This review discusses why prisons are a special concern during the COVID-19 pandemic and offers thoughts on how to proceed.

Prisons are epicenters for outbreaks because of a higher background prevalence of infection, more risk factors for infection, unavoidable close contact, poor ventilation, unsanitary facilities, and poor access to health-care services. Everyone is at risk, including prisoners, staff, and visitors. We must pay special attention to them in this pandemic.

An expert panel put out recommendations for action, including

• Joint planning
• Risk management
• Prevention and control
• Treatment
• Information sharing