COVID-19 Case and Mortality Rates in the Federal Bureau of Prisons

Toblin, Robin L.; Hagan, Liesl M.

Introduction People living in correctional facilities are at high risk for contracting the novel coronavirus disease 2019 (COVID-19). To characterize the burden of COVID-19 in the Federal Bureau of Prisons, inmate testing, case, and mortality rates are calculated and compared with the U.S. Methods Bureau of Prisons data were derived from its inmate management system and a Bureau of Prisons COVID-19–specific database. U.S. data were derived from the Centers for Disease Control and Prevention and the U.S. Census. Data were aggregated from February to September 2020 and accessed in September and November 2020. Testing rates were calculated for both the Bureau of Prisons and U.S. Case and infection fatality rates were calculated overall and by institution and compared with the U.S. An age- and sex-standardized mortality ratio was calculated. Results The Bureau of Prisons tested more than half of its inmates (50.3%); its crude case and mortality rates were 11,710.1 and 77.4 per 100,000, respectively. Compared with the U.S., the case ratio was 4.7 and the standardized mortality ratio was 2.6. The infection fatality rate for both the Bureau of Prisons and U.S. was 0.7%. Among institutions that tested ≥85% of inmates, the combined infection fatality rate was 0.8% and ranged from 0.0% to 3.0%. Conclusions The Bureau of Prisons COVID-19 case rates and standard mortality ratio were approximately 5 and 2.5 times those in U.S. adults, respectively, consistent with prisons nationwide. High testing rates and standardized death reporting could result in a more accurate infection fatality rate in the Bureau of Prisons than the U.S. Testing and other mitigation strategies, including reducing the population, have likely prevented further transmission and mortality in the Bureau of Prisons.