You Need a Plan for Corona virus in your Facility

Unless you’ve been living under a rock, you have been hearing about the threat of a Corona virus pandemic. Every day, the evening news anchor breathlessly gives an update of the number of new cases, the number of new countries affected and the number of new deaths.  You probably already know that this disease was originally found in China.  What you may not know (but you should if you work in corrections) is that Chinese prisons were especially hard hit.  This disease spreads most rapidly where people are enclosed together, like nursing homes, cruise ships and prisons.  If this disease gets a foothold in the United States, correctional institutions are likely to suffer. 

What we are talking about is officially known as “Covid-19.”  Covid -19 is the disease, not the virus.  The official name of the virus is “SARS-CoV-2,” better and more memorably known as “Novel Corona Virus.”  Corona virus has been around forever; it is one of the viruses that cause the common cold, a nuisance but hardly a pandemic concern.  However, viruses sometimes mutate and that is what this particular Corona virus did, becoming a new, or novel, Corona virus.  The Novel Corona Virus makes people sicker than the old version and also is more easily transmitted from person-to-person.  These two properties have turned the disease, Covid-19, into a global threat.

Once exposed to Corona Virus, people usually begin show symptoms 2-14 days later.  CoVid-19 is characterized by fever, cough, shortness of breath and body aches and so can be confused with influenza.  Most people who get Covid-19 have only a mild illness, but around 15% get very sick and around 2.5% die.

Corona virus’s ability to spread quickly from one person to another is one of its most prominent features. This virus is transmitted person-to-person in two ways: first, by a sick person coughing or sneezing droplets into the air and another person inhaling the droplets, and second, the virus gets on an inanimate object like a doorknob and is spread to the next person who touches the doorknob. The virus is spread mainly by people with Covid-19 who are clearly sick and coughing but also may be spread before an infected person knows that they are sick. The best way to prevent transmission is to quarantine infected people, which countries hardest hit by Covid-19 are trying to do.

There is no vaccine or antiviral drugs for Covid-19 at this time. Once someone gets sick with Covid-19, only supportive care can be given.  This means that preventing exposure is the single most important thing that people can do.  To protect yourself, you should take the following precautions:

  1.  Get a flu vaccination.  Since Covid-19 closely resembles the flu, it makes sense to try to eliminate this source of confusion.
  2. Wash your hands frequently
  3. Clean surfaces you regularly touch often.
  4. Don’t wear a mask if you are not sick!  According to the Centers for Disease Control (CDC), masks don’t help uninfected people.
  5. If you get sick with a coughing/sneezing illness, don’t go to work.
  6. If you get very sick, go to the doctor, where you may be tested for Covid-19. 

Since Covid-19 is spreading so rapidly worldwide, there are fears that it may become a pandemic.  If Covid-19 gets to your region, there is a very good chance that it will show up in correctional facilities.   We need to be prepared in advance. I recommend the following.

  1.  Each correctional facility should assign one person to be responsible for Covid-19 preparedness. I’ll call that person the Infection Control Supervisor.  Their job is to coordinate a response to a Covid-19 epidemic (or any other epidemic, for that matter).  If necessary, the Infection Control Supervisor may appoint an Infection Control Committee to assist in preparedness and to share committee responsibilities. 
  2. Meet with the District Health Department.  If a Covid-19 epidemic hits, the Health Department will be in charge of the overall response.  They need to know who to contact at the correctional facility and the Infection Control Supervisor needs to know who to contact at the District Health Department.
  3. Set up a meeting at your correctional facility to talk about Covid-19 preparedness. The Infection Control Committee should be there (of course) but also a representative of facility administration, and ideally someone from the regional health department and a representative of the hospital where you will send your sickest inmates. 
  4. Create a plan on how you are going to handle Covid-19 at your facility.  The plan should include obtaining necessary supplies, when to begin screening (usually when the Health Department tells you to), how and where you are going to quarantine infected patients, how you will transfer the sickest to the hospital and how you will release infected patients into the community when they are released from jail. 
  5. The Infection Control Supervisor should create Covid-19 educational materials for medical staff, detention staff and inmates.  These can consist of posters, brochures, classes, newsletters, etc. Education should emphasize facility cleanliness, the importance of hand washing and what to do when sick.

