Allied Health and Human Performance, University of South Australia, Australia.
Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
PLoS One. 2024 May 17;19(5):e0303062. doi: 10.1371/journal.pone.0303062. eCollection 2024.
Correctional centres (termed here 'prisons') are at high risk of COVID-19 and have featured major outbreaks worldwide. Inevitable close contacts, frequent inmate movements, and a disproportionate burden of co-morbidities mean these environments need to be prioritised in any public health response to respiratory pathogens such as COVID-19. We developed an individual-based SARS-CoV-2 transmission model for the prison system in New South Wales, Australia - incorporating all 33 correctional centres, 13,458 inmates, 578 healthcare and 6,909 custodial staff. Potential COVID-19 disease outbreaks were assessed under various mitigation strategies, including quarantine on entry, isolation of cases, rapid antigen testing of staff, as well as immunisation.Without control measures, the model projected a peak of 472 new infections daily by day 35 across the prison system, with all inmates infected by day 120. The most effective individual mitigation strategies were high immunisation coverage and prompt lockdown of centres with infected inmates which reduced outbreak size by 62-73%. Other than immunisation, the combination of quarantine of inmates at entry, isolation of proven or suspected cases, and widespread use of personal protective equipment by staff and inmates was the most effective strategy. High immunisation coverage mitigates the spread of COVID-19 within and between correctional settings but is insufficient alone. Maintaining quarantine and isolation, along with high immunisation levels, will allow correctional systems to function with a low risk of outbreaks. These results have informed public health policy for respiratory pathogens in Australian correctional systems.
惩教中心（此处称为“监狱”）极易感染 COVID-19，并且在全球范围内爆发了重大疫情。不可避免的密切接触、频繁的囚犯流动以及不成比例的合并症负担，意味着在应对 COVID-19 等呼吸道病原体的公共卫生应对中，这些环境需要优先考虑。我们为澳大利亚新南威尔士州的监狱系统开发了一种基于个体的 SARS-CoV-2 传播模型——纳入了所有 33 个惩教中心、13458 名囚犯、578 名医护人员和 6909 名狱警。在各种缓解策略下评估了 COVID-19 疾病爆发的可能性，包括入境检疫、病例隔离、快速抗原检测以及免疫接种。如果没有控制措施，模型预测到第 35 天，监狱系统每天将有 472 例新感染，到第 120 天所有囚犯将被感染。最有效的个体缓解策略是高免疫覆盖率和迅速封锁感染囚犯的中心，这将使疫情规模减少 62-73%。除免疫接种外，对入境囚犯进行检疫、隔离确诊或疑似病例以及广泛使用个人防护设备是最有效的策略。高免疫覆盖率可减轻 COVID-19 在惩教场所内和之间的传播，但单独使用是不够的。维持检疫和隔离以及高免疫水平将使惩教系统能够以低爆发风险运作。这些结果为澳大利亚惩教系统的呼吸道病原体公共卫生政策提供了信息。
