Researchers at the Department of Psychiatry, conducted a systematic review on managing outbreaks of highly contagious diseases in prisons, using 28 studies of investigations, which were all based in high-income countries with documented outbreaks of tuberculosis, influenza (types A and B), varicella, measles, mumps, adenovirus and COVID-19.
A number of challenges specific to managing infectious disease outbreaks in prisons were identified. Contact tracing in prisons is complicated by reluctance to disclose symptoms due to stigma, concerns about confidentiality, and fear of further restrictions, such as prolonged periods of medical isolation. Effective isolation and quarantine measures are difficult due to overcrowding, poor ventilation, sanitation and hygiene, which are common in many prisons. Prisons can easily become a reservoir for COVID-19 infection to the community as turnover is high and transmission can occur at multiple points including via staff.
In addition, people in prison have higher rates of many physical and mental health comorbidities, consistently shown to be more common than in community persons of similar age. Thus, the paper recommends a coordinated approach to managing outbreaks in these settings with prisons and public health authorities working closely.