Briefing: Justice System Response to the Epidemiological Challenge of Coronavirus Covid-19 in the Community (DOWNLOAD AS PDF)
- Infectious diseases flourish in conditions of overcrowding, poor ventilation, dirty surfaces & a population with compromised health.
- Such conditions are often prevalent in prisons and are not confined to any one type of country. They tend to be worse in countries with higher inequalities. This applies equally to “rich” and “poor” countries. See prisonstudies.org for countries with high prison population rates: those nearer the top of the highest to lowest list are at higher risk.
- Prisons amplify infectious diseases and reflect them back into society. Countries with higher prison population rates are likely to experience more significant epidemiological events in the community, driven by higher use of imprisonment.
- Justice system response to Covid-19
- In the coming weeks, the priority should be to reduce the custodial population by as much as possible.
- Conditions tend to be worse in remand / pre trial prisons. The first step therefore should be to reduce the remand population. The best way to achieve this is for prosecutors to not ask for custodial remand where possible and for judges to not grant it.
- Next, accelerate early release. A major amnesty may create more problems than it solves. Therefore the focus should be on those eligible for parole/early release, followed by those detained for non violent offences with appropriate risk assessment. This should be relatively achievable in a system with good records.
- The aim should be to reduce the custodial population commensurately to what epidemiologists expect to be the Covid-19 infection rate in society. Since prisons amplify infectious diseases, this might likely only bring it into line with community levels of infection if that. Additional resources may need to be directed to community supervision.
- Freeing up sufficient capacity in this way is essential, as there are likely be significant staff shortages as officers and civilian staff self isolate or become sick. This has implications not only for health but for safety and security.
- The primary intervention is not a clinical one, but rather a policy one of depenalisation.
- Regime considerations
- Hygiene is very important in the prison setting. Colour coded cleaning schedules and other best practices for keeping communal, private and clinical areas clean are of high priority and should be at the top of housekeeping / maintenance planning.
- Time out of cell is crucial in terms of maintaining overall health, and prisoners should have sufficient room for exercise. Overcrowding and definitions of overcrowding are major considerations in this context.
- Clinical considerations
- Covid-19 affects those who are immunocompromised Many prisoners will have comorbidity with HIV, TB, hepatitis and other conditions. The prison population is also getting older. These are factors which will affect clinical planning: in prisons they will be amplified.
- The main intervention is a policy one: to depenalise as soon as possible, with prosecutors & judges taking the lead. Managers and staff in prisons in the meantime should focus on maintaining hygiene & doing what’s possible to mitigate the effects of overcrowding by means of regime planning.
Selected relevant experience
UNODC, UNAIDS, WHO: HIV & AIDS in Places of Detention, A toolkit for policymakers, programme managers, prison officers and health care providers in prison settings
International Encyclopedia of Public Health entry on Populations at Special Health Risk: Incarcerated
UNODC Framework for an Effective National Response: HIV/AIDS Prevention, Care, Treatment and Support in Prison Settings