New England Journal of Medicine: Decarceration Necessary to Stop Spread of Covid

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Benjamin A. Barsky, J.D., M.B.E., Eric Reinhart, B.A., Paul Farmer, M.D., Ph.D., and Salmaan Keshavjee, M.D., Ph.D. are authors of a perspective published in the highly regarded New England Journal of Medicine. In it they call not only for prioritizing the vaccination of the US prison population but also large scale decarceration. They say that prisons "operate as high-pressure disease reservoirs that spread the virus into surrounding communities and exacerbate racial disparities in Covid-19 cases and deaths."

In high-severity environments, such as prisons, the effectiveness of even the best vaccines is considerably diminished. The authors site a study that showed that one US prison had what is equal to the highest known Covid-19 basic reproduction number in any context in the world. It is because of this high transmissibility within prisons, and the "churn that results in 55% turnover in the jail population each week," that correctional facilities contribute to community infections.

The authors say that mass incarceration itself threatens public safety, and that decarceration efforts early in the pandemic have not been associated with increases in rearrest rates.

Now that vaccines are becoming more readily available, both the public and legislators' focus has turned to vaccinating without the release of prisoners. The authors say that the medical community has the moral responsibility to supply the science and data to support large scale decarceration. However, it is federal and state legislators, state and local law enforcement, prosecutors, judges, mayors, governors, the U.S. attorney general, and, yes, the president of the United States who must heed their warning and make it happen.