COVID-19 Preventive Measures in Northern California Jails: Perceived Deficiencies, Barriers, and Unintended Harms
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (ScreenIT)
Abstract
Carceral facilities are high-risk settings for COVID-19 transmission. Little is known about the hidden burden of infection or practical barriers to infection control in these settings, especially in jails. There is also limited research on the mental health impacts of the pandemic among people living and working in carceral facilities.
Methods
Between July 8, 2020 and April 30, 2021, we performed SARS-CoV-2 rapid antibody testing and administered a questionnaire among residents and staff of four Northern California jails. We utilized multivariable logistic regression, adjusting for demographic and carceral characteristics, to analyze factors associated with prior infection, including perceived likelihood of prior infection and access to new masks. We additionally assessed the implementation of, perceptions toward, and impacts of COVID-19 policies in practice. We engaged stakeholder representatives, including incarcerated individuals, to guide study design, procedures, and results interpretation.
Results
We enrolled 788 jail residents and 380 jail staff. Nearly half of residents and two-thirds of staff who were antibody-positive had not previously tested positive for COVID-19. Among residents without a prior COVID-19 diagnosis, antibody positivity was significantly associated with perceived likelihood of prior infection (adjusted OR = 8.9; 95% CI, 3.6–22.0). Residents who had flu-like illness in jail cited inadequate responses to reported illness and deterrents to symptom reporting, including fears of medical isolation and perceptions of medical neglect. Residents also disclosed deficient access to face masks, which was associated with antibody positivity (adjusted OR = 13.8, 95% CI, 1.8–107.0). Worsened mental health was pervasive among residents, attributed not only to fear of COVID-19 and unsanitary jail conditions but also to intensified isolation and deprivation due to pandemic restrictions on in-person visitation, programs, and recreation time.
Conclusion
Carceral settings present significant challenges to maintaining infection control and human rights. Custody officials should work diligently to transform the conditions of medical isolation, which could mitigate deterrents to symptom reporting. Furthermore, they should minimize use of restrictive measures like lockdowns and suspension of visitation that exacerbate the mental health harms of incarceration. Instead, custody officials should ensure comprehensive implementation of other preventive strategies like masking, testing, and vaccination, in conjunction with multisector efforts to advance decarceration.
Article activity feed
-
-
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.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
-
-