Abstract

This is a scoping review of the literature on actions taken by countries during 2020 regarding the care for people living in the prison environment during the COVID-19 pandemic. We selected 54 publications for data mining and found data from 45 countries, which were organized into categories. Most of the literature addressed strategies adopted by countries with advanced economies. All of them mentioned some strategies to reduce viral transmission - the major ones were restricted/suspended family visits and desincarceration - and interventions to improve infrastructures in prisons, the provision of a telephone or other devices for calls or video calls being the most mentioned. Policies to mitigate the effects of the epidemic and interventions were found in publications referencing 33 countries, with the main focus on keeping family contact and reviewing the public safety policy. Concerning governance policies, measures from 11 countries were reported, and the most cited was national authority reinforcement. This study highlights the need for research on the success of each strategy and the differences among those countries.

Key words:
Prisons; COVID-19; Health policy; Global health; Pandemics

Introduction

More than 11 million people are incarcerated worldwide. The United States of America (U.S.), followed by China (CHN) and Brazil (BRA)¹1 Institute for Crime e Justice Policy Research. World Prison Brief [Internet]. 2021. [cited 2021 ago 17]. Available from: https://www.prisonstudies.org/country/united-states-america
https://www.prisonstudies.org/country/un... , lead the ranking. Besides the high population density, the unsanitary facilities, the substandard access to health services, basic sanitation, education, food and nutrition, and the confinement itself make prisons epicenters of infectious diseases, with rates higher than the general population²2 Abraham LA, Brown TC, Thomas SA. How COVID-19's Disruption of the U.S. Correctional System Provides an Opportunity for Decarceration. Am J Crim Justice 2020; 45(4):780-792.

3 Minayo M, Constantino P. Deserdados sociais: condições de vida e saúde dos presos do estado do Rio de Janeiro. Rio de Janeiro: Fiocruz; 2015.^-44 World Health Organization (WHO). Regional Office for Europe. Preparedness, prevention and control of COVID-19 in prisons and other places of detention: interim guidance [Internet]. 2020. [cited 2020 nov 11]. Available from: http://www.euro.who.int/__data/assets/pdf_file/0019/434026/Preparedness-prevention-and-control-of-COVID-19-in-prisons.pdf?ua=1
http://www.euro.who.int/__data/assets/pd... .

Since the World Health Organization considered COVID-19 a global pandemic, guidelines have been released for the prevention and control of the spread of Sars-CoV-2 geared to incarcerated populations, warning that the demographic characteristics of prisons show a population that faces a more significant disease burden and worse health conditions⁴4 World Health Organization (WHO). Regional Office for Europe. Preparedness, prevention and control of COVID-19 in prisons and other places of detention: interim guidance [Internet]. 2020. [cited 2020 nov 11]. Available from: http://www.euro.who.int/__data/assets/pdf_file/0019/434026/Preparedness-prevention-and-control-of-COVID-19-in-prisons.pdf?ua=1
http://www.euro.who.int/__data/assets/pd... .

This paper aims to answer which emergency and non-pharmacological government actions were adopted by countries during the first year of the COVID-19 pandemic.

Methods

This scoping review of the literature comprises publications from 2020 retrieved from PubMed, Scopus, Web of Science, Portal BVS, and SciELO databases, without geographic excerpts, using the search strategies described in Chart 1.

We identified 325 papers with no duplications. Two independent researchers selected the studies by title and abstract for full-text reading, and disagreements were resolved by consensus. We included full-text works published in Portuguese, English, Spanish, and French, dealing with government actions for the care of adult inmates and workers in the face of COVID-19. The ineligible publications were excluded (Figure 1).

We extracted each publication’s title, abstract, objective, method, and results. The results were retrieved in a form prepared per the categorization of strategies proposed by Peña et al.⁵5 Peña S, Cuadrado C, Rivera-Aguirre A, Hasdell R, Nazif-Munoz JI, Yusuf M, and group. PoliMap: a taxonomy proposal for mapping and understanding the global policy response to COVID-19 [Internet]. Open Science Framework 2020. [cited 2020 nov 11]. Available from: https://osf.io/h6mvs
https://osf.io/h6mvs... In category 2, we considered policies to improve prison infrastructure for adapting to the prison context.

The grouping of publications by countries by level of economic development was adopted for displaying the results, separating emerging and developing economies (EDE) and advanced economies (AE), as defined by the World Bank⁶6 World Bank. Global Economic Prospects, June 2021 [Internet]. 2021. [cited 2021 nov 14]. Available from: http://elibrary.worldbank.org/doi/book/10.1596/978-1-4648-1665-9
http://elibrary.worldbank.org/doi/book/1... . Data details are available on: https://data.scielo.org/dataset.xhtml?persistentId=doi:10.48331/scielodata.TU2NTH.

Results

Forty-six (85%) of the 54 publications analyzed were published in the second half of 2020, and 31 (67%) in October 2020. The most significant number of publications in October is due to a special edition organized by Byrne et al.⁷7 Byrne J, Hummer D, Rapisarda S. Introduction to Special Issue. Vict Offenders 2020; 15(7-8):835-838. Publications were found in 21 journals, ten journals in Health Sciences, five Multidisciplinary, three Human Sciences, and three Social Sciences. Data from 45 countries were found, and most publications referred to AE countries (Table 1).

