Chin ET, Ryckman T, Prince L, Leidner D, Alarid-Escudero F, Andrews, JR, Salomon JA, Studdert DM, Goldhaber-Fiebert JD. COVID-19 in the California State Prison System: an Observational Study of Decarceration, Ongoing Risks, and Risk Factors. Journal of General Internal Medicine, 2021;36(10): 3096–3102.
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Abstract
Background
Correctional institutions nationwide are seeking to mitigate COVID-19-related risks.
Methods
For California state prisons (March 1–October 10, 2020), we described residents’ demographic charac- teristics, health status, COVID-19 risk scores, room occupancy, and labor participation. We used Cox proportional hazard models to estimate the association between rates of COVID-19 infection and room occupancy and out-of-room labor, respectively.
Results
The incarcerated population decreased 19.1% (119,401 to 96,623) during the study period. On October 10, 2020, 11.5% of residents were aged ≥60, 18.3% had high COVID-19 risk scores, 31.0% participat- ed in out-of-room labor, and 14.8% lived in rooms with ≥10 occupants. Nearly 40% of residents with high COVID-19 risk scores lived in dormitories. In 9 prisons with major outbreaks (6,928 rooms; 21,750 residents), dormitory residents had higher infection rates than cell residents (adjusted hazard ratio [AHR], 2.51 95% CI, 2.25–2.80) and residents of rooms with labor participa- tion had higher rates than residents of other rooms (AHR, 1.56; 95% CI, 1.39–1.74).
Conclusions
Despite reductions in room occupancy and mixing, California prisons still house many medically vulnerable residents in risky settings. Reducing risks further requires a combination of strategies, including rehousing, decarceration, and vaccination.