Brendan Saloner (
Camille Kramer, Johns Hopkins University.
Health Aff (Millwood). 2023 Jun;42(6):841-848. doi: 10.1377/hlthaff.2022.01473.
COVID-19 has been an unprecedented challenge in carceral facilities. As COVID-19 outbreaks spread in the US in early 2020, many jails, prisons, juvenile detention centers, and other carceral facilities undertook infection control measures such as increased quarantine and reduced outside visitation. However, the implementation of these decisions varied widely across facilities and jurisdictions. We explored how carceral decision makers grappled with ethically fraught public health challenges during the pandemic. We conducted semistructured interviews during May-October 2021 with thirty-two medical and security leaders from a diverse array of US jails and prisons. Although some facilities had existing detailed outbreak plans, most plans were inadequate for a rapidly evolving pandemic such as COVID-19. Frequently, this caused facilities to enact improvised containment plans. Quarantine and isolation were rapidly adopted across facilities in response to COVID-19, but in an inconsistent manner. Decision makers generally approached quarantine and isolation protocols as a logistical challenge, rather than an ethical one. Although they recognized the hardships imposed on incarcerated people, they generally saw the measures as justified. Comprehensive outbreak control guidelines for pandemic diseases in carceral facilities are urgently needed to ensure that future responses are more equitable and effective.
新冠肺炎疫情给监狱带来了前所未有的挑战。2020 年初，美国新冠肺炎疫情爆发，许多监狱、拘留所、少年拘留中心和其他监禁设施采取了感染控制措施，如增加隔离和减少外部探视。然而，这些决定在设施和司法管辖区的执行情况差异很大。我们探讨了监禁决策者在大流行期间如何应对道德上令人困扰的公共卫生挑战。我们在 2021 年 5 月至 10 月期间对来自美国各种监狱的 32 名医疗和安全领导人进行了半结构化访谈。尽管一些设施有现有的详细疫情暴发计划，但大多数计划都不足以应对新冠肺炎等快速演变的大流行。因此，设施经常制定即兴的遏制计划。为应对新冠肺炎疫情，隔离措施迅速在各个设施中得到实施，但实施方式并不一致。决策者通常将隔离和隔离协议视为后勤挑战，而不是道德挑战。尽管他们认识到被监禁者所承受的困难，但他们普遍认为这些措施是合理的。迫切需要为监禁设施制定大流行病全面爆发控制指南，以确保未来的应对措施更加公平和有效。