This planning will pay off if and when Covid-19 shows up in your community.  Good luck!

As always, what I have written here is my opinion, based on my training, experience and research. I could be wrong! If you think I am wrong, please say why in comments.

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12 thoughts on “You Need a Plan for Corona virus in your Facility

  1. AvatarAlfred

    A thought – should there not be a plan already?

    Bird Flu, Swine Flu, SARS. MERS et. al.

    It may be totally wrong – but, seems the basics of disease transmission and infection control remain the same. Developing a good infection control plan and considering all the factors would be the approach to take – not reinventing the ‘wheel’ for each ‘new’ disease.

    An important consideration in developing the plan is housing – sick, potentially sick, not sick – should be collaborated with security ahead of time. Also, early furlough for sentenced and deferring admission of any who can receive a citation (won’t work for prisons). Had an influenza epidemic and the sheriff conferred with the local law enforcement agencies – no admission for anyone who could be cited; anyone who could be furloughed early or bail revised were out too. dropped the population by 50%. Made caring for the ill and protecting those not more feasible.

    If memory serves, the second wave of illness in SARS were the health care workers. A study of those who became ill and those not (among health care staff) revealed hand washing as the difference.

    Reply
  2. AvatarHomedika

    Plan ways to care for those who might be at greater risk for serious complications. There is limited information about who may be at risk for severe complications from COVID-19 illness. From the data that are available for COVID-19 patients, and from data for related coronaviruses such as SARS-CoV and MERS-CoV, it is possible that older adults and persons who have underlying chronic medical conditions may be at risk for more serious complications. Early data suggest older people are more likely to have serious COVID-19 illness. If you or your household members are at increased risk for COVID-19 complications, please consult with your health care provider for more information about monitoring your health for symptoms suggestive of COVID-19. CDC will recommend actions to help keep people at high risk for complications healthy if a COVID-19 outbreak occurs in your community.

    Reply
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  4. AvatarRolanda Williams

    QUESTION: Should detention staff who transfer or handle inmates suspected of OR have tested positive for COVID 19 wear N95 masks.

    Reply
  5. AvatarGlobaltel

    Our city jail here does not allow visitors and foods deliver inside. All the inmates can’t go outside their cells. They always wear face masks and practicing proper hygiene.

    Reply
  6. AvatarRicardo Alvarez, MD

    Thank you for addressing an overlooked crisis in the Covid-19 pandemic- prisons. Interestingly, Forbes magazine has been writing about this and some steps are being taken to release some prisoners. As the country with the highest rate of incarceration in the world do you believe there is role for the medical staff of the prison system to advocate for decarceration from the perspective of infection control and social justice?

    Reply
    1. AvatarJeffrey Keller MD Post author

      Absolutely I do. My jails have released an average of 30% of their inmates in preparation for Covid.

      Reply
  7. AvatarAlfred Cichon

    The strategy of ‘early release’ is one part of population decrease. One Sheriff – during a serious influenza episode – advised the law enforcement chiefs that they would not accept anyone who could be issued a citation (at the time about 20% of admissions). They cooperated well.

    Another strategy was to aggressively assess the current offenders and (to the best possible) divide the facility into ‘sick’ and ‘healthy’.

    It might be possible – based upon the ‘structure of the building’ to use an area as a secondary holding to ‘semi-quarantine’ those new inmates that must be admitted.

    Reply
  8. AvatarJailaid

    Imagine if one inmate is infected, all of the inmates’ lives are all at risk. They should plan for the security of all their inmates against this pandemic.

    Reply

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