Category 1 - Viral transmission reduction policies

All countries in this review have implemented some strategies to reduce viral transmission. The most mentioned strategy was isolation and quarantine of confirmed cases as case management, with a significant difference in data recurrence between the AE and EDE countries analyzed. The transfer of COVID-19 cases to health services outside the prison was a strategy found in papers referring to the U.S.⁸8 Irvine M, Coombs D, Skarha J, Del Pozo B, Rich J, Taxman F, Green TC. Modeling COVID-19 and Its Impacts on U.S. Immigration and Customs Enforcement (ICE) Detention Facilities, 2020. J Urban Health 2020; 97(4):439-447., Italy (ITA)⁹9 Pagano AM, Maiese A, Izzo C, Maiese A, Ametrano M, De Matteis A, Attianese MR, Busato G, Caruso R, Cestari M, Biasi S, Chiara A, De Matteis G, Goffredi G, La Russa R. Covid-19 risk management and screening in the penitentiary facilities of the Salerno Province in Southern Italy. Int J Environ Res Public Health 2020; 17(21):8033., Sweden (SWE)¹⁰10 Lindström M, Ahlstrand E, Kärrholm J. Sweden's response to the COVID-19 outbreak. Vict Offenders 2020; 15(7-8):1203-1214., Australia (AUS)¹¹11 Payne JL, Hanley N. COVID-19 and corrections in Australia: a summary review of the available data and literature. Vict Offenders 2020; 15(7-8):1367-1384., Russia (RUS)¹²12 Ovchinnikov S. The Penitentiary System of Russia during the COVID-19 pandemic: a global challenge and initial results. Vict Offenders 2020; 15(7-8):1148-1155., CHN¹³13 Li SD, Liu TH. Correctional system's response to the coronavirus pandemic and its implications for prison reform in China. Vict Offenders 2020; 15(7-8):959-969., Turkey (TUR)¹⁴14 Elbek O. COVID-19 pandemic threatening prison population. Turk Thorac J 2020; 21(6):433-437., Mexico (MEX)¹⁵15 Marmolejo L, Barberi D, Bergman M, Espinoza O, Fondevila G. Responding to COVID-19 in Latin American prisons: the cases of Argentina, Chile, Colombia, and Mexico. Vict Offenders 2020; 15(7-8):1062-1085., and Uganda¹⁶16 Rapisarda SS, Byrne JM. An examination of COVID-19 outbreaks in African prisons and jails. Vict Offenders 2020; 15(7-8):910-920. (Table 2).

Contact management was rarely addressed in the papers. Some reported contact screening and quarantine without explaining how it is performed. Clarke et al.¹⁷17 Clarke M, Devlin J, Conroy E, Kelly E, Sturup-Toft S. Establishing prison-led contact tracing to prevent outbreaks of COVID-19 in prisons in Ireland. J Public Health (Oxf) 2020; 42(3):519-524. described in detail the contact tracing center implemented in Irish prisons, comprising an IT system, protocols, and tools for contact identification. The strategy allowed tracing contacts of 230 COVID-19 cases.

Education and communication measures were the most used strategies to increase adherence to isolation and quarantine, and the provision of entertainment activities for prisoners who were in isolation was found only in one publication related to the U.S.¹⁸18 Brelje AB, Pinals DA. Provision of health care for prisoners during the COVID-19 pandemic: an ethical analysis of challenges and summary of select best practices. Int J Prison Health 2020; 17(3):194-205.

The primary active interventions to identify infected individuals were isolating new admissions in prisons and establishing screening strategies by signs and symptoms, such as using thermometers with differences between AE and EDE countries. Data on the isolation of new admissions were found in ten AE countries, whereas this strategy was found in nine EDE countries. The screening of new admissions was found in 11 countries, more predominant among publications referring to the AE countries.

Asymptomatic testing was considered when the mass testing strategy was mentioned. The strategy in prisoners was reported in Peru¹⁹19 Rapisarda SS, Byrne JM, Marmolejo L. An examination of COVID-19 outbreaks in South American prisons and jails. Vict Offenders 2020; 15(7-8):1009-1018., U.S.²⁰20 Hagan LM, Williams SP, Spaulding AC, Toblin RL, Figlenski J, Ocampo J, Ross T, Bauer H, Hutchinson J, Lucas KD, Zahn M, Chiang C, Collins T, Burakoff A, Bettridge J, Stringer G, Maul R , Waters K, Dewart C, Clayton J, de Fijter S, Sadacharan R, Garcia L, Lockett N, Short K, Sunder L, Handanagic S. Mass testing for SARS-CoV-2 in 16 prisons and jails - six jurisdictions, United States, April-May 2020. MMWR Morb Mortal Wkly Rep 2020; 69(33):1139-1143., and CHN¹³13 Li SD, Liu TH. Correctional system's response to the coronavirus pandemic and its implications for prison reform in China. Vict Offenders 2020; 15(7-8):959-969., and in professionals or visitors in four countries, namely, the same three countries plus the United Kingdom²¹21 Brennan PK. Responses taken to mitigate COVID-19 in prisons in England and Wales. Vict Offenders 2020; 15(7-8):1215-1233.. The low testing routine was explained by the unavailability²2 Abraham LA, Brown TC, Thomas SA. How COVID-19's Disruption of the U.S. Correctional System Provides an Opportunity for Decarceration. Am J Crim Justice 2020; 45(4):780-792.^,1212 Ovchinnikov S. The Penitentiary System of Russia during the COVID-19 pandemic: a global challenge and initial results. Vict Offenders 2020; 15(7-8):1148-1155.^,1616 Rapisarda SS, Byrne JM. An examination of COVID-19 outbreaks in African prisons and jails. Vict Offenders 2020; 15(7-8):910-920.^,1919 Rapisarda SS, Byrne JM, Marmolejo L. An examination of COVID-19 outbreaks in South American prisons and jails. Vict Offenders 2020; 15(7-8):1009-1018.^,2222 Murdoch DJ. British Columbia provincial corrections' response to the COVID-19 pandemic: a case study of correctional policy and practice. Vict Offenders 2020; 15(7-8):1317-1336.

