1
|
Franchi C, Rossi R, Malizia A, Gaudio P, Di Giovanni D. Biological risk in Italian prisons: data analysis from the second to the fourth wave of COVID-19 pandemic. Occup Environ Med 2023; 80:273-279. [PMID: 36927731 DOI: 10.1136/oemed-2022-108599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 03/04/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND The management of COVID-19 in Italian prisons triggered considerable concern at the beginning of the pandemic due to numerous riots which resulted in inmate deaths, damages and prison breaks. The aim of this study is to shed some light, through analysis of the infection and relevant disease parameters, on the period spanning from the second to the fourth wave of the outbreak in Italy's prisons. METHODS Reproductive number (Rt) and Hospitalisation were calculated through a Eulerian approach applied to differential equations derived from compartmental models. Comparison between trends was performed through paired t-test and linear regression analyses. RESULTS The infection trends (prevalence and Rt) show a high correlation between the prison population and the external community. Both the indices appear to be lagging 1 week in prison. The prisoners' Rt values are not statistically different from those of the general population. The hospitalisation trend of inmates strongly correlates with the external population's, with a delay of 2 weeks. The magnitude of hospitalisations in prison is less than in the external community for the period analysed. CONCLUSIONS The comparison with the external community revealed that in prison the infection prevalence was greater, although Rt values showed no significant difference, and the hospitalisation rate was lower. These results suggest that the consistent monitoring of inmates results in a higher infection prevalence while a wide vaccination campaign leads to a lower hospitalisation rate. All three indices demonstrate a lag of 1 or 2 weeks in prison. This delay could represent a useful time-window to strengthen planned countermeasures.
Collapse
Affiliation(s)
- Cristiano Franchi
- Industrial Engineering, University of Rome Tor Vergata Engineering Macro Area, Roma, Italy
| | - Riccardo Rossi
- Industrial Engineering, University of Rome Tor Vergata Engineering Macro Area, Roma, Italy
| | - Andrea Malizia
- Department of Biomedicine and Prevention, University of Rome Tor Vergata Faculty of Medicine and Surgery, Roma, Italy
| | - Pasqualino Gaudio
- Industrial Engineering, University of Rome Tor Vergata Engineering Macro Area, Roma, Italy
| | - Daniele Di Giovanni
- Industrial Engineering, University of Rome Tor Vergata Engineering Macro Area, Roma, Italy.,UniCamillus, Rome, Italy
| |
Collapse
|
2
|
Ismail N, Tavoschi L, Moazen B, Roselló A, Plugge E. COVID-19 vaccine for people who live and work in prisons worldwide: A scoping review. PLoS One 2022; 17:e0267070. [PMID: 36084037 PMCID: PMC9462803 DOI: 10.1371/journal.pone.0267070] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/04/2022] [Indexed: 11/18/2022] Open
Abstract
Overcrowding, poor conditions, and high population turnover make prisons highly susceptible to COVID-19. Vaccination is key to controlling COVID-19, yet there is disagreement regarding whether people who live and work in prisons should be prioritised in national vaccination programmes. To help resolve this, we critically examine the extent, nature, and quality of extant literature regarding prioritisation of COVID-19 vaccinations for people who live and work in prisons. Using a scoping review as our methodological framework, we conducted a systematic literature search of 17 databases. From 2,307 potentially eligible articles, we removed duplicates and screened titles and abstracts to retain 45 articles for review and quality appraisal. Findings indicated that while most countries recognise that prisons are at risk of high levels of COVID-19 transmission, only a minority have explicitly prioritised people who live and work in prisons for COVID-19 vaccination. Even among those that have, prioritisation criteria vary considerably. This is set against a backdrop of political barriers, such as politicians questioning the moral deservingness of people in prison; policy barriers, such as the absence of a unified international framework of how vaccine prioritisation should proceed in prisons; logistical barriers regarding vaccine administration in prisons; and behavioural barriers including vaccine hesitancy. We outline five strategies to prioritise people who live and work in prisons in COVID-19 vaccination plans: (1) improving data collection on COVID-19 vaccination, (2) reducing the number of people imprisoned, (3) tackling vaccine populism through advocacy, (4) challenging arbitrary prioritisation processes via legal processes, and (5) conducting more empirical research on COVID-19 vaccination planning, delivery, and acceptability. Implementing these strategies would help to reduce the impact of COVID-19 on the prison population, prevent community transmission, improve vaccine uptake in prisons beyond the current pandemic, foster political accountability, and inform future decision-making.
