Respuestas de salud pública para manejo de la COVID-19 en centros reclusión. Revisión de literatura

Piñeros-Báez, Víctor H.

doi:10.15446/rsap.v22n2.88704

RESUMEN

Objetivo

Identificar en la literatura las recomendaciones para la prevención y control de la COVID-19 en prisiones y centros de detención preventiva, con el fin de caracterizar las líneas de respuesta.

Materiales y Métodos

Se identificaron 88 publicaciones en bases datos y repositorios digitales usando términos clave. Luego de aplicar la metodología PRISMA, se seleccionaron 18 publicaciones para realizar el análisis cualitativo. Las publicaciones elegidas refieren a recomendaciones de académicos, investigadores y expertos. Para ilustrar el enfoque de la respuesta gubernamental, se analizan seis publicaciones emitidas por autoridades gubernamentales de Canadá, Bélgica, Francia y Estados Unidos. Se excluyeron publicaciones relacionadas con centros de detención para menores o pacientes psiquiátricos.

Resultados

Si bien hay poca literatura, se logró caracterizar las recomendaciones disponibles, agrupándolas en seis líneas de respuesta. En su caracterización resulta primordial el establecimiento de medidas físicas, administrativas, jurídicas, higiénicas y de salubridad. Asimismo, se plantea la necesidad de garantizar el manejo epidemiológico y la adecuación de los servicios de salud en concordancia con la carga de enfermedad y las vulnerabilidades de los detenidos.

Conclusiones

La respuesta a la COVID-19 en centros de reclusión es compleja y desafiante. Por ende, las medidas convencionales del orden higiénico, sanitario, médico y epidemiológico no son suficientes. Estas deben ir acompañadas por un ajuste de las políticas criminal y penitenciaria, con el fin de reducir y controlar la densidad poblacional, además de la adaptación permanente de la administración de justicia en función de las medidas de contención, mitigación o supresión de la pandemia.

Palabras Clave:
Prisiones; prisioneros; infecciones por coronavirus; control de infecciones; revisión; salud pública (fuente: DeCS, BIREME)

ABSTRACT

Objective

To identify in the literature the recommendations for the prevention and control of COVID-19 in prisons and other preventive detention centers, in order to characterize the response lines.

Materials and Methods

88 publications were identified in databases and digital repositories using key terms. After applying the PRISMA methodology, 18 publications were selected to carry out the qualitative analysis. The chosen publications refer to recommendations from academics, researchers and experts. 6 publications issued by the Governments of Canada, Belgium, France and United States of America were analyzed to make clear the government perspectives. Publications related to underage and psychiatric patients were not considered.

Results

Although there isn't enough literature, it was possible to characterize the available recommendations, grouping them into 6 lines of action. Within these lines, the establishment of physical, administrative, legal, hygienic and health measures is considered essential. In addition, it is necessary to ensure the epidemiological management and adaptation of health services based on the burden of disease and susceptibility of the persons under arrest.

Conclusions

The response to COVID-19 in detention centers is complex and challenging. Therefore, the conventional steps like hygienic, sanitary, medical and epidemiological care aren't enough. In fact, the adjustment of criminal and penitentiary policies and the transformation of the justice system are considered essential to reduce and control the residential density.

Key Words:
Prisons; prisoners; coronavirus infections; infection control; review; public health (source: MeSH, NLM)

En el mundo, hay más de 10,7 millones de personas recluidas en instituciones penitenciarias y carcelarias ¹1. Institute for Criminal Policy Research. 12th World Prison Population List. [Internet]. 2018 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2BsDoVK .
https://bit.ly/2BsDoVK... . En Colombia, esta población contabiliza 192 871 personas. De ellas, el 98,2% (189 373) está a cargo del Instituto Nacional Penitenciario y Carcelario (INPEC) bajo reclusión intramural, detención domiciliaria o vigilancia electrónica, mientras que el 1,5% (2 834) está recluida en cárceles del orden municipal y un 0,3% (664) en cárceles para la fuerza pública ²2. Instituto Nacional Penitenciario y Carcelario. No. 3 Informe estadístico población privada de la libertad, marzo 2020 [Internet]. Bogotá: INPEC; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/3eVLfsm .
https://bit.ly/3eVLfsm... .

