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October 27, 2020

National Academies Report Urges Reducing Inmate Population to Curb COVID-19 in Prisons, Jails

Author Affiliations
  • 1Consulting Editor, JAMA Health Forum and JAMA
JAMA Health Forum. 2020;1(10):e201343. doi:10.1001/jamahealthforum.2020.1343

Corrections officials should minimize incarceration in jails and prisons and use their discretion to identify candidates for release, according to a new report from the National Academies of Sciences, Engineering, and Medicine (NASEM).

Jails and prisons have been epicenters of the coronavirus pandemic in the United States. The NASEM report, “Decarcerating Correctional Facilities During COVID-19: Advancing Health, Equity, and Safety,” notes that as of August 2020, compared with the general population, coronavirus disease 2019 (COVID-19) case rates were nearly 5 times higher among incarcerated populations and 3 times higher among correctional staff.

According to the COVID Prison Project at the University of North Carolina at Chapel Hill, as of October 23, 2020, there have been 155 466 cases of COVID-19 among incarcerated individuals just in US prisons, with 1267 deaths. The group tallied another 31 400 COVID-19 cases among prison staff, with 71 COVID-19–related deaths.

Correctional and detention facilities in the United States “are often overcrowded, dense, poorly ventilated, and disconnected from public health systems, making COVID-19 prevention among incarcerated people and staff exceedingly difficult,” the report says. Other factors, such as the frequent comings and goings of correctional officers and other staff, foster the spread of the coronavirus in jails and prisons.

In addition, a high rate of chronic health issues among incarcerated populations may lead to a higher rate of severe disease among those who contract COVID-19. The death rate of COVID-19 is 3 times higher among prisoners than in the general population after adjusting for the fact that the prison population has a higher proportion of men and a lower proportion of individuals aged 65 years or older, an age group that accounts for more than 80% of COVID-19 deaths in the general population.

In response to COVID-19’s toll in crowded jails and prisons, there have been efforts to decarcerate correctional facilities—that is, reduce prison and jail populations by releasing and diverting people away from incarceration before they enter the criminal justice system.

From March through June, jail populations decreased by approximately 25% nationwide, with most of the decrease (22%) occurring from March 15 to April 15, according to an analysis by the Vera Institute of Justice. More than 100 000 people were released from state and federal prisons between March and June, a decrease of only 8%, according to an analysis by the Marshall Project and the Associated Press.

However, such reductions “appear to have resulted mainly from declines in arrests, jail bookings, and prisons admissions because of temporary closures of state and local courts rather than proactive efforts to decarcerate prisons and jails,” the NASEM report notes.

The NASEM report committee examined best practices for decarceration and offers recommendations to facilitate such efforts, urging federal, state, and local authorities to minimize incarceration in situations in which adhering to COVID-19 health guidelines requires reducing the number of prisoners and detainees in a facility. The group says that authorities should “exercise their discretion to divert individuals from incarceration” through a number of strategies, including the following:

  • Directing law enforcement to issue citations instead of making arrests

  • Avoiding pretrial detention and releasing individuals accused of a crime on their own recognizance, unless the release “would be at odds with public safety or court appearance”

  • Significantly reducing bail and eliminating the use of incarceration for failure to pay fees or fines, as well as prioritizing alternatives to incarceration for low-level offenses as much as possible

  • Revising “compassionate release” policies that consider an incarcerated individual’s age, health, functional or cognitive impairment, or family circumstances

  • Examining policies and procedures for parole and probation to limit individuals being returned to incarceration for technical violations

The committee also recommends developing plans to ensure a safe reentry and return of incarcerated persons to communities. This includes identifying resources to provide housing; addressing access to public benefits, such as the Supplemental Nutrition Assistance Program (popularly known as food stamps); and working with community health systems for access to health care.

Families and communities should also be protected from COVID-19–related risks from incarcerated individuals who are released, the committee notes. It recommended implementing COVID-19 testing and facilitating quarantines in the community for 14 days (if needed) before released individuals return to their families or group housing.

Some evidence suggests that decarceration has lowered infection rates in some jails, and the Centers for Disease Control and Prevention has published guidance on measures to curb COVID-19 spread in jails and prisons.

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Open Access: This is an open access article distributed under the terms of the CC-BY License.