In February of 2020, Community Oriented Correctional Health Services (COCHS) knew that that a recently named novel virus was going to prove the central thesis of our mission: that public health and public safety are inextricably entwined. Early in the pandemic, we sketched out the ways in which the criminal-legal system would need to engage with the public health systems in order to create solutions for those stuck behind the walls of the jail. COCHS lent its expertise to jurisdictions as they crafted emergency Medicaid waivers, requested technical assistance to convene community providers, and ran through the litany of non-pharmaceutical interventions that could prevent the virus’ spread while incarcerated and during decarceration. Throughout this process, we witnessed what happens when discrete health systems ignore the reality that the health of people on both sides of the bars are intimately tied. Now, with these lessons in hand, we have the opportunity to build better systems that respond to the critical health needs of incarcerated individuals, while simultaneously remedying the historical wrongs that create disparate impacts in our health and criminal legal systems.

COVID-19 hit jails and prisons particularly hard. Under normal conditions, carceral settings are ideal environments for infectious disease spread. Due to the massive overcrowding of jails and prisons, these sites serve as loci of outbreaks that cannot be contained. In the early days of COVID-19, one in six cases in Illinois could be traced back to the Cook County Detention Center. In December, a study from Prison Policy Initiative revealed that over 500,000 cases could be traced back to out-of-control spread at correctional facilities. If it were not clear to policymakers before, COVID-19 demanded careful reexamination of how public health agencies incorporate correctional facilities into their public health planning.

The disparities continued as states weighed which populations should be prioritized for vaccines. Many classified people in jails and prisons differently from people in living facilities. For example, Colorado initially placed incarcerated people into priority categories, but after facing public backlash, deprioritized these individuals, despite the science targeting high-risk settings remaining the same. Even to this day, as variant waves sweep through facilities and vaccine uptake is low, people in jail and prison are often falsely seen as being uniquely unreachable through public health interventions, such as peer support and learning from friends and family about why to vaccinate.

Read the full article about correctional and community care by Dan Mistak at Grantmakers In Health.