Los centros de reclusión del país conforman espacios sociales donde suceden y convergen múltiples situaciones de la vida diaria. En efecto, allí las personas privadas de las libertad cumplen sus condenas, los niños y las niñas que conviven con sus madres desarrollan sus primeros años de vida, los funcionarios penitenciarios trabajan, las familias visitan a los detenidos y los visitantes realizan un apoyo sociojurídico.

A la par de esta realidad, los centros de reclusión se configuran como lugares de alto riesgo para la salud y la vida, ya que predomina la sobrepoblación, el hacinamiento y las condiciones insalubres; situación agravada por el precario servicio de salud, la deficiente gestión sanitaria y la elevada carga de enfermedad. Esta población tiene una mayor prevalencia de trastornos y enfermedades mentales, sufre de drogodependencias y toxicomanías o padece enfermedades crónicas o infecciosas tales como el VIH-SI-DA, la hepatitis B o C y la tuberculosis ³3. Gómez IT, Llerena CR, Zabaleta AP. Tuberculosis y tuberculosis farmacorresistente en personas privadas de la libertad. Colombia, 2010-2012. Rev. salud pública (Bogotá). 2015; 17(1):97-105. DOI:10.15446/rsap.v17n1.50937.
https://doi.org/10.15446/rsap.v17n1.5093... . De ahí que estos lugares se constituyan como reservorios que podrían conducir al resurgimiento o amplificación de un problema de salud o una epidemia ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... , como la coviD-19.

Los agentes patógenos causantes de estas infecciones pueden transmitirse entre los reclusos, los funcionarios y los visitantes. Asimismo, entre las cárceles a través de transferencias o interacciones físicas, y a su vez, hacia y desde la comunidad ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... . Por ello, los centros de reclusión configuran escenarios que pueden facilitar o aumentar la transmisión comunitaria. De ahí que deban ser parte activa de la respuesta más amplia de salud pública, en especial, por su significativa vulnerabilidad a la coviD-19 ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,⁶6. Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551.
https://doi.org/10.1136/bmj.m1551... .

Sobre este hecho, Lofgren ⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
https://doi.org/10.1101/2020.04.08.20058... , en una estimación epidemiológica desarrollada en un entorno de prisión, indica que una limitada protección frente al riesgo de infección tendrá un impacto en la salud de los detenidos, el personal de prisiones, los trabajadores del sistema judicial y la población general. Según sus estimaciones, en ausencia de acciones de mitigación como el distanciamiento social, 30 días después de la introducción de la primera infección en la comunidad de estudio, se pueden esperar 2 566 infecciones entre las personas encarceladas, lo que puede resultar en 3 muertes relacionadas. De igual forma, agrega que cuando se compara con un modelo de referencia de población general sin interacción con una cárcel, la existencia de una dinámica de la enfermedad impulsada por la cárcel aumenta el número total de casos en la población y, con ello, el número total de muertes.

Es por ello que la respuesta más amplia de salud pública debe considerar la implementación de medidas conducentes a la prevención y control de la infección en los centros de reclusión. En especial, porque en estos espacios la respuesta puede ser compleja y desafiante y, por ende, obliga a una acción coordinada entre todos los niveles de gobierno y la sociedad en general ⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... .

En este marco, resulta fundamental identificar y mapear las respuestas de salud pública recomendadas por investigadores, académicos, expertos y organizaciones no gubernamentales, así como las implementadas por las autoridades de Gobierno responsables de la administración de los centros de reclusión, a fin de comprender su enfoque y alcance.

MATERIALES Y MÉTODOS

Siguiendo el estándar PRISMA de revisiones sistemáticas, entre el 1 de enero y el 23 de abril de 2020, se realizó una revisión de literatura relacionada con la emisión de recomendaciones para la prevención y control de la coviD-19 en centros de reclusión: prisiones, cárceles y otros centros de detención preventiva. Dada la poca literatura disponible, se procedió a conformar un banco de publicaciones en español, inglés y francés que incluyera artículos de revisión, artículos originales, cartas al editor, editoriales, notas, comentarios, guías, protocolos y procedimientos producidos por investigadores, académicos y expertos. Además, para ilustrar el alcance de la respuesta gubernamental, se presentan algunos lineamientos emitidos por los gobiernos de Canadá, Bélgica, Francia y Estados Unidos.

No se tuvieron en cuenta informes de gestión gubernamental, tampoco noticias emitidas por medios de comunicación, ni publicaciones relacionadas con centros de detención para menores o pacientes psiquiátricos.

