COVID-19 dynamics in an Ohio prison

KhudaBukhsh, W.; Khalsa, S. K.; Kenah, E.; Rempala, G.; Tien, J. H.

Importance. Incarcerated individuals are a vulnerable population for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Understanding SARS-CoV-2 dynamics in prisons is crucial for curbing transmission both within correctional facilities and in the surrounding community. Objective. The purpose of this study was to identify transmission scenarios that could underly rapid, widespread SARS-CoV-2 infection among inmates in Marion Correctional Institution (MCI). Design. Publicly available data reported by the Ohio Department of Rehabilitation and Corrections (ODRC) was analyzed using mathematical and statistical models. Setting. We consider SARS-CoV-2 transmission dynamics among MCI inmates prior to and including April 16, 2020. Participants. This study uses de-identified, publicly available SARS-CoV-2 test result data for MCI inmates. Exposures. Inmates at MCI were considered exposed to potential infection with SARS-CoV-2. Main outcome and measures. Results from mass testing conducted on April 16, 2020 were analyzed together with time of first reported SARS-CoV-2 infection among MCI inmates. Results. Rapid, widespread infection of MCI inmates was reported, with nearly 80% of inmates infected within three weeks of first reported inmate case. These data are consistent with (i) a basic reproduction number greater than 14, together with a single initially infected inmate, (ii) an initial super-spreading event resulting in several hundred initially infected inmates, together with a basic reproduction number of approximately three, and (iii) earlier undetected circulation of virus among inmates prior to April. Conclusions and relevance. Mass testing data are consistent with extreme transmissibility, super-spreading events, or undetected circulation of virus among inmates. All scenarios consistent with these data attest to the vulnerabilities of prisoners to COVID-19.