Interim Guidance on Management of COVID-19 in Correctional and Detention Facilities

By: Tyler S. Lemen

Last week, the U.S. Centers for Disease Control and Prevention (“CDC”) issued interim guidance on the management of coronavirus disease in correctional and detention facilities.  This guidance was issued to provide healthcare and non-healthcare administrators of correctional and detention facilities assistance in preparing for potential introduction, spread and mitigation of COVID-19 in their facilities. The guidance was issued since the protection of incarcerated or detained individuals presents a unique challenge to healthcare providers as this population lives, works, eats, and socializes in groups, indoors.  The constraints on this population heighten the potential for COVID-19 to spread once introduced. This guidance by the CDC is summarized below:

Operational and Communications Preparation for COVID-19

The CDC recommends training all persons in the facility on the symptoms of COVID-19 and how to respond to symptoms if they develop.  Further, be sure sufficient stocks of hygiene, cleaning, and medical supplies, as well as personal protective equipment (“PPE”) for all staff are on hand. In addition, consider restricting transfers of incarcerated and detained persons to and from other jurisdictions and facilities, as well as reviewing visitation guidelines.

Enhanced Cleaning, Disinfecting and Hygiene Practices

Begin implementing intensified cleaning and disinfecting procedures according to the CDC’s prior guidance, which can be found here.  Consider increasing the number of staff and incarcerated or detained persons trained and responsible for cleaning common areas during the day.  In addition, consider providing incarcerated and detained persons, and staff no-cost access to soap and alcohol-based hand sanitizer (where permissible). 

Social Distancing Strategies to Increase Space Between Individuals in the Facility

Perform pre-intake screening and temperature checks for all new entrants.  This screening should take place in the sally port, before beginning the intake process, to look for symptoms of COVID-19–fever, cough, and shortness of breath.  If these symptoms are present, consider requiring the individual to wear a facemask, ensure staff interacting with the individual wear PPE, place the individual in medical isolation and contact healthcare staff to coordinate further care.

Further, consider implementing “social distancing” measures, including: six feet of space between all individuals, stagger recreation spaces, stagger mealtimes, rearrange seating in the dining hall, and limit group activities.  If these changes are implemented, be sure to communicate clearly and frequently with the incarcerated or detained persons regarding changes to their daily routines and how they can contribute to risk reduction.

How to Limit Transmission from Visitors

If possible, communicate with potential visitors to discourage contact visits, perform screening checks of visitors for possible COVID-19 symptoms, promote non-contact visits, and consider suspending or modifying visitation programs–where legally permissible. Consider providing no-cost access to phone or video visitation instead of contact visitation.

Medical Isolation of Confirmed and Suspected Cases and Quarantine of Contacts

 As soon as an individual develops symptoms of COVID-19, they should wear a face mask, and, if possible, be placed in medical isolation in a separate environment from other individuals.  Custody staff should be designated to monitor these individuals exclusively where possible.  Refer to the CDC’s guidance on the amount of time an individual should be in isolation based upon their presentation and symptoms.  In addition, any individual who was in close personal contact with an individual who is confirmed to have COVID-19 should be placed in quarantine according to the CDC’s guidelines for 14 days.  

Clinical Care for Confirmed and Suspected Cases

Facilities should ensure that incarcerated and detained individuals receive medical evaluation and treatment at the first sign of COVID-19 symptoms.  If medical staff are not continuously onsite, a plan for transporting individuals to the local hospital should be implemented.  Staff evaluating and providing care to persons with confirmed or suspected COVID-19 cases should follow the CDC’s guidance for the management of patients with COVID-19, found here.  The facility should develop a plan to safely transfer persons with severe illness from COVID-19 to a local hospital if they require care beyond what the facility is able to provide. 

For more in-depth information on this topic, please refer to the CDC’s Interim Guidance here

**The above guidance is suggested solely for the purpose of providing healthcare to incarcerated or detained individuals and is not meant to supersede, contradict, or overrule any constitutional or other rights guaranteed to incarcerated or detained individuals.  The rights of an incarcerated or detained individual should be considered before implementing restrictions or changes related to the prevention and treatment of COVID-19.**