Written By: Sophia Desai
The COVID-19 pandemic has killed nearly 5 million people worldwide since its emergence in late 2019. Countries around the world have experienced an astounding number of deaths, severe unemployment, and exacerbated inequalities, as certain groups of people became significantly more vulnerable due to the pandemic. Prisons around the world have highlighted these inequalities as they have become the hub of a large portion of COVID-19 cases. These conditions communicate the importance of considering prison health in public health crises.
Advocates Rex Walton and Paul Feilmann hold a sign outside the Nebraska State Penitentiary in Lincoln.¹
Framing the Issue
For far too long, the conversation regarding mass incarceration has been highly debated in the United States. With the U.S. making up only 5% of the world’s population, it comes as a surprise to many that they hold nearly 25% of the globe’s incarcerated population- an astounding, and quite frankly, embarrassing statistic.² However, while COVID-19 has brought devastating loss to the country over the past roughly 2 years, it has also brought about a never-before-seen effort to lower the United States’ incarcerated population in prisons. With nearly half a million COVID-19 cases reported among incarcerated Americans in prison, prisons have become incubators for the spread of the virus, highlighting the importance of prison conditions in overall public health.³
Overcrowding in the Prison System
The largest and more immediate concern for prisons during this pandemic has to do with overcrowding. 59% of all countries worldwide have prison occupancy levels exceeding their capacities, linking them to adverse health outcomes and heightened risks of infection.⁴ Based on a research article written by Tony Butler, a research professor on the epidemiology of prisoner health, prison cell spatial density can be associated with the outcome of infectious diseases including tuberculosis and pneumonia.⁴ Additionally, overcrowding in prisons coincides with poor prison hygiene conditions, insufficient testing procedures, limited access to adequate healthcare services, and insufficient isolation measures. Solving the issue of overcrowding in prisons has thus far proven to be the key to solving the issue of COVID-19 in prisons and the public.
Mental Health and COVID-19
With COVID-19 being one of the most significant public health challenges in the last decade, the issue of mental illness is only exacerbated due to preventative isolation and social distancing measures. Nearly 10 million people remain in prison worldwide, and their population holds a significantly high prevalence of morbidity and vulnerability to poor health outcomes such as suicide and premature death.⁵ Although measures such as quarantine and isolation implemented in prisons have helped to slow the spread of the virus, they have also been associated with anxiety and psychological distress. The crisis has also restricted visitation rates, further heightening the feeling of isolation felt among prisoners. Several events that have taken place globally within prisons have reflected these effects of the pandemic. For example, in 2020, 12 Italian prisoners tragically passed away in a riot linked to pandemic prison restrictions.⁵ While the COVID-19 situation in prisons presents a harrowing threat to physical health, it also threatens prisoners’ mental well-being.
The U.S. Response
As COVID-19 worsened in 2020, it was no surprise that correctional facilities were some of the most vulnerable. As a result, countries such as Ireland began to implement measures to control outbreaks in prisons.⁵ These policies included reducing the prison population through the disposal of criminal affairs, moving to non-shared accommodations, improving COVID-19 screening procedures, psychological examinations, and access to treatments and vaccines. Many countries followed suit in reducing their prison populations, including China and the United States. According to a nationwide analysis by The Marshall Project and The Associated Press, from March to June 2020, more than 100,000 Americans were released from state and federal prisons, resulting in a nearly 8% decline in the national prison population since the start of the pandemic.⁶ Additionally, U.S. correctional facilities adapted their mental health services to deal with the heightened need during the pandemic. And currently, a little over 50% of incarcerated individuals in prison are vaccinated.
What's Happening Now?
While there were many drastic policy initiatives to reduce prison populations early on in the pandemic, this did not continue. As of December 2020, prison systems were still at 90% capacity or higher, making them large hubs for the spread of COVID-19.⁷ Additionally, nearly 4,500 people, on home confinement as a result of the pandemic, are currently facing the possibility of being returned to prisons.⁸ The effort to improve COVID-19 conditions in prisons does not seem to be improving.
The case of the pandemic in prisons proves how prison health plays a crucial role in overall public health. While the Biden administration speaks of having a large commitment to improving the prison system, their recent actions and inaction are showing a move in the wrong direction. COVID-19 might have been the best chance at improving prison conditions around the world, but what will it take to maintain progress in the right direction?
References:
Covid-19: Protect incarcerated nebraskans. ACLU of Nebraska. https://www.aclunebraska.org/en/covid-19-protect-incarcerated-nebraskans. Published May 14, 2020. Accessed November 3, 2021.
Mass incarceration. American Civil Liberties Union. https://www.aclu.org/issues/smart-justice/mass-incarceration. Accessed November 3, 2021.
The COVID Prison Project. COVID Prison Project. https://covidprisonproject.com/. Published 2021. Accessed November 3, 2021.
Simpson PL, Butler TG. Covid-19, prison crowding, and release policies. BMJ. April 2020:m1551. doi:10.1136/bmj.m1551
Gulati G, Dunne CP, Kelly BD. Prisons and the COVID-19 pandemic. Irish Journal of Psychological Medicine. 2020;38(3):232-233. doi:10.1017/ipm.2020.65
Sharma D, Li W, Lavoie D, Lauer C. Prison populations drop by 100,000 during pandemic. The Marshall Project. https://www.themarshallproject.org/2020/07/16/prison-populations-drop-by-100-000-during-pandemic. Published July 16, 2020. Accessed November 3, 2021.
Criminal justice responses to the coronavirus pandemic. Prison Policy Initiative. https://www.prisonpolicy.org/virus/virusresponse.html. Published November 1, 2021. Accessed November 3, 2021.
Gaines P. Thousands were released from prison because of covid. will they have to return? NBCNews.com. https://www.nbcnews.com/news/nbcblk/thousands-released-prison-covid-will-return-rcna1977. Published September 13, 2021. Accessed November 3, 2021.
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