Collapse
Affiliation(s)
- Nasrul Ismail
- School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Babak Moazen
- Department of Health and Social Work, Institute of Addiction Research (ISFF), Frankfurt University of Applied Sciences, Frankfurt/Main, Germany
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | | | - Emma Plugge
- UK Health Security Agency, London, United Kingdom
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| |
Collapse
|
3
|
Adamson JP, Smith C, Pacchiarini N, Connor TR, Wallsgrove J, Coles I, Frost C, Edwards A, Sinha J, Moore C, Perrett S, Craddock C, Sawyer C, Waldram A, Barrasa A, Thomas DR, Daniels P, Lewis H. A large outbreak of COVID-19 in a UK prison, October 2020 to April 2021. Epidemiol Infect 2022; 150:e134. [PMID: 35634739 PMCID: PMC9304949 DOI: 10.1017/s0950268822000991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/05/2022] [Accepted: 05/22/2022] [Indexed: 11/30/2022] Open
Abstract
Prisons are susceptible to outbreaks. Control measures focusing on isolation and cohorting negatively affect wellbeing. We present an outbreak of coronavirus disease 2019 (COVID-19) in a large male prison in Wales, UK, October 2020 to April 2021, and discuss control measures.We gathered case-information, including demographics, staff-residence postcode, resident cell number, work areas/dates, test results, staff interview dates/notes and resident prison-transfer dates. Epidemiological curves were mapped by prison location. Control measures included isolation (exclusion from work or cell-isolation), cohorting (new admissions and work-area groups), asymptomatic testing (case-finding), removal of communal dining and movement restrictions. Facemask use and enhanced hygiene were already in place. Whole-genome sequencing (WGS) and interviews determined the genetic relationship between cases plausibility of transmission.Of 453 cases, 53% (n = 242) were staff, most aged 25-34 years (11.5% females, 27.15% males) and symptomatic (64%). Crude attack-rate was higher in staff (29%, 95% CI 26-64%) than in residents (12%, 95% CI 9-15%).Whole-genome sequencing can help differentiate multiple introductions from person-to-person transmission in prisons. It should be introduced alongside asymptomatic testing as soon as possible to control prison outbreaks. Timely epidemiological investigation, including data visualisation, allowed dynamic risk assessment and proportionate control measures, minimising the reduction in resident welfare.
Collapse
Affiliation(s)
- James P. Adamson
- Centre for Disease Surveillance and Control, Public Health Wales, Cardiff, Wales, UK
- UK Field Epidemiology Training Programme, UK Health Security Agency, London, UK
| | | | | | - Thomas Richard Connor
- Pathogen Genomics Unit, Public Health Wales, Cardiff, Wales, UK
- Cardiff University School of Biosciences, Cardiff University, Cardiff, Wales, UK
| | | | | | | | | | - Jaisi Sinha
- Microbiology, Public Health Wales, Cardiff, Wales, UK
| | | | - Steph Perrett
- Health Protection Division, Public Health Wales, Cardiff, Wales, UK
| | | | - Clare Sawyer
- Centre for Disease Surveillance and Control, Public Health Wales, Cardiff, Wales, UK
- UK Field Epidemiology Training Programme, UK Health Security Agency, London, UK
| | - Alison Waldram
- UK Field Epidemiology Training Programme, UK Health Security Agency, London, UK
| | - Alicia Barrasa
- UK Field Epidemiology Training Programme, UK Health Security Agency, London, UK
| | - Daniel Rh. Thomas
- Centre for Disease Surveillance and Control, Public Health Wales, Cardiff, Wales, UK
| | | | | |
Collapse
|
4
|
Kim H, Hughes E, Cavanagh A, Norris E, Gao A, Bondy SJ, McLeod KE, Kanagalingam T, Kouyoumdjian FG. The health impacts of the COVID-19 pandemic on adults who experience imprisonment globally: A mixed methods systematic review. PLoS One 2022; 17:e0268866. [PMID: 35594288 PMCID: PMC9122186 DOI: 10.1371/journal.pone.0268866] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/09/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The prison setting and health status of people who experience imprisonment increase the risks of COVID-19 infection and sequelae, and other health impacts of the COVID-19 pandemic. OBJECTIVES To conduct a mixed methods systematic review on the impacts of the COVID-19 pandemic on the health of people who experience imprisonment. DATA SOURCES We searched Medline, PsycINFO, Embase, the Cochrane Library, Social Sciences