Daniel C. Semenza, an assistant professor in the Department of Sociology, Anthropology and Criminal Justice at Rutgers—Camden, said a more centralized coronavirus disease (COVID-19) response is needed in prisons and jails.
He said prisons and jails are an example of states’ responses to COVID-19, which without any national mask mandate or federally enforced regulations, have been fragmented and disconnected.
"With rules regarding social distancing, personal protective equipment (PPE) provisions, visitation rights and so on, all these guidelines have been very patchwork in the same way the U.S. response has been very patchwork and caused numerous problems," he said.
The situation has been complicated further by the criminal justice system, which contains thousands of centers with different COVID-19 responses and degrees of punitive measures against the incarcerated population, Semenza said.
He said that as states continue to make up their own rules regarding COVID-19, the lack of consensus has bled into jails, making it hard to pin down and compare how every system is implementing PPE provisions.
Semenza said individuals in prisons and jails have been disproportionately affected by COVID-19 because the conditions in these facilities are perfect for an infectious disease to spread. People in jails and prisons remain together for long periods of time and often lack room to socially distance, he said.
"People who are in prisons and jails tend to have worse health already, as they have higher rates of asthma, diabetes (and) sexually transmitted diseases,” Semenza said. “They're already at risk the same way we think about older adults at risk for COVID-19 (due to) persisting health conditions."
Incarcerated individuals may have also previously engaged in lifestyles that lead to poor health conditions, such as smoking and substance abuse, he said. The combination of a population already at risk for COVID-19 and facilities ideal for the spread of infectious diseases explains some of the outbreaks at prisons and jails across the United States, Semenza said.
“Not only are they getting poorer (health) services once they’re in, but they’re (also) bringing poorer health into the facility that they’re coming into in the first place,” he said. “So it’s like a two-headed dragon in that way.”
Health conditions are not the only risk that incarcerated populations carry, Semenza said. After COVID-19 spread to the U.S., every state had to shut down visitation, meaning incarcerated people have lost their primary connection to the outside world. This has had an adverse effect on the incarcerated population, especially with the long length of the pandemic, he said.
In response, many states and prisons increased the number of phone and video calls allowed, with some states waiving the fee people in prison had to pay per call, Semenza said.
In conversations about the vaccine distribution for “at-risk” priority populations, the Centers for Disease Control and Prevention (CDC) has identified essential workers, health care workers, older persons and people with high-risk medical conditions as falling into this category. He said the incarcerated population is often not included in these conversations.
"People who've been incarcerated need to be high on that priority list, right along with health care workers and people who're in long-term assisted living facilities simply because they're in the riskiest place they can possibly be and they don't have agency in determining that access," Semenza said.
Considering jails and local facilities are run individually by states, he said a set of guidelines should be established that could come either from the CDC or the U.S. attorney general to lay down specific recommendations for visitation, masks and PPE provisions.
Semenza said it is most important to implement a federally driven mass testing policy, as every state is conducting COVID-19 tests differently, which has trickled down to prisons and jail reports.
With news revolving around the vaccine, he said the COVID-19 situation has appeared to be more hopeful, but the incarcerated population will continue to face adverse effects until there is a centralized policy for COVID-19 prevention.
“My worry is that people in prisons and jails will get lost in the shuffle and will be forgotten and held away longer from vaccines and the proper things that need to be done when really, they should be at the forefront,” Semenza said. “That’s not just good for them, it’s good for the rest of the country, it’s good for improving community spread and eradicating (COVID-19) as a whole.”