©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. 2 www.unodc.org

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