Trends in Correctional Facilities

The authors of this study aim to document trends in COVID-19 cases among staff working in correctional facilities.  Data were included from March through November 2020 and were extracted from the Federal Bureau of Prisons and Departments of Corrections in all states.   The period prevalence was calculated using active and recovered cases and those cases that resulted in mortality.  The results showed case prevalence for staff was 3-5 times higher compared to the U.S. population prevalence.  On average, case prevalence increased daily by 42 cases per 100,000 employees, compared to 61 cases per 100,000 prisoners and 13 cases per 100,000 U.S. residents. When examining trends at the beginning of the pandemic (March – May), case prevalence among staff increased at a mean daily rate of 40 new cases per 100,000 employees. The daily prevalence decreased from May – June to 21 new cases per 100,000 employees and then there was a significant increase to an average of 52 new cases per 100,000 employees from June to November. Specifically, on November 4 , the national prevalence among prison staff was 9,316 cases per 100,000 employees.  This was 3.2 times greater than the U.S. population prevalence (2,900 cases per 100,000) and 30% lower than the incarcerated population prevalence (13,384 cases per 100,000). Among U.S. resident and prisoner populations, there was not much variation with case prevalence.  Most rapid increases among prisoners occurred when cases were detected.

Global Health Security Index

This article seeks to answer the question “Should policy makers trust composite indices?”  The Global Health Security (GHSI) Index is the first comprehensive assessment of global health security capabilities in 195 countries. Each country has a score out of 100 and this score is determined by six subcategories:

1. Prevention of the emergence or release of pathogens
2. Early detection and reporting of epidemics of potential international concern
3. Rapid response to and mitigation of the spread of an epidemic
4. Sufficient and robust health system to treat the sick and protect health workers
5. Commitments to improving national capacity, financing and adherence to norms
6. Overall risk environment and country vulnerability to biological threats.

According to the article, U.S. UK, Sweden and Brazil were the worst hit countries yet they ranked high on the GHSI as being “more” or “most” prepared whereas Germany, Norway, Singapore, New Zealand and Vietnam surpassed expectations that were indicated in the GHSI.  Jamaica and Fiji also have virtually eliminated Covid-19, but were ranked among the least prepared.  There are limitations to the GHSI as there is incorrect weighting and incomplete definitions of the subcategories and this is important to address when combining subcategories to create a score that is assigned to each country.  Furthermore, the authors state that political leadership and previous experiences with epidemics should be counted as a crucial factor for preparedness.  This is essential given that the GHSI was constructed to guide effective policy-making around the world.  The authors conclude by stating that indices may not be as useful as they claim to be and that simple heuristics and adaptive management strategies are better able to guide policy-making.