- Coronavirus outbreaks in prisons are a growing threat that could entirely overwhelm the healthcare system and seriously harm efforts to flatten the epidemic curve.
- Inmates are a high-risk group for an outbreak because they live in cramped, unsanitary conditions, have notoriously bad medical care, and a high percentage of them are old or have pre-existing conditions.
- Workers and visitors are in-and-out of prisons and similar detention facilities frequently, which also increases the risk of spread.
- In response, some states and countries are releasing prisoners to pre-empt the spread, while prison breaks over coronavirus fears and anger continue to occur in other places.
Incarceration and the Coronavirus
With the influx of constant news about the coronavirus, there is a huge population of people who are being left out of most mainstream conversations— prisoners.
But here’s the thing: it is incredibly important to include prisoners in discussions about coronavirus and public health for a number of reasons.
This is especially true for the U.S., which has the highest incarceration rates in world by far, holding around 2.3 million people in prisons, jails, psychiatric hospitals, immigration detention centers, and other similar facilities.
According to the Prison Policy Initiative, even the states with the lowest incarceration rates still lock up more people than nearly every other country in the world.
This is not just a human rights and criminal justice reform issue, but a public health issue as well.
Incarceration facilities are exceptionally high risk when it comes to the spread of the coronavirus. Just think about it: the vast majority of incarcerated people can not social distance. In U.S. prisons, multiple people share cells, bathrooms, eating areas, and laundry facilities.
On top of that, most inmates live in highly unsanitary conditions. Oftentimes toilets do not have lids and double as sinks where people wash their hands and brush their teeth. In some places, soap might only be available for purchase at the commissary.
That in itself discourages proper hygiene, and it is exacerbated by the fact that most prisons do not allow hand sanitizer because of its alcohol content.
These circumstances are made worse by a number of other structural issues. Prisoners are notoriously underserved medically. In many places, basic medical care is often delayed or denied.
Those factors make it even more likely that there could be a situation in which the virus is either rapidly spreading undetected or brushed off as the flu.
Further complicating matters is the fact that a large percentage of prisoners are already considered at-risk populations.
According to the New York Times, around 40% of incarcerated people suffer from chronic health conditions — meaning some of them are immunocompromised — and there are about 274,000 people that are 50 or older in state and federal prisons.
Risk to the Curve & Public Health
Another major concern with the coronavirus and prisons is the high potential for spillover to the communities outside of facilities if there were to be an outbreak.
At most prisons, there are countless people going in and out everyday including employees, health care workers, vendors, visitors, educators and more. In some towns, the local jail or prison is a major employer.
Even beyond that, the jail population itself is exceedingly transitory: more than half of the people in jails are only in there for two or three days.
There is also significant overlap between incarcerated and homeless populations.
“Someone released from a jail, then, could infect people in a homeless shelter, or vice versa, causing an outbreak that could bounce back and forth between both places, infecting far more people than would be in a jail or homeless shelter alone,” said Tyler Winkelman, a doctor and researcher at the University of Minnesota who focuses on health care and criminal justice.
As a result, an outbreak in a prison or similar facility poses a serious threat to public health and efforts to fight the coronavirus.
“Coronavirus in these settings will dramatically increase the epidemic curve, not flatten it, and disproportionately for people of color,” said Dr. Homer Venters, the former chief medical officer of the New York City jail system.
Failure to flatten the curve could prolong the need for everyone to practice social distancing and isolation.
Examples in States & Other Countries
Unfortunately, when it comes to coronavirus outbreaks in prisons, most experts believe it is a matter of when not if— but there is still time to prepare.
Most experts suggest pretty basic solutions, like making hand washing and other good hygiene practices easier and more accessible. Others also recommend canceling activities and non-medical visits, especially near areas that already have an outbreak.
Some experts also point to recent guidance by the Washington Association of Sheriffs and Police Chiefs. In addition to increased screenings, the guidance also recommends some more unconventional possibilities, like releasing some inmates either permanently or temporarily and asking police to consider scaling down arrests for certain crimes to avoid adding more people to the mix.
There are already some places that are taking precautions. Last week, the Federal Department of Correction announced visits from family, friends, and attorneys will be stopped in all 122 federal correctional facilities in the U.S.
After an employee at a correctional facility in Pennsylvania tested positive, 34 inmates and staffers were quarantined.
The New York City Department of Correction (NYCDOC) is screening people for flu-like symptoms and looking at other measures. Those practices will likely be increased, as it was reported Monday that a NYCDOC investigator died from the coronavirus.
Some places have even started releasing inmates. Hundreds of inmates were released from a county jail in Ohio over the weekend.
The Los Angeles County Sheriff’s Department also announced Monday that it is also releasing some inmates as well as cutting down on how many people it puts in custody.
Iran, which has the third-highest number of confirmed cases after China and Italy, has temporarily released a total of 85,000 prisoners since last week.
