Quick Take: Management of COVID-19 in correctional and detention facilities

Isolation vs. quarantine, staff PPE guidelines and COVID screening were key considerations addressed during two recent webinars


Two recent webinars focused on guiding the management of COVID-19 in correctional and detention facilities.

The first webinar, Practical Correctional Considerations in Response to COVID-19, was presented by Liesl Hagan, an epidemiologist at the CDC, who gave recommendations on how to handle COVID-19 in correctional and detention facilities.

The second webinar, COVID-19 in Jails: Talk to the Experts, was presented by American Jail Association President Elias Diggins with recommendations for correctional facility management during the COVID-19 outbreak. Additionally doctors Stern and Akiyama discussed medical precautions and guidelines.

A Los Angeles County Sheriff's Department prisoner transportation bus leaves the Twin Towers Correctional Facility in Los Angeles on Wednesday, April 1, 2020. California plans to release inmates due to be paroled to free space in prisons in anticipation of a coronavirus outbreak. (AP Photo/Damian Dovarganes)
A Los Angeles County Sheriff's Department prisoner transportation bus leaves the Twin Towers Correctional Facility in Los Angeles on Wednesday, April 1, 2020. California plans to release inmates due to be paroled to free space in prisons in anticipation of a coronavirus outbreak. (AP Photo/Damian Dovarganes)

Memorable quotes on COVID-19 preparedness

“Now is the time for us as a country and as jail leaders to break down barriers and get together to discuss our response.” – Elias Diggins, president of the American Jail Association and Chief of Operations of the Denver Sheriff Department

“In this situation, prepare for the worst possible case scenarios and work backward from that.” – Elias Diggins

“Despite our best effort to slow the spread of COVID-19 and the many other infectious diseases, some way or another the virus is likely to infiltrate our facilities.” – Dr. Marc Stern, a general internist who specializes in correctional healthcare and is on the faculty at the University of Washington and University of Albany schools of Public Health

Top takeaways on correctional facility response to COVID-19

1. Start planning now

Things you need to start thinking about:

  • What is the plan for when the majority of your staff is sick or unable to work?
  • Where will you isolate inmates who test positive or have symptoms?
  • How much PPE do you have?
  • Should we release inmates who are at high risk (elderly, diabetics, those with respiratory conditions)?

2. Communication is key

Staff and inmates should be well aware of what’s happening, what the leaders are doing to help protect them and how they can prevent the spread of COVID-19. The CDC has posters available for printing and posting in facilities here.

Additionally, make sure you are in contact with your local public health department so that you can be current on what’s going on in your area and what interventions they are implementing.

3. Screening is critical

Staff, visitors and incoming inmates should all be screened for COVID-19. This includes:

  • Temperature check;
  • Asking if they’ve had any of the common symptoms (cough, fever, diarrhea, etc) in the past week;
  • Asking if they've had any contact with COVID-19 positive individuals in the past 14 days.

These procedures should occur in a specified area so that the individual can be checked before they enter more populous areas. For example, new inmates should be screened in the sallyport.

4. Isolation vs. quarantine

Isolation is for inmates who have symptoms or have tested positive, quarantine is for individuals who have been exposed to someone who is suspected/known to have COVID-19. These two groups shouldn’t be placed together! It’s important to separate those with known COVID-19 from those with suspected COVID-19. Additionally, inmates with symptoms should be wearing face masks.

5. Staff PPE guidelines

The following chart is based on CDC-recommended guidelines.

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6. When does medical isolation end?

Test-based strategy:

  • Fever-free for >72 hours (without fever-reducing medications) AND
  • Respiratory symptoms have improved AND
  • Tested negative in >2 consecutive respiratory specimens collected greater than >24 hours apart

Symptom-based strategy:

  • Fever-free for >72 hours (without fever-reducing medications) AND
  • Respiratory symptoms have improved AND
  • At least 7 days have passed since the first symptoms appeared

If a person had a positive test but never had symptoms:

  • At least 7 days have passed since the first positive COVID-19 test AND
  • The person has had no subsequent illness.

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