23 Rapisarda SS, Byrne J, Marmolejo L. An examination of COVID-19 outbreaks in prisons and jails in North America, Central America, and the Caribbean. Vict Offenders 2020; 15(7-8):1234-1243.

24 Novisky MA, Narvey CS, Semenza DC. Institutional responses to the COVID-19 pandemic in American prisons. Vict Offenders 2020; 15(7-8):1244-1261.

25 Lemasters K, McCauley E, Nowotny K, Brinkley-Rubinstein L. COVID-19 cases and testing in 53 prison systems. Health Justice 2020; 8(1):24.

26 Rapisarda SS, Byrne JM. The impact of COVID-19 outbreaks in the prisons, jails, and community corrections systems throughout Europe. Vict Offenders 2020; 15(7-8):1105-1112.

27 Rapisarda SS, Byrne JM. An examination of COVID-19 outbreaks in prisons and jails in Oceania. Vict Offenders 2020; 15(7-8):1361-1366.^-2828 Rapisarda SS, Byrne JM. An examination of COVID-19 outbreaks in prisons and jails throughout Asia. Vict Offenders 2020; 15(7-8):948-958.. Hagan et al.²⁰20 Hagan LM, Williams SP, Spaulding AC, Toblin RL, Figlenski J, Ocampo J, Ross T, Bauer H, Hutchinson J, Lucas KD, Zahn M, Chiang C, Collins T, Burakoff A, Bettridge J, Stringer G, Maul R , Waters K, Dewart C, Clayton J, de Fijter S, Sadacharan R, Garcia L, Lockett N, Short K, Sunder L, Handanagic S. Mass testing for SARS-CoV-2 in 16 prisons and jails - six jurisdictions, United States, April-May 2020. MMWR Morb Mortal Wkly Rep 2020; 69(33):1139-1143. state that the number of known cases hiked from 642 to 8,239 after mass testing in 16 U.S. prisons.

The Personal Protective Equipment (PPE) supply stood out among the personal hygiene measures and was more recurrent among AE countries. Reports of the installation of mask manufacturing in prisons were found in some countries, such as Romania (ROM)²⁹29 Durnescu I, Morar I. An examination of the Romanian Prison System during the COVID-19 pandemic. Are "zero cases" possible? Vict Offenders 2020; 15(7-8):1133-1147., South Africa (RSA)³⁰30 Kras KR, Fitz L. The social and environmental implications of the novel coronavirus on institutional and community corrections in South Africa. Vict Offenders 2020; 15(7-8):933-947., ITA³¹31 Pattavina A, Palmieri MJ. Fears of COVID-19 contagion and the Italian Prison System response. Vict Offenders 2020; 15(7-8):1124-1132., RUS¹²12 Ovchinnikov S. The Penitentiary System of Russia during the COVID-19 pandemic: a global challenge and initial results. Vict Offenders 2020; 15(7-8):1148-1155., and Spain (ESP)³²32 Redondo S, Gonçalves RA, Nistal J, Soler C, Moreira JS, Andrade J, Andrés-Pueyo A. Corrections and crime in Spain and Portugal during the COVID-19 pandemic: impact, prevention and lessons for the future. Vict Offenders 2020; 15(7-8):1156-1185.. Disinfection of cells and common areas was reported in 15 countries, predominating among AE countries.

For mobility restriction, the suspension/restriction of visits by families or lawyers was found in 41 countries and was addressed as a significant issue to be managed. Some protests and rebellions against the suspension of visitation were identified¹⁵15 Marmolejo L, Barberi D, Bergman M, Espinoza O, Fondevila G. Responding to COVID-19 in Latin American prisons: the cases of Argentina, Chile, Colombia, and Mexico. Vict Offenders 2020; 15(7-8):1062-1085.^,1616 Rapisarda SS, Byrne JM. An examination of COVID-19 outbreaks in African prisons and jails. Vict Offenders 2020; 15(7-8):910-920.^,1919 Rapisarda SS, Byrne JM, Marmolejo L. An examination of COVID-19 outbreaks in South American prisons and jails. Vict Offenders 2020; 15(7-8):1009-1018.^,3131 Pattavina A, Palmieri MJ. Fears of COVID-19 contagion and the Italian Prison System response. Vict Offenders 2020; 15(7-8):1124-1132.^,3333 Agoff C, Sandberg S, Fondevila G. Women providing and men free riding: work, visits and gender roles in Mexican prisons. Vict Offenders 2020; 15(7-8):1086-1104.. Agof et al.³³33 Agoff C, Sandberg S, Fondevila G. Women providing and men free riding: work, visits and gender roles in Mexican prisons. Vict Offenders 2020; 15(7-8):1086-1104. reported that suspending visits prevents female inmates from providing resources to the family, while men are prevented from receiving family support.

