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    2 Comments for this article
    EXPAND ALL
    The Point Is?
    Peter Westerman, BS | None applicable.
    The “IMR” (Infection to Mortality Ratio) reported in this article is only 1.21% - a fraction of the 10-12% experienced in/around Detroit and the double-digit numbers in/around New York City and many East Coast locations.

    Comparing prison numbers with long term care facilities (which are also prisons of a sort) makes much more sense than comparing with the general population.
    CONFLICT OF INTEREST: None Reported
    Data Problem is Understated
    Bruce Reilly, J.D. | Voice of the Experienced
    The authors acknowledge the limitations of "official data" yet the prison and jail data problem during COVID is more severe than it seems.

    1. The federal government does not require any data from jails and prisons;

    2. Jails and prisons have a historic pattern of not testing, thus not knowing, about any diseases (which alleviates the need to treat any ailment);

    3. Because there is no simple manner of providing treatment, and no funding at the ready to do so (Medicaid only reimburses for overnight hospitalizations), there is less incentive to "know";

    4. Correctional security
    officials will not cede decision-making power to public health officials, attributing to some prevention programs with no basis in science;

    5. With already poor medical treatment being further stretched due to COVID, staff absences, and lock down procedures, many people are getting even worse treatment for their non-COVID medical needs. This conflates the "cause of death" in some situations, yet if COVID is preventing prior treatment, then one could argue the cause of death is indeed COVID.

    6. Prison, jail, and Governor staffs are facing massive pressure to decarcerate until social distancing can be achieved. Thus, these officials have a deep set of interests in underselling the prison pandemic, including transmission and death.

    To whatever degree the authors wanted to make these points, the overall point should have been a top line caveat... and the toll is certainly worse than advertised.
    CONFLICT OF INTEREST: None Reported
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    Research Letter
    July 8, 2020

    COVID-19 Cases and Deaths in Federal and State Prisons

    Author Affiliations
    • 1Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
    • 2UCLA Law COVID-19 Behind Bars Data Project, Los Angeles, California
    • 3University of California Los Angeles School of Law, UCLA Law COVID-19 Behind Bars Data Project, Los Angeles
    JAMA. Published online July 8, 2020. doi:10.1001/jama.2020.12528

    Novel coronavirus disease 2019 (COVID-19) represents a challenge to prisons because of close confinement, limited access to personal protective equipment, and elevated burden of cardiac and respiratory conditions that exacerbate COVID-19 risk among prisoners.1 Although news reports document prison outbreaks of COVID-19, systematic data are lacking.2 Relying on officially reported data, we examined COVID-19 case rates and deaths among federal and state prisoners.

    Counts of COVID-19 cases and presumed or confirmed deaths among prisoners were collected daily by the UCLA Law COVID-19 Behind Bars Data Project from March 31, 2020, to June 6, 2020.3 Counts were extracted daily from departments of corrections websites and, as needed, supplemented with news reports and press releases. Data included all states, the District of Columbia, and the Federal Bureau of Prisons. Cases were reported cumulatively (including active confirmed cases, recoveries, and decedents). Deaths attributable to COVID-19 were defined by each department of corrections based on the determination of the departments of corrections or external medical examiners. COVID-19 case rates and deaths for the states were obtained for the same period from the US Centers for Disease Control and Prevention.4

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