COVID-19 policies in practice and their direct and indirect impacts in Northern California jails
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Abstract
Background
Although the increased risk of COVID-19 in carceral facilities is well documented, little is known about the practical barriers to infection control and indirect impacts of pandemic policies in these settings. Evidence in jails is especially scarce.
Methods
Between July 8, 2020 and April 30, 2021 we performed SARS-CoV-2 serology testing and administered a questionnaire among residents and staff in four Northern California jails. We analyzed seroprevalence in conjunction with demographic factors and survey responses of self-perceived COVID-19 risk, recent illness, COVID-19 test results, and symptom reporting behaviors. We additionally assessed COVID-19 policies in practice and evaluated their impacts on court dates, mental health, and routine health care. We engaged stakeholder representatives, including incarcerated individuals and their advocates, to guide study design, conduct, and interpretation.
Results
We enrolled 788 incarcerated individuals and 380 staff across four county jails. Most seropositive individuals had not previously tested positive for COVID-19, despite many suspecting prior infection. Among incarcerated participants, we identified deficient access to face masks and prevalent symptom underreporting associated with fears of isolation and perceptions of medical neglect in jail. Incarcerated participants also reported substantial hindrances to court cases and reductions in routine health care due to COVID-19. Incarcerated individuals and staff both cited worsened mental health due to COVID-19, which for incarcerated individuals was largely attributable to further isolation from loved ones and other pandemic restrictions on recreation and programming.
Conclusion
Perceptions of inadequate protection from COVID-19 were pervasive among incarcerated individuals. Simultaneously, restrictive measures compounded poor mental health and fostered fears of isolation that undermined effective infection control. Custody officials should work to systematically improve provision of masks, understand and mitigate fears and mistrust, and take proactive steps to minimize the detrimental impacts of restrictive policies on residents’ mental health and well-being.
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SciScore for 10.1101/2022.01.11.22269106: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: This study was approved by the Stanford University and Valley Medical Center Institutional Review Boards (protocol #56169 and #20-022, respectively). Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources Survey data were recorded in a HIPAA-secure REDCap database [27]. REDCapsuggested: (REDCap, RRID:SCR_003445)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the …SciScore for 10.1101/2022.01.11.22269106: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: This study was approved by the Stanford University and Valley Medical Center Institutional Review Boards (protocol #56169 and #20-022, respectively). Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources Survey data were recorded in a HIPAA-secure REDCap database [27]. REDCapsuggested: (REDCap, RRID:SCR_003445)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:According to custody health officials, incarcerated individuals could ask custody staff or medical personnel to exchange their soiled or torn mask for a new one without limitation. However, our findings suggest that in practice, access to new masks was extremely limited and highly variable across individuals. Relatedly, and perhaps consequently, most incarcerated participants felt unable to protect themselves from COVID-19. Our findings emphasize the need for systematic implementation and oversight of mask availability and distribution in these settings. Both counties surveyed here recognized the importance of jail de-densification to COVID-19 control and subsequently extended California’s emergency bail schedule for lesser charges, leading to population reductions of up to 45% [30, 31]. However, many who remained in custody experienced severe hindrances to their cases due to COVID-19, citing substantial delays and cancellations of court dates. These findings correspond to those of a recent investigation into the backlog of cases in California that has been exacerbated by COVID-19, which found that over a quarter of unsentenced jail residents in the two counties we studied had been in custody for more than a year awaiting arraignment, trial, or sentencing [32]. Beyond delays, our survey respondents also reported limits on court attendance, not only of witnesses but also of family and community members. As highlighted by our CAB, such attendance is essential for participatory ...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
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- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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