Desincarceration was the most frequent social distancing strategy used in 49 countries. The criteria used were release and deportation of immigrants, replacement by house arrest or pecuniary penalty, reassessment of incarcerations without conviction, the anticipation of regime progression, and release of pregnant and postpartum women, older adults, the sick, and inmates who committed non-violent crimes.

The countries that did not opt for extrication were ROM²⁹29 Durnescu I, Morar I. An examination of the Romanian Prison System during the COVID-19 pandemic. Are "zero cases" possible? Vict Offenders 2020; 15(7-8):1133-1147., SWE¹⁰10 Lindström M, Ahlstrand E, Kärrholm J. Sweden's response to the COVID-19 outbreak. Vict Offenders 2020; 15(7-8):1203-1214., New Zealand (NZL)³⁴34 Murray LJ, Kras KR. "We must go hard and we must go early": how New Zealand halted coronavirus in the community and corrections. Vict Offenders 2020; 15(7-8):1385-1395., El Salvador (ESA)²³23 Rapisarda SS, Byrne J, Marmolejo L. An examination of COVID-19 outbreaks in prisons and jails in North America, Central America, and the Caribbean. Vict Offenders 2020; 15(7-8):1234-1243., and RUS¹²12 Ovchinnikov S. The Penitentiary System of Russia during the COVID-19 pandemic: a global challenge and initial results. Vict Offenders 2020; 15(7-8):1148-1155.. Except for ESA, the other countries used strategies to strengthen prison health services. Furthermore, SWE, NZL, and RUS have an occupancy rate below their installed capacity and managed to offer single cells for those incarcerated. No publication reported the construction of new dormitories, only the installation of tents in the U.S.³⁵35 Hummer D. United States Bureau of Prisons' response to the COVID-19 pandemic. Vict Offenders 2020; 15(7-8):1262-1276. and an attempt to use containers in BRA³⁶36 Costa JS, Silva JCF, Brandão ESC, Bicalho PPG. COVID-19 in the Brazilian prison system: from indifference as a policy to a death policy. Psicol Soc 2020;32:e020013..

Category 2 - Prison infrastructure improvement policies

Of the strategies aimed at improving prisons, expanding testing capacity, that is, acquisition of equipment, supplies, and strengthening of the laboratory network, was pointed out in publications referring to four countries: CHN¹³13 Li SD, Liu TH. Correctional system's response to the coronavirus pandemic and its implications for prison reform in China. Vict Offenders 2020; 15(7-8):959-969., U.S.³⁷37 Wetzel JE, Davis JM. The response to the COVID19 crisis by the Pennsylvania Department of Corrections. Vict Offenders 2020; 15(7-8):1298-1304., Philippines (PHI)³⁸38 Cahapay MB. National responses for persons deprived of liberty during the COVID-19 pandemic in the Philippines. Vict Offenders 2020; 15(7-8):988-895., and Ethiopia¹⁶16 Rapisarda SS, Byrne JM. An examination of COVID-19 outbreaks in African prisons and jails. Vict Offenders 2020; 15(7-8):910-920. (Table 2).

Access to communication technologies (CT) was facilitated in 17 countries, predominantly in AE countries, through the supply of telephones or increased telephone calls. Thirteen provided devices or internet access for video calls, and 15 implemented virtual hearings. Access to CT targeted family contact, preventing mental distress and providing inmates with food and medical and hygiene supplies¹¹11 Payne JL, Hanley N. COVID-19 and corrections in Australia: a summary review of the available data and literature. Vict Offenders 2020; 15(7-8):1367-1384.^,1515 Marmolejo L, Barberi D, Bergman M, Espinoza O, Fondevila G. Responding to COVID-19 in Latin American prisons: the cases of Argentina, Chile, Colombia, and Mexico. Vict Offenders 2020; 15(7-8):1062-1085.^,2121 Brennan PK. Responses taken to mitigate COVID-19 in prisons in England and Wales. Vict Offenders 2020; 15(7-8):1215-1233.^,2323 Rapisarda SS, Byrne J, Marmolejo L. An examination of COVID-19 outbreaks in prisons and jails in North America, Central America, and the Caribbean. Vict Offenders 2020; 15(7-8):1234-1243.^,2626 Rapisarda SS, Byrne JM. The impact of COVID-19 outbreaks in the prisons, jails, and community corrections systems throughout Europe. Vict Offenders 2020; 15(7-8):1105-1112.^,3939 Collica-Cox K, Molina L. A case study of the Westchester County New York's jail response to COVID-19: controlling COVID while balancing service needs for the incarcerated-a national model for jails. Vict Offenders 2020; 15(7-8):1305-1316.^,4040 Fovet T, Lancelevée C, Eck M, Scouflaire T, Bécache E, Dandelot D. Prisons confinées: quelles conséquences pour les soins psychiatriques et la santé mentale des personnes détenues en France? Encephale 2020; 46(3):S60-S65..

