a pandemic, shouldn't send anyone to jail). His death is being investigated. 

Elected officials who visited Rikers recently described the situation as “an absolute humanitarian crisis” and a “symbol of brutality and inhumanity.” Although the systematic abuse and neglect of incarcerated people at Rikers – exacerbated by low staffing connected to COVID – has garnered a high level of media attention, the circumstances there are far from exceptional.

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Similar abusive conditions can be found at jails and prisons across the country. If our lawmakers refuse to implement sensible policies such as mass clemency and targeted support instead of punishment for people who are living in poverty, struggling with addiction and dealing with homelessness, they will continue to preside over cruel and unconstitutional treatment of incarcerated individuals. They will also be enforcing conditions that fuel COVID-19 cases and deaths across communities, undermining public health and safety for everyone everywhere.

Mass incarceration drives the spread of infectious diseases throughout America and is fundamentally incompatible with public health and biosecurity. This is the core conclusion of my research with Daniel Chen, head of the Data and Evidence for Justice Reform program at The World Bank, published earlier this month in JAMA Network Open. Our study provides direct evidence in support of a policy solution that should be immediately implemented to protect public safety and global public health: large-scale decarceration of jails and prisons.

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With few exceptions, the typically crowded conditions in which incarcerated people are confined produce ideal settings for rapid disease transmission and epidemic outbreaks.

Biological networks do not respect prison walls or other tools of segregation, so outbreaks among incarcerated people quickly spill over into surrounding communities. Guards, visitors and released individuals unknowingly carry infections back to their families and neighbors. This in turn fuels community spread

During a pandemic, poor epidemic control in one country can send rippling tides of death to the entire world. Indeed, that's what we all witnessed at the outbreak of this pandemic, which started in China and quickly spread to Europe and America. Our incarceration system – a major pandemic hot spot – is an urgent problem for global public health and international biosecurity.

When we neglect the health of incarcerated people, the consequences inevitably boomerang back to harm the rest of society.

This carceral boomerang effect has been observed throughout history. Doctors saw this in prison-driven epidemics in Russia after intensifying poverty and associated petty crime during the 1990s led to massive growth of the Russian incarceration rate.

Similar connections between incarceration and disease spread have been found in Brazil. And a recent study published in Scientific Reports of public health in Paraguay warned that the nation’s tuberculosis control system is on the verge of collapse due to increasing incarceration rates that have caused disease spread across the country. Countless additional examples illustrate that the health of incarcerated people and broader communities is always intertwined.

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It should come as no surprise that one of the first large COVID-19 outbreaks in the world was in the Wuhan prison system. By the end of February 2020, Wuhan prisons contained a large number of the world’s cases. Soon thereafter, outbreaks began spreading through jails and prisons worldwide. A handful of public health experts sounded alarms that the world’s largest system of incarceration – which, perversely, has been built in America, one the world’s wealthiest nations – posed a major threat to public safety and global public health.

But many policymakers turned a blind eye to these warnings – a choice from which we have all since suffered. The most recent consequences are seen at Rikers, but last year, prisons and jails in this country were already suffering in ways that far surpassed the already high rates of disease and death seen in the general population.

In March 2020, one of the biggest outbreaks in the nation happened in Chicago's Cook County jail. Since that jail outbreak in Chicago, approximately 700,000 cases of COVID-19 have been documented inside U.S. jails, prisons and immigrant detention centers. Outbreaks continue to plague these facilities, exacerbated by high rates of unvaccinated U.S. prison staff

It is in this context that our study analyzed the role of jails in the spread of coronavirus across the country. The results suggest that a staggering number of COVID-19 cases and deaths are tied to the cycling of individuals through U.S. jails. There are more than 630,000 people held in America's jails. And as of a 2019 Bureau of Justice Statistics report, 53% of people are discharged within one week. 

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When an infectious disease enters a jail, it spreads much more rapidly than in other locations. Social distancing is all but impossible and health care access and quality are abysmal, while neglect is rampant. As a result, jails operate as infectious disease multiplication factories. A single case in translates to many more cases out.

This is preventable.

Our study shows that decarceration is associated with massive public health gains for everyone. Indeed, reducing incarceration in jails is one of the most important government interventions for reducing the spread of COVID-19 in communities. 

Dismantling prison systems worldwide is vital for stemming the continued spread and mutation of coronavirus during an ongoing plague. Decarceration must also be a centerpiece of long-term efforts to rebuild global public health and pandemic preparedness systems that have failed us all.

For reasons of both ethics and simply crude self-interest, Americans must demand that policymakers reject the politics of punishment that have built taxpayer-funded epidemic engines throughout our communities.

Our leaders must find the courage to condemn fearmongering crime rhetoric and to redirect public investments away from nationally self-destructive systems of policing and incarceration.

In one of the wealthiest nations in the world, it’s long past time that we finally build the public systems of care and repair that are required to ensure genuine public safety – and public health – for everyone.

Eric Reinhart is an anthropologist of public health, psychoanalyst and resident physician at Northwestern University. Follow him on Twitter: @_Eric_Reinhart

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