World Health Organisation publishes guidance on preventing Covid-19 outbreak in prisons

23rd March 2020

On the 12th of March 2020, the Covid-19 outbreak was declared a pandemic by the World Health Organisation (WHO). Since then, the WHO released an interim guidance document, Preparedness, prevention and control of COVID-19 in prisons and other places of detention. The document aims to assist countries in developing plans in response to the international Covid-19 outbreak.

The guide provides essential information for prison staff and health care staff who are working in prisons. It details the signs and symptoms of the coronavirus and how to reduce the spread of the virus. Controlling the spread of infection in prison settings is essential for limiting the spread both within prisons and communities.

The report emphasises the importance of human rights and reaffirms a number of principles that should be respected:

• The State is responsible for the healthcare of people in prisons and other places of detention
• Equal standards of healthcare should apply in these settings to that in the community
• Gender-responsive measures should be introduced 
• Prisons and other detention facilities need to ensure that those in custody maintain contact with the outside world.
• Prisoners should have access to information and adequate healthcare provision.
• Consideration should be given to the use of non-custodial sanctions at all stages of the criminal justice system   
• Procedures should facilitate that prisoners at high risk are separated from others and that single-cell accommodation would be available to the most vulnerable.
• Measures should be introduced to avert stigmatisation of potential carriers of COVID-19      
• To prevent the spread of COVID-19, those who are admitted to prisons and other places of detention should be screened for fever and lower respiratory tract symptoms.
• Decisions to place people in medical isolation should be made by a clinical healthcare professional and be authorised by law. People held in isolation should be informed of the reason and should be permitted to contact a third party.
• There should be adequate measures to protect those who are placed in isolation from ill-treatment. Human contact should be facilitated through an appropriate means (e.g. video-calls)
• The Covid-19 outbreak must not be used to undermine essential safeguards that are contained in the United Nations Standard Minimum Rules for the Treatment of Prisoners.
• External inspections by independent monitoring bodies should continue to be carried out, retaining access to people detained in isolation units.         

Contingency planning is essential in ensuring that the health response is adequate while preserving a secure, safe and humane detention setting. Collaboration between agencies that are responsible for the health of those in prisons and other places of detention is needed. The document highlights that prisons and public health authorities, policymakers and prison governors have a responsibility to increase their level of preparedness, manage and care for new cases of COVID-19.

Actions that need to be taken by key stakeholders include:

1. Joint Planning: Custodial/detention staff and healthcare teams in prisons must work together to follow existing protocols; to identify suspected cases among employees; to identify suspected cases among prisoners and subsequent isolation in single-cell accommodation and medical assessment.
2. Risk Assessment: Health care teams should screen people on entrance to prisons. This includes: prisoners/detainees, visitors and prison staff. Information should be collected on: any history of cough, shortness of breath, recent travel history and possible contact with confirmed cases in the last 14 days. A detailed daily registry of people coming in and out of the prison should be maintained.
3. Clinical Management: Persons should be quarantined for 14 days if they have been exposed to an individual with COVID-19. Prisons should be aware of the hospitals they can transfer persons who need admission (e.g. for respiratory support or for access to intensive care units).

The guidance document provides important information on training, risk communication and prevention measures. It further highlights that there is no ‘one size fits all’ approach and countries will have to adapt responses taking into account the context of the local environment.

The full guidance document is available at: World Health Organisation (2020) Preparedness, prevention and control of COVID-19 in prisons and other places of detention