Data regarding investments in infrastructure improvement were scarce. CHN increased the number of times windows were opened as a measure of environmental ventilation¹³13 Li SD, Liu TH. Correctional system's response to the coronavirus pandemic and its implications for prison reform in China. Vict Offenders 2020; 15(7-8):959-969.. In the PHI, a basic sanitation and ventilation strategy was implemented without detailing the strategy³⁸38 Cahapay MB. National responses for persons deprived of liberty during the COVID-19 pandemic in the Philippines. Vict Offenders 2020; 15(7-8):988-895.. TUR adopted a strategy to ensure sufficient food quantity and quality¹⁴14 Elbek O. COVID-19 pandemic threatening prison population. Turk Thorac J 2020; 21(6):433-437.. Six countries reported installing COVID-19 centers to improve the health care infrastructure, with a predominance of AE countries, as follows: AUS¹¹11 Payne JL, Hanley N. COVID-19 and corrections in Australia: a summary review of the available data and literature. Vict Offenders 2020; 15(7-8):1367-1384., France⁴⁰40 Fovet T, Lancelevée C, Eck M, Scouflaire T, Bécache E, Dandelot D. Prisons confinées: quelles conséquences pour les soins psychiatriques et la santé mentale des personnes détenues en France? Encephale 2020; 46(3):S60-S65., Portugal (POR)³²32 Redondo S, Gonçalves RA, Nistal J, Soler C, Moreira JS, Andrade J, Andrés-Pueyo A. Corrections and crime in Spain and Portugal during the COVID-19 pandemic: impact, prevention and lessons for the future. Vict Offenders 2020; 15(7-8):1156-1185., ROM²⁹29 Durnescu I, Morar I. An examination of the Romanian Prison System during the COVID-19 pandemic. Are "zero cases" possible? Vict Offenders 2020; 15(7-8):1133-1147., U.S.³⁷37 Wetzel JE, Davis JM. The response to the COVID19 crisis by the Pennsylvania Department of Corrections. Vict Offenders 2020; 15(7-8):1298-1304., and Guatemala (GUA)⁴¹41 Pitts WJ, Inkpen CS. Assessing the effects of COVID-19 in Prisons in the Northern Triangle of Central America. Vict Offenders 2020; 15(7-8):1044-1061..

Ten countries changed the work schedule of professionals, mainly adopting a 15-day in prison and 15-day at-home scale. Eight countries evidenced data on the recruitment of new health and safety professionals. The guarantee of flow with the municipal health service for the care of workers was reported as a strategy implemented in MEX³³33 Agoff C, Sandberg S, Fondevila G. Women providing and men free riding: work, visits and gender roles in Mexican prisons. Vict Offenders 2020; 15(7-8):1086-1104..

Adopting clinical protocol and therapeutic guidelines was more prevalent in prison health services processes in AE countries. Joint coordination between the health and prison systems was implemented in nine countries, and case and death surveillance in nine countries.

Category 3 - Mitigating the consequences of the pandemic and interventions

Strategies aimed at mitigating the consequences of the pandemic and interventions were addressed in 12 AE countries and 9 EDE countries. Assistance for prisoners or workers was a strategy found in publications referring to AE countries: Germany⁴²42 Dünkel F. The impact of COVID-19 on prisons and penal policy in Germany. Vict Offenders 2020; 15(7-8):1113-1123., ESP³²32 Redondo S, Gonçalves RA, Nistal J, Soler C, Moreira JS, Andrade J, Andrés-Pueyo A. Corrections and crime in Spain and Portugal during the COVID-19 pandemic: impact, prevention and lessons for the future. Vict Offenders 2020; 15(7-8):1156-1185., POR⁴³43 Cordeiro-Rodrigues L. Social justice for public health: the COVID-19 response in Portugal. J Bioethical Inq 2020; 17(4):669-674., ITA³¹31 Pattavina A, Palmieri MJ. Fears of COVID-19 contagion and the Italian Prison System response. Vict Offenders 2020; 15(7-8):1124-1132., and the United Kingdom³²32 Redondo S, Gonçalves RA, Nistal J, Soler C, Moreira JS, Andrade J, Andrés-Pueyo A. Corrections and crime in Spain and Portugal during the COVID-19 pandemic: impact, prevention and lessons for the future. Vict Offenders 2020; 15(7-8):1156-1185..

Publications referring to five countries mentioned strategies for reviewing penal policy to reduce the use of prison sentences. In Colombia, house arrest was created to replace the prison sentence⁴⁴44 Hernández Jiménez N. Covid-19 y decisión judicial: competencia para decidir las medidas del Decreto 546 de 2020. Justicia 2020; 25(37):215-226.. In GUA, the National Congress analyzed six bills to review the criminal procedure⁴¹41 Pitts WJ, Inkpen CS. Assessing the effects of COVID-19 in Prisons in the Northern Triangle of Central America. Vict Offenders 2020; 15(7-8):1044-1061.. Aiming at the population’s adherence to isolation and quarantine, Chile and ITA reviewed the criminal law to include the prison sentence for crimes against public health¹⁵15 Marmolejo L, Barberi D, Bergman M, Espinoza O, Fondevila G. Responding to COVID-19 in Latin American prisons: the cases of Argentina, Chile, Colombia, and Mexico. Vict Offenders 2020; 15(7-8):1062-1085.^,3131 Pattavina A, Palmieri MJ. Fears of COVID-19 contagion and the Italian Prison System response. Vict Offenders 2020; 15(7-8):1124-1132..

