MMWR Morb Mortal Wkly Rep. 2020 May 15;69(19):594-598. doi: 10.15585/mmwr.mm6919e3.
Correctional and detention facilities face unique challenges in the control of infectious diseases, including coronavirus disease 2019 (COVID-19) (1-3). Among >10 million annual admissions to U.S. jails, approximately 55% of detainees are released back into their communities each week (4); in addition, staff members at correctional and detention facilities are members of their local communities. Thus, high rates of COVID-19 in correctional and detention facilities also have the potential to influence broader community transmission. In March 2020, the Louisiana Department of Health (LDH) began implementing surveillance for COVID-19 among correctional and detention facilities in Louisiana and identified cases and outbreaks in many facilities. In response, LDH and CDC developed and deployed the COVID-19 Management Assessment and Response (CMAR) tool to guide technical assistance focused on infection prevention and control policies and case management with correctional and detention facilities. This report describes COVID-19 prevalence in correctional and detention facilities detected through surveillance and findings of the CMAR assessment. During March 25-April 22, 489 laboratory-confirmed COVID-19 cases, including 37 (7.6%) hospitalizations and 10 (2.0%) deaths among incarcerated or detained persons, and 253 cases, including 19 (7.5%) hospitalizations and four (1.6%) deaths among staff members were reported. During April 8-22, CMAR telephone-based assessments were conducted with 13 of 31 (42%) facilities with laboratory-confirmed cases and 11 of 113 (10%) facilities without known cases. Administrators had awareness and overall understanding of CDC guidance for prevention of transmission in these facilities but reported challenges in implementation, related to limited space to quarantine close contacts of COVID-19 patients and inability of incarcerated and detained persons to engage in social distancing, particularly in dormitory-style housing. CMAR was a useful tool that helped state and federal public health officials assist multiple correctional and detention facilities to better manage COVID-19 patients and guide control activities to prevent or mitigate transmission.
惩教和拘留设施在控制传染病方面面临着独特的挑战，包括 2019 年冠状病毒病（COVID-19）（1-3）。在美国每年超过 1000 万次的入狱人数中，每周约有 55%的被拘留者被释放回社区（4）；此外，惩教和拘留设施的工作人员也是其所在社区的成员。因此，惩教和拘留设施中 COVID-19 的高发病率也有可能影响更广泛的社区传播。2020 年 3 月，路易斯安那州卫生署（LDH）开始对路易斯安那州惩教和拘留设施中的 COVID-19 进行监测，并在许多设施中发现了病例和疫情。作为回应，LDH 和 CDC 开发并部署了 COVID-19 管理评估和应对（CMAR）工具，以指导针对感染预防和控制政策以及与惩教和拘留设施人员进行病例管理的技术援助。本报告描述了通过监测发现的惩教和拘留设施中 COVID-19 的流行情况和 CMAR 评估结果。在 3 月 25 日至 4 月 22 日期间，报告了 489 例实验室确诊的 COVID-19 病例，包括 37 例（7.6%）住院和 10 例（2.0%）死亡的被监禁或被拘留者，以及 253 例，包括 19 例（7.5%）住院和 4 例（1.6%）死亡的工作人员。在 4 月 8 日至 22 日期间，对 31 个有实验室确诊病例的设施中的 13 个（42%）和 113 个没有已知病例的设施中的 11 个（10%）进行了基于电话的 CMAR 评估。管理人员对 CDC 关于预防这些设施中传播的指南有认识和全面的了解，但在实施方面报告了挑战，这与隔离 COVID-19 患者的密切接触者的空间有限以及被监禁和被拘留者无法保持社交距离有关，特别是在宿舍式住房中。CMAR 是一种有用的工具，帮助州和联邦公共卫生官员协助多个惩教和拘留设施更好地管理 COVID-19 患者，并指导控制活动，以防止或减轻传播。
