Unsafe, Inhumane, and Preventable: The COVID-19 Pandemic in U.S. Prisons and Jails and Decarceration as a Bioethical Imperative

Abstract

When the COVID-19 pandemic erupted in early 2020, many of the first known clusters were in jails and prisons. With poor ability to socially distance, inadequate access to prophylactic and preventative supplies, and a populace with more comorbidities than the general population, prisons and jails quickly transformed into incubation centers for the most virulent novel antigen of the last century. The United States faced a particularly daunting challenge in that despite making up just 4.2% of the global population, the correctional system houses 25% of the world’s incarcerated population. With public health experts sounding the alarm regarding the dangers to the incarcerated and surrounding communities, bold strategies were needed to prevent the spread of COVID-19. Reducing population, it was argued, by either temporarily or permanently releasing inmates who were deemed the most medically vulnerable and least threatening to public safety, was largely viewed as the most effective strategy nationwide. Instead of heeding these recommendations, administrators and legislators at both the federal and local level opted instead to try to combat the virus in prison and jails primarily with quarantines and lockdowns, draconian violations of human rights that 18 months after the pandemic’s beginning would result in an infection rate for the incarcerated population 5.5 times higher than the general population and a mortality rate 3 times that of the general population. By looking at a timeline of the pandemic in the US with a particular focus on Pennsylvania and Philadelphia County more specifically, we are able to confront the missteps that led to this humanitarian crisis. Using contemporary data and research we establish the bioethical violations that occurred due to the abdication of population reduction policies and provide data corroborating the efficacy of decarceration as a preventative tool. Furthermore, acknowledging that this public health crisis is both ongoing and likely to occur again, we argue that there is a bioethical imperative for broad decarceration measures that are inclusive of the majority of inmates in the United States. Recognizing the failures of lengthy sentencing policies to deter crime, the exorbitant costs associated with high per capita incarceration, and the obsolete and racist policies that led to these high incarceration rates in this country, we argue that our elderly and ill incarcerated population poses a negligible risk to public safety, and it is essential we reduce the number of individuals in our nation’s jails and prisons immediately. By reassessing the role of our corrections system we can not only prevent the next humanitarian crisis but recalibrate our correctional system within a rehabilitative rather than punitive paradigm.