Abstracts, CINAHL, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Sociology Database, Coronavirus Research Database, ERIC, Proquest Dissertations and Theses, Web of Science, and Scopus in October 2021. We reviewed reference lists for included studies. STUDY ELIGIBILITY CRITERIA Original research conducted in or after December 2019 on health impacts of the COVID-19 pandemic on adults in prisons or within three months of release. STUDY APPRAISAL AND SYNTHESIS METHODS We used the Joanna Briggs Institute's Critical Appraisal Checklist for Qualitative Research for qualitative studies and the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data for quantitative studies. We qualitized quantitative data and extracted qualitative data, coded data, and collated similar data into categories. RESULTS We identified 62 studies. People in prisons had disproportionately high rates of COVID-19 infection and COVID-19 mortality. During the pandemic, all-cause mortality worsened, access to health care and other services worsened, and there were major impacts on mental wellbeing and on relationships with family and staff. There was limited evidence regarding key primary and secondary prevention strategies. LIMITATIONS Our search was limited to databases. As the COVID-19 pandemic is ongoing, more evidence will emerge. CONCLUSIONS Prisons and people who experience imprisonment should be prioritized for COVID-19 response and recovery efforts, and an explicit focus on prisons is needed for ongoing public health work including emergency preparedness. PROSPERO REGISTRATION NUMBER 239324.
Collapse
Affiliation(s)
- Hannah Kim
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Emily Hughes
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Alice Cavanagh
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Emily Norris
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Angela Gao
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Susan J. Bondy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Katherine E. McLeod
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Tharsan Kanagalingam
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | | |
Collapse
|
5
|
Vicente-Alcalde N, Ruescas-Escolano E, Franco-Paredes C, Tuells J. Control of a COVID-19 Outbreak in a Spanish Prison: Lessons Learned in Outbreak Control. Front Med (Lausanne) 2022; 9:806438. [PMID: 35391892 PMCID: PMC8981719 DOI: 10.3389/fmed.2022.806438] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 02/18/2022] [Indexed: 12/05/2022] Open
Abstract
The rapid spread of highly transmissible respiratory infections in carceral settings occurs due to their conglomerate nature. The COVID-19 pandemic has resulted in large outbreaks in jails and prisons in many settings. Herein, we describe an outbreak of SARS-CoV2 infection in a prison in Alicante, Spain. Prior to January 2021, testing for coronavirus infection was not widely available in jails and prisons nationwide. Offering of testing services in Spanish carceral facilities, coincided with the deployment of COVID-19 vaccination in the larger community. However, COVID-19 vaccine role out of incarcerated individuals occurred later during the deployment plan. With the identification of the initial cases of this outbreak, two units of the facility were assigned for population management: one for inmates with confirmed infection by positive PCR detection of SARS-COV-2 infection in nasopharyngeal swabs. Inmates with confirmed exposure and thus considered close contacts were place in a second isolation unit. Functional quarantine was employed in some instances. A reactive testing strategy was instituted at baseline, and at 7 and 14 days of nasopharyngeal specimens by PCR. A total of 1,097 nasopharyngeal specimens were obtained for PCR testing during the outbreak, which lasted a total of 80 days between the index case the end of medical isolation of the last case. A total of 103 COVID-19 cases were identified during the outbreak. Of these, three inmates developed severe manifestations requiring hospitalization, and one died. Were identified, among which there were three hospitalized and one deceased. Among cases and confirmed contacts, we conducted close clinical monitoring, symptom screening, and daily temperature checks. The implementation of these interventions along with early medical isolation of cases, quarantining of contacts, and interval testing to detect presymptomatic or asymptomatic cases were instrumental in containing this outbreak.
