The protection of health in prison during the Covid-19 pandemic

Abstract

Being detained in jail is an acknowledged risk factor for physical and psychiatric morbidity. The impact of COVID-19 pandemic
on the penitentiary system, already characterized by criticalities in terms of healthcare, including high infectious risk, has been
considered a source of further danger within the prison and for the community. This problem has been raised by several observers, in the absence of a shared approach between states. The Italian Government enacted a series of measures aimed at penitentiary structures, to contain and manage health and safety risks. General precautions for infections prevention have been used, including frequent hands washing and environmental cleaning and disinfection procedures. Physical distancing in jail is extremely challenging, and we deem that it was still impossible to apply it, despite the release of almost 8000 detainees, among those at greater health risk. Measures have been also ordered to limit external contacts with detainees, including a substantial or absolute suspension of visits from relatives, operators and lawyers, replaced by video meetings. Quarantine and isolation of suspect cases has also been ordered, including new prisoners. Despite unfavorable premises the analysis we did on available data indicates lower infection rate and lethality rate in prison than in general population. In this paper a synthetic framework of the sanitary problems in detention will be provided, then the data will be analyzed, providing possible interpretations potentially useful for the management of the pandemic at the community level. Infectious surveillance, compliance with sanitation standards, early treatment of suspected cases, lower mean age, efficacious isolation and quarantine strategies may explain the better outcomes in Italian penitentiary system, also in the impossibility to systematically apply physical distancing.