There is pressure in other countries too. Last week, Italy experienced several jailbreaks, specifically in Milan, after prisoners rioted over concerns that they were not being properly cared for amid the outbreak.
According to reports, 16 prisoners were able to break free and are still at large.
In Brazil, hundreds of prisoners escaped from four different prisons on Monday, reportedly over fears of coronavirus and anger over Easter holidays and visits being canceled.
As more countries consider their options, experts hope that the U.S. will learn from the actions they take.
“We can learn what works in terms of mitigation from other countries who have seen spikes in coronavirus already,” said Winkelman. “But none of those countries have the level of incarceration that we have in the United States.”
See what others are saying: (Vox) (The New York Times) (CNN)
Trump Signs Order Allowing Former Troops to Be Called Upon for Coronavirus Fight
- President Trump signed an executive order that allows for former troops to be brought back to active duty to help fight the coronavirus pandemic.
- This is not an immediate order to call former service members back, but it is typically used when the military is in need of specific skill sets, like persons with high demand medical capabilities.
- Officials are still reviewing who might be activated.
- The order comes just days after the Army called upon former service members to voluntarily rejoin and help in the military’s response efforts. Over 14,000 have expressed interest as of Friday.
Trump Signs Executive Order
President Donald Trump signed an executive order Friday that allows the Pentagon to bring former U.S. troops and members of the National Gaurd and reserve back to active duty to help those already battling the county’s coronavirus outbreaks.
During his press conference Friday night, Trump said the decision allows the federal government “to mobilize medical, disaster and emergency response personnel to help wage our battle against the virus by activating thousands of experienced service members including retirees.”
“We have a lot of people, retirees, great military people — they’re coming back in,” Trump added.
What This Means
The executive order released by the White House states that anyone recalled can remain on active duty for up to 24 months straight. It provides the Department of Defense and the Department of Homeland Security the authority to order as many as 1 million individuals at one time, however, it is not an order to do so.
According to Pentagon spokesperson Jonathan Hoffman, the order applies to units and individual members in the National Guard and Reserves and certain Individual Ready Reserve members who are normally in an inactive status.
Hoffman said that decisions about who may be activated are still being reviewed, but he added, “Generally, these members will be persons in Headquarters units and persons with high demand medical capabilities whose call-up would not adversely affect their civilian communities.”
As of now, the Individual Ready Reserve contains 224,841 members, according to the Department of Defense, and nearly 11,000 of those members “have medical capabilities.”
“This is a dynamic situation, we do not currently have a projected number of expected activations, but the Department is now fully authorized to make activations as needed,” Hoffman said.
He also stressed that the departments would consult with state officials before using any National Gaurd Reserve Component units under the executive order.
Earlier this week, the Army called upon former service members to voluntarily rejoin and help in the military’s pandemic response efforts. The Army said the initial response has been positive, with at least 14,6000 people expressing interest as of Friday.
See what others are saying: (Politico) (CNN) (Fox News)
FDA Authorizes Portable Test Kit That Can Detect COVID-19 in 5 Minutes
- The FDA has approved the use of a new coronavirus test kit that can give positive results in as little as 5 minutes and negative results in 13, leaps faster than the hours and sometimes days laboratory tests normally take.
- The tests are run on a lightweight and small portable device that can be used in emergency rooms, urgent care clinics, and even outside hospital walls.
- Abbott, the medical device company that makes the kits, plans to send out 50,000 tests a day starting next week.
New Test Approved
The U.S. Food and Drug Administration gave Emergency Use Authorization to the medical device company Abbott for a new coronavirus test kit that gives results within minutes.
Abbott announced the news in a Friday press release, saying it plans to start delivering 50,000 tests a day beginning next week. The tests run on the company’s ID NOW platform, a portable device about the size of a small toaster than weights only 6.6 pounds.
Its portability means it can be used directly in an emergency room or urgent care clinic and even, “outside the traditional four walls of a hospital in outbreak hotspots.”
The company called it “the fastest available molecular point-of-care test for the detection of novel coronavirus(COVID-19), delivering positive results in as little as five minutes and negative results in 13 minutes.”
Second Rapid Test to Be Approved by FDA
The approval from federal health officials means that regulators were satisfied with the test’s validation data and are confident that its benefits outweigh any risk, like false positives or negatives.
The FDA’s approval marks the seconds time it has green-lit a fast working test that could accelerate testing across the country. Last week, it approved a 45-minute rapid point of care test by the molecular diagnostics company Cepheid. However, that test is primarily intended for emergency rooms and hospitals, not doctors’ officers or urgent care clinics.
Still, those turnaround times are leaps faster than the hours to days it takes most laboratory tests to bring results.
Medical Shortages Still Cause Concern
The approval of the Abbott test comes as cities across the nation battle with numbers of potential patients that surpass available tests and resources. Even with insufficient testing, the United States became the country with the largest number of reported cases of coronavirus on Thursday, exceeding China and Italy. By Friday, the U.S. hit more than 100,000 cases.
