COVID-19 testing and prevention in correctional settings

PROJECT SUMMARY Correctional settings account for 39 of the 50 largest outbreaks of COVID-19 in the US to date. Transmission of the COVID-19 virus (SARS-CoV-2) is amplified in correctional settings due to restricted access to sanitizing supplies, personal protective equipment and diagnostic tests, close congregant living conditions, and exposure to correctional staff who unknowingly transmit the infection from the community. Incarcerated people are also more likely to die from COVID-19 compared to the general population. Therefore, there is an urgent need for the development and implementation of long-term COVID-19 testing and prevention strategies targeting incarcerated populations and correctional staff. However, there are also long-standing ethical and pragmatic concerns unique to corrections, which may present as barriers to the successful implementation of prevention strategies. Prior work has not explored the ethical, legal, and social barriers to COVID-19 testing and vaccine administration in corrections, especially centered around the values, preferences, and needs of those who work and live in correctional facilities. Until this knowledge gap addressed, it will be difficult to reduce COVID-19 morbidity and mortality in correctional facilities. In response to NOSI-20-121, and as a supplement to aNIDA Justice Community Opioid Innovation (JCOIN) consortium's grant (1UG1DA050072-01), the overall objective of our study, "COVID-19 Testing and Prevention in Correctional Settings," is to increase the reach, access, uptake, and impact of COVID-19 testing and mitigate the impact of COVID-19 among incarcerated people and staff. Our specific aims are to: (1) Identify ethical concerns and potential solutions for COVID-19 testing and vaccine strategies in correctional facilities using a community-engaged strategy; and (2) Characterize baseline COVID-19 incidence, disease progression and related-outcomes among incarcerated individuals and correctional staff. At the core of this work is a long-standing multidisciplinary team, including people with histories of incarceration, correctional policymakers, public health scientists, historians, legal scholars, and ethicists, which will identify ethical concerns and potential solutions to testing and vaccine implementation in correctional settings. We have partnered with the Florida, Rhode Island, and Minnesotastate departments of corrections and the Yakima County jail in Washington, to implement mass testing to characterize COVID-19 incidence, risk factors, and long-term outcomes in a diverse set of jails and prisons inrural and urban geographies. Together, the knowledge produced by this proposal will have a positive impact by providing feasible and ethical solutions for corrections to prevent COVID-19 morbidity and mortality through testing and vaccine distribution.