Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, speaks in the briefing room of the White House in Washington, Monday, March, 9, 2020, about the coronavirus outbreak as Health and Human Services Secretary Alex Azar, Dr. Robert Redfield, director of the Centers for Disease Control and Prevention, U.S. Surgeon General Jerome Adams, Vice President Mike Pence, and Dr. Deborah Birx, White House coronavirus response coordinator, listen.  © 2019 AP Photo/Carolyn Kaster

(Washington, DC) – Authorities in the United States should take all necessary steps to protect people in prisons, jails, and immigration detention centers from infection by the coronavirus, Human Rights Watch said today. They should consider supervised release and other non-custodial alternatives for detained individuals who are at high risk of serious effects from COVID-19.

COVID-19, like other infectious diseases, poses a particularly serious risk to populations that live in close proximity to each other, such as in nursing homes, military barracks, college dormitories, prisons, jails, and immigration detention centers. People in prisons, jails, and immigration detention centers are not free to leave. They are in institutions that have often been found to provide inadequate health care even under normal circumstances. For example, severely substandard health care has contributed to recent deaths of immigrants in the custody of Immigration and Customs Enforcement (ICE). Prison, jail, and detention center populations often also include people with serious chronic health conditions, making them more vulnerable to COVID-19.

“People behind bars are often forgotten by society during a crisis, but protecting their health is crucial for protecting overall public health,” said Nicole Austin-Hillery, US Program executive director at Human Rights Watch. “Protecting people in custody also protects staff and visitors from those facilities who return to their communities each day.”

Prisons, jails, and immigration detention centers should consider reducing their populations through supervised release or other measures for individuals at high risk of suffering serious effects from the virus, such as older people and people with underlying health conditions. Many people in US jails have not been convicted of a crime but are locked up simply because they cannot afford to pay the bail set in their case. Older men and women are the fastest growing group in US prisons, due to lengthy sentences, and prison officials already have difficulty providing them appropriate medical care.

The number of people in US immigration detention has ballooned from an average daily population of 20,000 people in 2003 to more than 50,000 in 2019, not because there are more people who have violated US immigration laws but because of changes in policies. For example, under the Trump administration, there has been a severe decrease in the number of people granted parole, or release, after passing the first step of the asylum application process. The administration has also ended policies that limit the detention of populations facing heightened risks to health, like pregnant women.

“With a smaller population, prisons, jails, and detention centers can help diseases spread less quickly by allowing people to better maintain social distance,” Dr. Marc Stern, a correctional health expert and former health services director for Washington State’s Department of Corrections, told Human Rights Watch. “If staff cannot come to work because they are infected, a smaller population poses less of a security risk for remaining staff.”

Prisons, jails, and immigration detention centers should also take steps to ensure they are appropriately coordinating with public health departments and communicating openly with staff and people in custody. They should also screen and test for COVID-19 according to the most recent recommendations from the Centers for Disease Control and Prevention and local health authorities, and provide appropriate hygiene training and supplies. They should create plans for housing people exposed to or infected with the virus. Any plans for lockdowns or isolation should be limited in scope and duration based on the best science available, and they should not seem punitive, as fear of being placed in lockdowns or isolation could delay people notifying medical staff if they experience symptoms of infection.

“All governments, including the US, have an obligation to protect the rights of people deprived of their liberty, including the right to health, especially when custody heightens the risks they face,” Austin-Hillery said. “Officials in the US should take immediate steps to prevent transmission of the coronavirus and consider finding alternatives to custody for those who are at high risk should they become infected.”