At the Eddie Warrior Correctional Center in Oklahoma, over 90 percent of inmates tested positive for COVID-19. Virtually every facility in the Oklahoma prison system has been affected by the virus, says Nicole McAfee, director of politics and advocacy at the Oklahoma ACLU. She assumes they haven’t seen the worst – and to complicate matters, flu season is just around the corner.
The flu spreads regularly in prisons and prisons in the United States for the same reasons as COVID-19. The facilities offer vulnerable people access to soap or other means of protecting themselves against an infectious disease in a confined space. Dealing with a single outbreak is already a struggle in these locations, and it is often insufficient to protect the health of the people living in them. Now they may have to deal with two.
“The idea of mitigating and combating a possible simultaneous spread of the flu and the COVID-1
One of the best ways to treat the flu is to get the flu shot, which prevents people from getting sick and makes the disease less serious in people who get it. Public health experts are all pushing for flu vaccinations this year as lower flu levels make more resources available to the healthcare system to treat COVID-19. However, in some prisons and prisons, getting a flu shot can be difficult.
“There’s absolutely no match across the board,” says Lauren Brinkley-Rubinstein, assistant professor of social medicine at the University of North Carolina at Chapel Hill, who studies health and incarceration.
The federal prison office recommends offering flu vaccinations to all staff and inmates, and priority should be given to older inmates or inmates with chronic illnesses. However, these guidelines do not mean that most inmates in the United States will get the flu vaccinations. Outbreaks occur regularly in prisons where most inmates are not vaccinated. In 2011, two Maine prisons where fewer than 10 percent of inmates were vaccinated had outbreaks. In 2018, a woman died of flu in an Oregon prison where only 18 percent of inmates received the flu vaccinations.
Access to a flu shot is even less likely in prisons as people usually only stay in them for a few days. The short length of stay makes it harder to offer a shot, says Brinkley-Rubinstein. “But I also think this is not good enough, especially in the context of COVID-19 where we have seen these major outbreaks in prisons,” she says.
According to Tyler Winkelman, a health policy researcher at Hennepin Healthcare Research Institute in Minnesota, people can cycle in and out of prisons. “There will be many people who would benefit from the influenza vaccine who will go to prison and they should be able to get a flu shot while they are there,” he says.
Winkelman also works as a doctor in Hennepin County Jail. Anyone taken to this prison will be offered a flu shot while they are ingested, he says. “We have already started offering it,” he says. “We have several options for people to be asked if they refuse while taking it.”
However, the Hennepin County Jail Health Clinic is unique: it functions more like a community clinic that happens to be in a jail. It enables doctors to leverage resources that are available throughout the health system, which most prisons do not. “I would guess that many prisons will have difficulty offering influenza vaccines,” says Winkelman.
Fight two outbreaks
If outbreaks of flu emerge in prisons and prisons that have already had cases of COVID-19, the challenges these facilities are already facing could worsen. In Oklahoma, many prisons and prisons are already tight on resources to fight the coronavirus, McAfee says. She has heard rumors that employees, especially medical workers, are leaving Oklahoma prisons because the working conditions are dangerous or because they get sick themselves. “I just wonder how people get the care they need,” says McAfee.
A shortage of medical staff would make it particularly difficult for prisons and prisons to separate people with COVID-19 from people with the flu in order to give them the right treatments. The symptoms can be similar. “Screening symptoms, especially during the flu season, won’t relieve it,” says Brinkley-Rubinstein.
The best way to differentiate between the two diseases is through testing, Winkelman says. However, access to testing resources for COVID-19 varies widely from prison to prison and from prison to prison. “There are some prisons that are well equipped to do this and others that really don’t have the resources to test all of the things that should be tested,” he says.
Some of the procedures used to prevent the spread of COVID-19 in prisons and prisons could, in theory, help stave off major influenza outbreaks. However, these guidelines were unsuccessful in many places. COVID-19 was still causing devastating outbreaks in dozen of facilities across the country. Over 100,000 people detained have tested positive for the virus.
The widespread COVID-19 outbreaks are another problem. After months of watching these outbreaks, inmates may be reluctant to work with health workers, which could complicate flu reduction efforts. Men in San Quentin State Prison, California, told the story The edge that they don’t trust prison officials who they believe are deliberately letting in the coronavirus. You also can’t report symptoms or consent to testing if saying you’re sick means moving to an isolation area, says Brinkley-Rubinstein. “You could be taken to a quarantine facility, which must look a lot like solitary confinement,” she says. Since the beginning of the COVID-19 pandemic, the use of solitary confinement in US prisons has increased by 500 percent, according to research by nonprofit group Solitary Watch.
The intersection of COVID-19 and flu poses a threat to prisons and prisons for the same reasons it does in the wider community: Every other respiratory disease is dragging much-needed resources away from the pandemic. It would add more disease to an already struggling system.
In addition, prisons are filled with people who are more likely to experience health problems than people in the general population. These people are susceptible to COVID-19 and are also at a higher risk of severe flu. “In general, incarcerated people are at greater risk for poorer results,” says Winkelman.
The best way to protect people in prisons and jails from the dual threat is to get them out of the facilities, says Brinkley-Rubinstein. Public health experts have recommended prisons and prisons to reduce their populations since the pandemic began. Some facilities made slight reductions early on, although in many cases they were insufficient to prevent the spread of COVID-19. Now, months after the pandemic, some facilities are starting to populate back to March levels, she says.
To have the safest flu season during an active pandemic, it’s important to view prisons and prisons as part of the community – not separate from them, Winkelman says. Efforts to reduce flu in prisons and prisons are important to the health of the population, and vice versa. “It’s all part of our overall ability to test and treat people during influenza season,” he says.