Except for CHN¹³13 Li SD, Liu TH. Correctional system's response to the coronavirus pandemic and its implications for prison reform in China. Vict Offenders 2020; 15(7-8):959-969. and NZL³⁴34 Murray LJ, Kras KR. "We must go hard and we must go early": how New Zealand halted coronavirus in the community and corrections. Vict Offenders 2020; 15(7-8):1385-1395., no data were found on social protection for released people, such as financial aid, housing provision, social assistance, health, culture, and leisure in most countries. In CHN, Li et al.¹³13 Li SD, Liu TH. Correctional system's response to the coronavirus pandemic and its implications for prison reform in China. Vict Offenders 2020; 15(7-8):959-969. reported a coordinated action between prisons and correctional services in liberty to monitor the health conditions of the released. In NZL³⁴34 Murray LJ, Kras KR. "We must go hard and we must go early": how New Zealand halted coronavirus in the community and corrections. Vict Offenders 2020; 15(7-8):1385-1395., in 2019, the Department of Corrections started a program with the government on housing for the released. In the U.S., some states revised the rules of access to the food security program to allow the concession to released inmates⁴⁵45 Golembeski CA, Irfan A, Dong KR. Food insecurity and collateral consequences of punishment amidst the COVID-19 pandemic. World Med Health Policy 2020; 12(4):357-373..

Regarding mental health care of people imprisoned during the blockade of prisons, we found data referring to CHN¹³13 Li SD, Liu TH. Correctional system's response to the coronavirus pandemic and its implications for prison reform in China. Vict Offenders 2020; 15(7-8):959-969., with increased physical and mental health promotion services. France⁴⁰40 Fovet T, Lancelevée C, Eck M, Scouflaire T, Bécache E, Dandelot D. Prisons confinées: quelles conséquences pour les soins psychiatriques et la santé mentale des personnes détenues en France? Encephale 2020; 46(3):S60-S65. reorganized to attend psychiatric emergencies. Catalonia³²32 Redondo S, Gonçalves RA, Nistal J, Soler C, Moreira JS, Andrade J, Andrés-Pueyo A. Corrections and crime in Spain and Portugal during the COVID-19 pandemic: impact, prevention and lessons for the future. Vict Offenders 2020; 15(7-8):1156-1185. drew up an action plan to prevent the use of psychoactive drugs and overdose.

In California (U.S.), in partnership with health professionals, community organizations conducted a public awareness campaign about the risks of mass incarceration to awaken positive attitudes towards inmates. Civil society organizations also led the discussion on healthy communities to push for a penal policy reform⁴⁶46 Minkler M, Griffin J, Wakimoto P. Seizing the moment: policy advocacy to end mass incarceration in the time of COVID-19. Health Educ Behav 2020; 47:514-518..

Category 4 - Governance

Among the four categories of policy strategies for the prevention and care of incarcerated people during the COVID-19 pandemic, aspects related to governance were the least mentioned, although desincarceration was the second most used strategy in the countries (Table 3).

Regarding strengthening national authority to decide on desincarceration and strategies adopted among AE countries, the U.S. expanded the powers of the Bureau of Prisons through Congress in the Coronavirus, Aid, Relief and Economic Security Act. Abraham et al.²2 Abraham LA, Brown TC, Thomas SA. How COVID-19's Disruption of the U.S. Correctional System Provides an Opportunity for Decarceration. Am J Crim Justice 2020; 45(4):780-792. reported that using this attribution was confusing when establishing the criteria for release. Furthermore, the government allocated US$ 100 million to control and prevent COVID-19 in the federal prison system^2,1818 Brelje AB, Pinals DA. Provision of health care for prisoners during the COVID-19 pandemic: an ethical analysis of challenges and summary of select best practices. Int J Prison Health 2020; 17(3):194-205.^,3535 Hummer D. United States Bureau of Prisons' response to the COVID-19 pandemic. Vict Offenders 2020; 15(7-8):1262-1276..

The decree “Cura Italia” (Heal Italy) provided house detention for people serving a residual sentence of up to 18 months. However, the measure was criticized for not being sufficient to reduce the occupancy rate of Italian prisons⁹9 Pagano AM, Maiese A, Izzo C, Maiese A, Ametrano M, De Matteis A, Attianese MR, Busato G, Caruso R, Cestari M, Biasi S, Chiara A, De Matteis G, Goffredi G, La Russa R. Covid-19 risk management and screening in the penitentiary facilities of the Salerno Province in Southern Italy. Int J Environ Res Public Health 2020; 17(21):8033.. The government established a crisis unit under the General Direction for Prisoners and Treatment for monitoring and decision-making⁴⁷47 Cingolani M, Caraceni L, Cannovo N, Fedeli P. The COVID-19 epidemic and the prison system in Italy. J Correct Health Care 2020; 27(1):3-7..

