COVID-19 in U.S. Prisons and Jails, Early 2020: The First National Count

On any given day, an estimated 2.1 million U.S. adults are held in approximately 5,000 correctional and detention facilities — prisons, which hold people sentenced to more than a year, and jails and detention centers, which hold people awaiting trial, sentencing or deportation, usually for less. These places are hard to protect from a fast-spreading virus like SARS-CoV-2:

• crowded dormitories and shared bathrooms
• limited medical care and space to isolate the sick
• staff and visitors coming and going every day
• a constant flow of newly admitted people
• transport in shared vehicles to court, medical appointments or other facilities

The first count

In late April 2020, CDC asked all 54 state and territorial health departments for data on laboratory-confirmed COVID-19 cases in state, local and federal facilities — including those of U.S. Immigration and Customs Enforcement, the U.S. Marshals Service and the Federal Bureau of Prisons — reported from January 21 to April 21, 2020. 37 (69%) responded, and 32 of them reported at least one case.

The cases came from 420 facilities. Among the 32 jurisdictions, the median number of affected facilities was 10 (range 1–59).

Staff as a way in

More than half the affected facilities — 221 (53%) — reported cases only among staff. Because staff move between facilities and their communities every day, they may be an important route by which the virus gets in.

What helps

• Symptom screening of staff, new arrivals and people returning from court or medical visits.
• Screening quarantined close contacts twice a day and isolating anyone with symptoms at once.
• But screening is not enough: in a nursing home outbreak, about half the cases found by facility-wide testing had no symptoms yet, and likely spread the virus. So CDC also recommended physical distancing, movement restrictions, cloth face coverings, intensified cleaning and disinfection of shared surfaces, and infection control training for staff.
• Some jurisdictions reduced crowding by reducing or eliminating bail and releasing people to home confinement or community supervision.
• Testing could become an important tool once more widely available, with plans for using the results.

Protecting people inside these facilities also protects staff and the communities people return to.

Limits

The count is almost certainly too low:

• only 69% of jurisdictions reported
• many facilities did not test staff, relying on them to report diagnoses
• some jurisdictions had data only from state prisons, not local jails or federal and private facilities
• totals of facilities, people held and staff were unknown, so rates couldn’t be calculated
• one jurisdiction counted only outbreaks of more than one case
• differences in testing between states couldn’t be measured

Sources

Based on Wallace M, Hagan L, Curran KG, et al., "COVID-19 in Correctional and Detention Facilities — United States, February–April 2020," MMWR Vol. 69, No. 19, CDC (as corrected); a work of the United States government in the public domain.