COVID-19 in prisons – a major public health risk

Catherine Heard, Director of the World Prison Research Programme at the Institute for Crime and Justice Policy Research (ICPR) at Birkbeck, discusses the impact of COVID-19 on prison populations.

Prison

The coronavirus pandemic presents formidable challenges for prisons worldwide – challenges they will struggle to meet, with potentially grave consequences for the health of prisoners, prison staff, their families, and all of us.

This is a fast-moving situation: since the outbreak was declared a pandemic on 12 March, prisoners and prison staff have tested positive in several European countries, and prisoners have died in England and France. These cases will only be the tip of the iceberg globally. With prison health systems in so many parts of the world struggling to provide even basic healthcare, many sick prisoners and prison staff will not have been tested. Overcrowded and under-resourced prisons offer the perfect conditions for the rapid spread of any contagious disease, including COVID-19, within and beyond their confines.

Last year, we published a report examining the effects of failed penal policies through the lens of health. We showed that well over 60% of countries have overcrowded prison systems (based on information held on our World Prison Brief database). Our research included evidence from ten diverse jurisdictions across five continents. Prisoners spoke of extreme overcrowding (for example, 60 men sharing cells built for 20 in Brazil); inadequate medical treatment, with too few doctors to deal even with routine health issues let alone serious disease outbreaks; constant hunger; lack of fresh air and exercise; shared buckets instead of toilets; not enough fresh water or soap; having to eat while seated on the toilet due to lack of space in a shared cell.

These are the realities of prisons across the world. They provide important context for the World Health Organisation’s warning that global efforts to tackle the spread of the disease may fail without proper attention to infection control inside prisons.

How have prison systems around the world responded to the pandemic? Many prison authorities – including in England & Wales – have suspended visits to prisoners, and cancelled temporary release schemes. In Columbia, Brazil, India, Italy, Romania and Lebanon, prisoners have rioted at these measures and in protest at the life-threatening conditions in which they are being held. Prisoner deaths, escapes and widespread violence have been reported.

More recently, some governments have responded by releasing prisoners: in Turkey, legislation was passed to release 100,000 of the country’s roughly 286,000 prisoners; similar steps have been taken in Iran and are under consideration in the United States, Canada and Ireland. In England and Wales, the government has so far declined to do this, despite the severe challenges already facing our overcrowded prison estate.

Now, detailed guidance from WHO, running to 32 pages, should leave no government in doubt about the serious risks presented by the virus, and how to tackle them. It states: ‘The risk of rapidly increasing transmission of the disease within prisons or other places of detention is likely to have an amplifying effect on the epidemic, swiftly multiplying the number of people affected.’ It calls for ‘strong infection prevention and control measures, adequate testing, treatment and care’ and provides detail on what this means in practice.

The parlous state in which prisons find themselves throughout the world today will make it difficult for them to follow the guidance, as they lack the resources – human, material, and financial – with which to do so. Even before the pandemic they were struggling to provide basic sanitation and healthcare for those in their care, as our research has shown.

COVID-19 provides the clearest illustration yet that prison health is public health. It is more important than ever for our governments and prison administrations to abide by the principle, enshrined in international law, that prisoners have an equal right to health and healthcare. Realistically, the only way that most countries could afford to meet this obligation is by first reducing their use of incarceration. This means ruling out custody for less serious, non-violent offending; and reversing the recent growth in the length of prison sentences.

It also means cutting substantially the use of pre-trial detention.  In America, thousands of the country’s nearly half a million pre-trial detainees are in jail for no better reason than that they cannot afford bail – although senator Kamala Harris has called for this to end.

No one should be remanded in custody unless absolutely necessary. But, of the more than three million people in pre-trial detention across the world, a large proportion are there purely because they cannot afford bail, or their country’s courts are hopelessly backlogged (a situation that will only worsen as courts around the world are forced to stop hearing all but the most urgent matters because of the current health emergency). On 2 April, we will release the latest global data on pre-trial prisoner numbers. It will reveal a significant upward trend, and should provide a wake-up call for governments the world over.

All news items and other sources referred to in this piece can be accessed via a dedicated COVID-19 page on ICPR’s World Prison Brief database: https://www.prisonstudies.org/news/news-covid-19-and-prisons

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