In POR, through the “Exceptional regime for easing the execution of sentences and freedom measures in the context of the COVID-19 disease pandemic”, a partial pardon was granted to some sentenced to prison, in addition to a special compensation regime to inmates over 65 with comorbidities or with a level of autonomy incompatible with life imprisonment³²32 Redondo S, Gonçalves RA, Nistal J, Soler C, Moreira JS, Andrade J, Andrés-Pueyo A. Corrections and crime in Spain and Portugal during the COVID-19 pandemic: impact, prevention and lessons for the future. Vict Offenders 2020; 15(7-8):1156-1185..

We found strategies to strengthen the national authority and establish decision-making processes and health surveillance (HS) in Ireland. In a partnership between the National Infection Control Team of the Irish Prison Service, the National Quality Improvement, and Health Service Executive, the contact tracing and isolation program was built in all prisons in the country¹⁷17 Clarke M, Devlin J, Conroy E, Kelly E, Sturup-Toft S. Establishing prison-led contact tracing to prevent outbreaks of COVID-19 in prisons in Ireland. J Public Health (Oxf) 2020; 42(3):519-524..

A nationwide technical support group was established in ROM, responsible for coordinating the implementation of COVID-19 prevention measures, deciding on transfers between prisons, and mobilizing the necessary resources for purchasing PPE, disinfectants, tests, and medical supplies²⁹29 Durnescu I, Morar I. An examination of the Romanian Prison System during the COVID-19 pandemic. Are "zero cases" possible? Vict Offenders 2020; 15(7-8):1133-1147.. In SWE, the Swedish Prison and Probation Service created a prison crisis management team that decided and coordinated the implementation of actions in all prisons. This team established surveillance and internal and external communication mechanism¹⁰10 Lindström M, Ahlstrand E, Kärrholm J. Sweden's response to the COVID-19 outbreak. Vict Offenders 2020; 15(7-8):1203-1214..

Regarding strengthening national authority among EDE countries for decisions regarding desincarceration, the Indian judiciary system guided provisional bail for people on trial with a sentence of fewer than seven years imprisonment⁴⁸48 Dmello JR, Ranjan S. Lock unlock: the impact of COVID-19 on health security in Pakistani and Indian prisons. Vict Offenders 2020; 15(7-8):970-987.. In RSA, the judiciary system eliminated records of people for admitting crimes and reconsidered convictions concerning financial and property crimes³⁰30 Kras KR, Fitz L. The social and environmental implications of the novel coronavirus on institutional and community corrections in South Africa. Vict Offenders 2020; 15(7-8):933-947.. In MEX, the National Congress passed an amnesty law for federal prisoners, but no amnesty was granted for state prisoners. Thus, the measure was ineffective because it impacted only 7% of the imprisoned population³³33 Agoff C, Sandberg S, Fondevila G. Women providing and men free riding: work, visits and gender roles in Mexican prisons. Vict Offenders 2020; 15(7-8):1086-1104..

The Brazilian National Council of Justice (CNJ), through Recommendation nº 62/2020, guided the adoption of preventive measures, desincarceration, and restricted mobility. However, the recommendation was ineffective for not having the power of law, leaving decision-making at the discretion of state and federal judges and prison administrators⁴⁹49 Vasconcelos NP, Machado MR, Wang DWL. COVID-19 in prisons: a study of habeas corpus decisions by the São Paulo Court of Justice. Rev Adm Publica 2020; 54(5):1472-1485.. Moreover, the Minister of Justice and Public Security spoke against using the pandemic to justify the release of people⁵⁰50 Ribeiro L, Diniz AMA. The Brazilian penitentiary system under the threat of COVID-19. Vict Offenders 2020; 15(7-8):1019-1043.^,5151 Tavares N, Garrido R, Santoro A. Política de saúde no cárcere fluminense: impactos da pandemia de COVID-19. REI 2020; 6(1):277-300.. The Brazilian National Penitentiary Department (DEPEN) established the HS system for case and death monitoring¹⁹19 Rapisarda SS, Byrne JM, Marmolejo L. An examination of COVID-19 outbreaks in South American prisons and jails. Vict Offenders 2020; 15(7-8):1009-1018.. Peer care was reported in Peru¹⁹19 Rapisarda SS, Byrne JM, Marmolejo L. An examination of COVID-19 outbreaks in South American prisons and jails. Vict Offenders 2020; 15(7-8):1009-1018..

Regarding forming a decision-making committee, CHN adopted a centralized and vertical strategy. Municipalities and states were responsible for funding, providing PPE, and testing the CCP emergency branches set up in each prison. Branches were responsible for establishing rules, protocols, and HS system¹³13 Li SD, Liu TH. Correctional system's response to the coronavirus pandemic and its implications for prison reform in China. Vict Offenders 2020; 15(7-8):959-969..

Discussion

This paper was restricted to analyzing 2020, when governments implemented emergency actions without extensive knowledge of the disease, and when pharmacological measures were unavailable to managers. Due to the large number of works selected and the strategies mentioned, we could not show data by publication; therefore, we chose to present the results regarding the country’s economic development level.

We conclude that the two main strategies to reduce viral transmission were desincarceration and suspended/restricted family visits. Regarding the improvement of prison infrastructure, the strategy of providing telephones or telephone calls was the most frequent. Communication with family members was prioritized among the measures to mitigate the consequences of the pandemic and interventions, while the strengthening of national authority was the intervention most found in publications regarding governance. Moreover, we noticed a significant discrepancy between the AE and EDE countries.

