Pandemic Ethics in Prisons

Because of the rampant nature and deep impacts of the COVID-19 pandemic, this global crisis has not only created various new issues and considerations, but has exacerbated many prior societal concerns. In the past year, we have witnessed the shortcomings of medical supply, overburdened hospitals, and various instances of lack of compliance with CDC guidelines. However, despite the sudden acceleration of the novel coronavirus last year for everyone, this pandemic has had a vastly disproportionate impact on certain communities – one being incarcerated populations.

Of the 329 million people in the United States, 2.3 million people are incarcerated. However, this population is 5.5 times more likely than the general US population to contract COVID-19 and 3 times more likely to experience a consequent death (1). The higher rates of COVID-19 in the prison population are largely due to the living conditions of inmates and practices of correctional facilities to adapt to the pandemic.

Overcrowding has consistently plagued correctional facilities where there are more inmates than the facility was designed to house (2). This results in inadequate space per person which hinders the ability for inmates to maintain social distance. Further, the poor sanitation and ventilation within these facilities increases the risks of COVID-19 contraction within the inmate population.

Throughout their process in adapting to the COVID-19 pandemic, many states’ Department of Corrections have been inefficient in making decisions to help slow the spread of the virus. As of late August 2020, 30 states require staff to wear masks in correctional facilities, while only 15 require incarcerated people to wear masks. Regardless of requirements, there have been many instances of delayed provision of masks to inmates (3). Despite mask requirements, there have been many cases of non-compliance and a lack of accountability.  These practices, coupled with the limited COVID-19 testing opportunities provided in correctional facilities, place inmates at a significantly increased risk for the adverse impacts of COVID-19.

In context of the disproportionate impact of COVID-19 on the inmate population, the ethical concerns of mass incarceration are exacerbated through the implications of increased risk. In jails, many people who are detained are awaiting trial and have not yet been convicted of a crime (2). Despite the presumption of innocence in our legal system, these detainees are placed in an environment of inequitable health risk, where outcomes may largely center around if they have the money to post bail. Further, inmates are more likely to have infectious and chronic diseases, which render them immunocompromised and at greater risk for increased adverse effects due to COVID-19 (4). While incarcerated members of society have limited rights under the Constitution, they are still protected under the 8th Amendment, protecting them from cruel and unusual punishment and requiring that they are provided with a minimum standard of living (5). Thus, the adverse, potentially fatal, health implications of incarceration during the pandemic raises severe ethical concerns due to the undue harm experienced by inmates.

With the onset of distribution of COVID-19 vaccines, the CDC has provided recommendations for phased allocation of the vaccines, balancing their goals of minimizing death and adverse health outcomes, preserving societal function and alleviating the impact of COVID-19 on those who already face disparities (6). Based on these goals, they recommended correctional staff have access to the vaccine during phase 1b and encourage staff and incarcerated populations to be vaccinated during the same phase (6, 7). However, while the CDC can provide recommendations, vaccination plans are under state or local jurisdictions (7). While states have began to vaccinate corrections staff and inmates, Florida still has not provided vaccine access to inmates despite opening eligibility for all adults above the age of 16 (8).

Overall, the variations between different states and institutions in how they are prioritizing and handling the safety of incarcerated populations during the pandemic embody the lack of holistic action that could reduce the ethical concerns and potential adverse health outcomes. While some states like New Jersey and California have released some nonviolent offenders early during the earlier months of the pandemic, these releases do not address the larger systematic changes necessary in order to ensure the health and safety of the incarcerated population throughout the country (2). Further, despite vaccine distribution in correctional facilities beginning, the incarcerated population experienced disproportionate illness and death due to the pandemic over the past year and they are still experiencing these issues.

References:

1. Van Beusekom, Mary. “US Prison Inmates among Those Hit Hard with COVID-19.” CIDRAP, University of Minnesota Center for Infectious Disease Research and Policy, 9 July 2020, cidrap.umn.edu/news-perspective/2020/07/us-prison-inmates-among-those-hit-hard-covid-19.

2. “Covid-19's Impact on People in Prison.” Equal Justice Initiative, Equal Justice Initiative, 7 Jan. 2021, org/news/covid-19s-impact-on-people-in-prison/#:~:text=Most state prison systems show,in response to the pandemic.&text=More than 2%2C000 incarcerated people,prison population by about 35%.

3. Herring, Tiana, and Emily Widra. “Half of States Fail to Require Mask Use by Correctional Staff.” Prison Policy Initiative, Prison Policy Initiative, 14 Aug. 2020, prisonpolicy.org/blog/2020/08/14/masks-in-prisons/.

4. “Data and Statistics about Correctional Health.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 6 Mar. 2014, cdc.gov/correctionalhealth/health-data.html.

5. “Prisoners' Rights.” Legal Information Institute, Cornell Law School, 26 Dec. 2019, law.cornell.edu/wex/prisoners'_rights#:~:text=Although prisoners do not have,a minimum standard of living.

6. “When Vaccine Is Limited, Who Should Get Vaccinated First?” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 8 Jan. 2021, cdc.gov/coronavirus/2019-ncov/vaccines/recommendations.html.

7. “COVID-19 Vaccine FAQs in Correctional and Detention Centers.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 11 Jan. 2021, cdc.gov/coronavirus/2019-ncov/community/correction-detention/vaccine-faqs.html.

8. Klein, Ann Hinga, and Derek M. Norman. “Covid Outbreaks Devastated Prisons, but State Inmates' Access to the Vaccine Varies Widely.” The New York Times, The New York Times, 17 Mar. 2021, www.nytimes.com/2021/03/17/us/covid-prisoners-vaccine.html.