Many fear that shortages of other critical medical equipment, like masks and swabs, could stifle the new rapid test’s impact. That’s because the kit requires a swab sample collected from patients, and many health care facilities are running desperately low on the tools needed to safely collect those samples.
The Center for Disease Control issued guidance Tuesday that allows some patients to collect their own nasal swabs in health care facilities, in an effort to reduce the amount of protective equipment needed for health care workers.
On the opposite end, however, others note that fast and efficient testing can help medical professionals determine how much protective equipment they actually need to wear when interacting with a patient, as well as what kind of care to provide. Since this test can be done in a doctor’s office, it could even potentially help diagnose patients with mild or asymptomatic cases of the virus and help stop them from unknowingly spreading it.
Experts also say drastically increasing testing capacity can help get the economy back on track sooner. With increased testing, measures like keeping everyone at home could be replaced with more targeted identification and isolation of those infected.
EPA Limits Environmental Regulations During Coronavirus Crisis
- The U.S. Environmental Protection Agency announced Thursday that it is scaling back its enforcement of environmental rules during the coronavirus emergency as businesses face challenges like layoffs and accessibility issues.
- The temporary policy allows companies to monitor their own compliance with environmental laws, and the EPA said it will not issue penalties for violations of certain reporting requirements.
- Many critics slammed the move, arguing that it opens doors to excess pollution and does not prioritize the health and safety of people and wildlife.
- The EPA defended the policy, saying it has reserved its authorities for situations other than routine monitoring and reporting and will consider the pandemic’s impacts on a “case-to-case basis.”
The U.S. Environmental Protection Agency (EPA) says it will limit the enforcement of certain regulations as the coronavirus pandemic continues, leaving companies in charge of monitoring their own compliance with environmental laws.
The agency unveiled the temporary policy on Thursday, arguing that businesses are running into obstacles like layoffs and accessibility issues as the virus alters normal life across the nation.
“EPA is committed to protecting human health and the environment, but recognizes challenges resulting from efforts to protect workers and the public from COVID-19 may directly impact the ability of regulated facilities to meet all federal regulatory requirements,” EPA Administrator Andrew Wheeler said in a statement.
Under normal circumstances, companies must report when their facilities release a certain amount of pollution into the air or water. Now, that requirement will be put on hold for the time being.
“In general, the EPA does not expect to seek penalties for violations of routine compliance monitoring, integrity testing, sampling, laboratory analysis, training, and reporting or certification obligations in situations where the EPA agrees that Covid-19 was the cause of the noncompliance and the entity provides supporting documentation to the EPA upon request,” the policy states.
The agency also said it would exercise “discretion” in enforcing other environmental rules. It noted that the policy does not apply to criminal violations or hundreds of the country’s most toxic waste sites that fall under the Superfund act. The EPA also said it expects public water systems to maintain high standards.
“Public water systems have a heightened responsibility to protect public health because unsafe drinking water can lead to serious illnesses and access to clean water for drinking and handwashing is critical during the COVID-19 pandemic,” the policy says.
The memo said that the changes will apply retroactively beginning on March 13, with no set end date indicated.
Criticism of New Policy
Some, including people in the oil industry, had been asking for these regulations to be loosened, but others slammed the EPA’s choice, claiming it is too broad and lax.
Gina McCarthy, who headed the EPA under the Obama administration and is now president of the Natural Resources Defense Council, called the policy an “open license to pollute.”
Some called the changes “outrageous” and “evil,” accusing the EPA of prioritizing businesses over the health of individuals and wildlife.
Prominent figures in the climate change fight slammed the move as well.
“The EPA uses this global pandemic to create loopholes for destroying the environment,” teenage climate activist Greta Thunberg tweeted. “This is a schoolbook example for what we need to start looking out for.”
Others pointed out the irony of suspending rules that preserve air quality while a respiratory disease makes its rounds across the country.
“What part of, ‘air pollution increases our vulnerability to respiratory diseases LIKE CORONAVIRUS,’ is not clear, EPA?” one Twitter user wrote.
Defense of Policy
The EPA stood behind their move and did not agree with its classification as a dismissal of regulations.
“It is not a nationwide waiver of environmental rules,” Andrea Woods, an E.P.A. spokeswoman, told The New York Times. “For situations outside of routine monitoring and reporting, the agency has reserved its authorities and will take the pandemic into account on a case-by-case basis.”
Susan Parker Bodine, the EPA official who issued the policy, said that it does not excuse organizations from consequences if they do committ environmental violations.
“If you do have violations of your permit, you’re still obligated to meet your permit limits, you’re supposed to do everything possible,” Bodine told ABC. “And after the fact the agency will take that all into consideration but there isn’t a promise of no penalties in those kinds of situations.”
“If you have an acute risk, if you have an imminent threat … the facility has to come in and talk to their regulator, their authorized state or come into the agency,” she added. “And the reason for that is that we want to, we want to put all of our resources into keeping these facilities safe keeping communities safe.”