Most publications that addressed desincarceration did not describe policies and planning in municipalities/states to support released people, nor investment in healthy community programs, pointing out the need to investigate the effectiveness of the desincarceration strategy that may have only increased turnover.

A study by Reinhart et al.⁵²52 Reinhart E, Chen DL. Incarceration and its disseminations: COVID-19 pandemic lessons from Chicago's Cook County Jail. Health Aff Proj Hope 2020; 39(8):1412-1418. revealed that prison turnover is a positive predictor of COVID-19. We found that while 87% of countries chose to desincarcerate, only 22% suspended or restricted new admissions, indicating that prison turnover may have continued.

In the case of BRA, the publications pointed to the desincarceration of 30,000 people, but new admissions were not suspended/restricted and, according to DEPEN, from July to December 2020, 233,612 people entered prisons⁵³53 Brasil. Ministério da Justiça e Segurança Pública. Sistema de Informação do Departamento Penitenciário Nacional [Internet]. 2021. [citado 2021 nov 18]. Disponível em: www.gov.br/depen/pt-br/sisdepen
www.gov.br/depen/pt-br/sisdepen... . This data is consistent with Vasconcelos et al.⁴⁹49 Vasconcelos NP, Machado MR, Wang DWL. COVID-19 in prisons: a study of habeas corpus decisions by the São Paulo Court of Justice. Rev Adm Publica 2020; 54(5):1472-1485. when analyzing habeas corpus decisions at the São Paulo Court of Justice, concluding that the CNJ’s recommendation was ineffective.

It is obvious that policies to improve prison infrastructure were not found in most publications, nor was the mobilization of resources, despite the worldwide recognition that the infrastructure conditions are an essential factor for prisons to be called “Petri plate”⁵⁴54 Braithwaite R, Warren R. The African American Petri Dish. J Health Care Poor Underserved 2020; 31(2):491-502. of COVID-19, compromising the guarantee of the rights of prisoners, as agreed at the international level⁵⁵55 Organização das Nações Unidas (ONU). Regras mínimas das Nações Unidas para o tratamento de reclusos [Internet]. 2015. [citado 2021 nov 23]. Disponível em: https://www.unodc.org/documents/justice-and-prison-reform/Nelson_Mandela_Rules-P-ebook.pdf
https://www.unodc.org/documents/justice-... .

The lack of tests and HS systems for people who experience the prison environment is a challenge for decision-making concerning the health policy to face COVID-19. The planning and allocation of resources for developing a health strategy that can be effective in its actions in prisons depends on an effective HS system.

It should be noted that prison systems worldwide diverge regarding administrative centralization. We have countries such as BRA, AUS, U.S., United Kingdom, South Korea, and Canada¹¹11 Payne JL, Hanley N. COVID-19 and corrections in Australia: a summary review of the available data and literature. Vict Offenders 2020; 15(7-8):1367-1384.^,2121 Brennan PK. Responses taken to mitigate COVID-19 in prisons in England and Wales. Vict Offenders 2020; 15(7-8):1215-1233.^,2222 Murdoch DJ. British Columbia provincial corrections' response to the COVID-19 pandemic: a case study of correctional policy and practice. Vict Offenders 2020; 15(7-8):1317-1336.^,2424 Novisky MA, Narvey CS, Semenza DC. Institutional responses to the COVID-19 pandemic in American prisons. Vict Offenders 2020; 15(7-8):1244-1261.^,3535 Hummer D. United States Bureau of Prisons' response to the COVID-19 pandemic. Vict Offenders 2020; 15(7-8):1262-1276.^,5656 Lee CS. South Korea's responses regarding mitigating the COVID-19 crisis behind bars. Vict Offenders 2020; 15(7-8):996-1008., in which the management of the prison system is decentralized and hybrid, with federal, regional or local administration, with public and private prisons. In other countries, such as SWE, NZL, RSA, Kenya, and CHN, the administration is centralized and under federal responsibility¹⁰10 Lindström M, Ahlstrand E, Kärrholm J. Sweden's response to the COVID-19 outbreak. Vict Offenders 2020; 15(7-8):1203-1214.^,1313 Li SD, Liu TH. Correctional system's response to the coronavirus pandemic and its implications for prison reform in China. Vict Offenders 2020; 15(7-8):959-969.^,3030 Kras KR, Fitz L. The social and environmental implications of the novel coronavirus on institutional and community corrections in South Africa. Vict Offenders 2020; 15(7-8):933-947.^,3434 Murray LJ, Kras KR. "We must go hard and we must go early": how New Zealand halted coronavirus in the community and corrections. Vict Offenders 2020; 15(7-8):1385-1395.^,5757 Deche M, Bosire C. The silver lining in the COVID-19 cloud: an appraisal of accelerated prison decongestion in Kenya. Vict Offenders 2020; 15(7-9):921-932.. Such administrative differences can cause discrepancies in the effectiveness of actions, requiring an evaluation.

Finally, most countries in the literature delegate health policies in prisons to the judiciary and public security systems, while health systems assume a supporting or consultative role. There are indications, and it is necessary to investigate whether the experiences that put health systems at the forefront of decision-making in prisons were more successful in controlling the pandemic.

References

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