The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19

Eric Lofgren; Kristian Lum; Aaron Horowitz; Brooke Madubuowu; Nina Fefferman

Having considered these potential strategies for categorical reduction in intake into 316 jails, we also considered the case in which the categorical consideration for reduction in 317 intake stemmed instead from the health of the arrested person. In this case, we get the 318 expected reduction in the within-jail outbreak that would have been associated with a 319 general reduction of the same percent intake (≈36.9%, allowing for a small number of 320 incarcerations in these groups), but we fail to achieve any significant reduction in 321 disease burden in the broader community by taking this action. It is therefore more 322 effective to reduce the intake rate across the entire population than to attempt to single 323 out particular categories of individuals due to their likely susceptibility to severe 324 morbidity or mortality from infection. The larger the reduction in overall intake, the 325 greater the reduction in disease achieved for all populations (incarcerated people, the 326 broader community, and jail staff, in decreasing proportion of effect). These broader 327 interventions are also likely to be relatively straightforward to implement 328 administratively, without knowledge of an individual's underlying comorbidities, if any. 329 In addition to reducing rates of intake into the jail system, another obvious, concrete 330 step we might take to reduce disease risks for everyone is to increase the rate of release 331 from jails. This should clearly be coupled with a decreased rate of intake rather than 332 enacted in isolation, since increasing release rates while maintaining the same rate of 333 intake would increase infection risks for incarcerated people, the staff who work at the 334 jails and court systems, and the broader community. This may even still occur when 335 expedited release is coupled with decreased rates of intake if the rate of release is To be maximally effective, each of these interventions should anticipate, rather than 340 react to, widespread infection incidence in jail populations.