©ICRC
BACKGROUND
The COVID-19 pandemic constitutes a crisis unlike any in the 75-year history of the United
Nations. The virus which causes the disease is highly contagious, and even asymptomatic people
can infect others. Pending the development of a vaccine and specific medication, the world is
mobilizing to “flatten the curve” of further infections, including through unprecedented public
health interventions aimed at community-wide physical distancing. While doing so, we must
ensure that more attention is paid to marginalized segments of our societies who are at particular
risk of infection, in particular when they live close together, with a high potential for transmission. Places of deprivation of liberty undoubtedly constitute high-risk environments for those
who live and work there.
Prisoners and prison personnel are at-risk groups for COVID-19
By definition, prisoners live, work, eat (and often sleep) in close proximity within strictly
restricted areas. It is alarming to recall that in another confined setting, on board the cruise
ship Diamond Princess, around 700 of the 3,700 passengers and crew members tested positive
for COVID-19 in February 2020 following almost one month of quarantine at sea off Japan.
What aggravates the risk and potential impact of the coronavirus entering prisons even further
is the health profile of prison populations, which tends to be significantly lower when compared
to the community at large. This includes a higher prevalence of communicable diseases, such as
tuberculosis, hepatitis C and HIV, as well as non-communicable diseases, such as mental health
and drug use disorders. Due to their close interaction with prisoners on a daily basis, officers and
health-care professionals working in prisons are equally exposed to an enhanced risk of infection.
Prisons are hazardous environments as regards COVID-19
The systemic neglect of prisons and other places of detention in many countries has resulted
in inadequate resources, management, oversight and accountability mechanisms, including illequipped personnel and limited linkages to public health systems. Prison overcrowding persists
in most countries and constitutes one of the most fundamental obstacles to providing safe and
healthy custodial environments in line with fundamental human rights. Cramped accommodation areas, poor hygiene, ventilation and nutrition as well as insufficient health-care services in
many prison systems will equally undermine infection control measures and thus significantly
increase the risk for infection, amplification and spread of COVID-19.
Prison health is public health
The vast majority of prisoners will eventually return to their communities. There should be no
doubt, therefore, that the scenario of a rapidly increasing transmission of COVID-19 within
prison systems will have an amplifying effect on the epidemic within the general public. The
high turnover of prisoners being admitted and released as well as the daily interaction of
prisoners with prison officers, health-care professionals, visitors and service providers all provide for an intrinsic linkage between prisons and public health. On these grounds, any control
strategy for COVID-19 in the community which does not encompass the prison context will
not be sustainable.
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