Collapse
Affiliation(s)
- Nancy Vicente-Alcalde
- Penitentiary Center Alicante II, General Secretariat of Penitentiary Institutions, Villena, Spain
| | | | - Carlos Franco-Paredes
- Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
- Hospital Infantil de Mexico, Federico Gomez, Mexico City, Mexico
| | - José Tuells
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain
- *Correspondence: José Tuells
| |
Collapse
|
6
|
Mazzilli S, Tavoschi L, Soria A, Fornili M, Cocca G, Sebastiani T, Scardina G, Cairone C, Arzilli G, Lapadula G, Ceccarelli L, Cocco N, Bartolotti R, De Vecchi S, Placidi G, Rezzonico L, Baglietto L, Giuliani R, Ranieri R. COVID-19 Infection Among Incarcerated Individuals and Prison Staff in Lombardy, Italy, March 2020 to February 2021. JAMA Netw Open 2022; 5:e224862. [PMID: 35353164 PMCID: PMC8968466 DOI: 10.1001/jamanetworkopen.2022.4862] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
IMPORTANCE Owing to infrastructural and population characteristics, the prison setting is at increased risk for transmission of SARS-CoV-2 and for severe clinical outcomes. Because of structural and operational reasons, research in prison settings is challenging and available studies are often monocentric and have limited temporal coverage; broader-based research is necessary. OBJECTIVES To assess the extent and dynamics of the COVID-19 pandemic within the prison system of a large Italian region, Lombardy, and report the infection prevention and control measures implemented. DESIGN, SETTING, AND PARTICIPANTS This repeated cross-sectional study was carried out from March 1, 2020, through February 28, 2021 (first wave, March-June 2020; second wave, October 2020-February 2021) in the prison system of Lombardy, which includes 18 detention facilities for adults. All incarcerated persons and the prison staff of the penitentiary system of the Lombardy region participated in the study. EXPOSURES The main exposures of interest were the weekly average number of incarcerated individuals placed in quarantine in single or shared isolation rooms, the rate of sick leave by symptomatic and asymptomatic prison staff reported to the prison occupational medicine department on a weekly basis, and the level of overcrowding. MAIN OUTCOMES AND MEASURES The primary outcome measures were weekly COVID-19 crude case rates, weekly test positivity rate, and the relative risk of acquiring the infection for prison staff, incarcerated persons, and the general population. RESULTS The study population comprised a mean of 7599 incarcerated individuals and 4591 prison staff. Approximately 5.1% of the prison population were women; demographic characteristics of the prison staff were not available. During the study, COVID-19 occurred in 1564 incarcerated individuals and 661 prison staff. Most of these cases were reported during the second wave (1474 in incarcerated individuals, 529 in prison staff), when stringent measures previously enforced were relaxed. During both epidemic waves, incarcerated individuals and prison staff had a higher relative risk for COVID-19 infection than the general population during both the first wave (incarcerated individuals: 1.30; 95% CI, 1.06-1.58; prison staff: 3.23; 95% CI, 2.74-3.84) and the second wave (incarcerated individuals: 3.91; 95% CI, 3.73-4.09; prison staff: 2.61; 95% CI, 2.41-2.82). CONCLUSIONS AND RELEVANCE The findings of this study suggest that the prison setting was an element of fragility during COVID-19 pandemic, with a high burden of COVID-19 cases among both the incarcerated individuals and prison staff. The prison setting and prison population need to be included and possibly prioritized in the response during epidemic events.
Collapse
Affiliation(s)
- Sara Mazzilli
- Scuola Normale Superiore, Pisa, Italy
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Alessandro Soria
- Clinic of Infectious Diseases, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Marco Fornili
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giorgia Cocca
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Teresa Sebastiani
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Giuditta Scardina
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Cristina Cairone
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Guglielmo Arzilli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giuseppe Lapadula
- Clinic of Infectious Diseases, San Gerardo Hospital, ASST Monza, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Luca Ceccarelli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Nicola Cocco
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Raffaella Bartolotti
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Stefano De Vecchi
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Giacomo Placidi
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Leonardo Rezzonico
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Laura Baglietto
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Ruggero Giuliani
- Infectious Diseases Service, Penitentiary Health System, San Vittore Prison Health Unit, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, Milan, Italy
| | - Roberto Ranieri
- Welfare General Directorate, Lombardy Regional Health Authority, Milan, Italy
| |
Collapse
|