Para realizar la búsqueda, se emplean los descriptores prisión, cárcel, infección por coronavirus SARS-COV2, coviD-19, medidas de prevención y control de la infección. Además, se realizó una combinación de descriptores o palabras claves empleando el operador booleano AND.

Se exploraron las bases de datos Scopus, PubMed, Web Science, Science Direct, ciSMeF y WHO coviD-19 database. De igual forma, se hicieron búsquedas en los repositorios digitales The International Corrections and Prisons Association (ICPA) y Worldwide Prison Health Research & Engagement Network (WEPHREN). Asimismo, se empleó el motor de búsqueda Google Scholar (Tabla 1).

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Tabla 1
Caracterización de literatura por tipo de publicación sometida a screening

En total, se recopilaron 88 publicaciones. Luego de aplicar la metodología PRISMA (Figura 1), se seleccionaron 18 publicaciones que cumplían con los criterios de inclusión. Las recomendaciones fueron separadas en irtud de su enfoque. Luego del análisis de contenido, se definieron seis categorías de agrupación que derivaron en las líneas de respuesta.

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Figura 1
Procedimiento PRISMA para búsqueda de literatura

Para ajustar y limitar la búsqueda, se define como pregunta ¿qué medidas de intervención se han recomendado para prevenir y controlar la COVID-19 en centros de reclusión?

RESULTADOS

Identificación de las líneas recomendadas de respuesta

A partir de la valoración y el análisis cualitativo de la información contenida en las 18 publicaciones seleccionadas, se definieron seis líneas de respuesta (Tabla 2). Por cada línea, se definieron las estrategias operativas y las acciones más relevantes. Si bien esta relación de líneas no constituye una lista sistemática, podría aportar en la construcción y fortalecimiento de la respuesta gubernamental.

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Tabla 2
Síntesis de las recomendaciones para organizar la respuesta de salud pública a COVID-19 en entornos de reclusión

Caracterización de las estrategias operativas y las acciones recomendadas de respuesta

Línea 1: Medidas físicas

Estas medidas se focalizan en dos estrategias operativas. Inicialmente, se aconseja el control de acceso, la restricción de movimiento y la reorganización de los espacios de reclusión ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁵15. Rubin R. The Challenge of Preventing COVID-19 Spread in Correctional Facilities. JAMA. 2020. DOI:10.1001/jama.2020.5427.
https://doi.org/10.1001/jama.2020.5427...

16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730.
https://doi.org/10.1111/phn.12730...

17. Comité Internacional de la Cruz Roja Internacional CICR. Recomendaciones para la Prevención y Control de La COVID-19 en Lugares De Detención [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdKi2a .
https://bit.ly/2EdKi2a... ^-¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... . Por otro lado, se plantea la necesidad de garantizar el control del distanciamiento y la limitación de la interacción social ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
https://doi.org/10.1101/2020.04.08.20058... ^,⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... .

Para el control de acceso, la restricción de movimiento y la reorganización de los espacios de reclusión, se plantea realizar un control de ingreso y circulación con toma de temperatura e indagación de antecedentes y condiciones de salud aplicable a toda persona que ingrese al centro de reclusión ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁵15. Rubin R. The Challenge of Preventing COVID-19 Spread in Correctional Facilities. JAMA. 2020. DOI:10.1001/jama.2020.5427.
https://doi.org/10.1001/jama.2020.5427... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... . Además, se hace necesario reorganizar y controlar el uso de espacios intramurales, procurando la continuidad del proceso regular de encarcelamiento, el tratamiento penitenciario y la realización efectiva de los aislamientos y cuarentenas (5,16-18). Finalmente, se sugiere la reducción del ingreso de personal no esencial a las áreas internas o lugares críticos ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... .

En cuanto al distanciamiento e interacción social, se aconseja la supervisión y regulación de la circulación del personal con toma preventiva de temperatura asegurando la distancia social ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
https://doi.org/10.1101/2020.04.08.20058... ^,⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... . Asimismo, se plantea procurar la exposición controlada diaria al aire libre y el desarrollo regulado de actividades recreativas y de bienestar ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... .

Línea 2: Medidas de higiene y salubridad

En esta línea, se propone reforzar tanto las acciones de higiene individual y colectiva ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30...

6. Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551.
https://doi.org/10.1136/bmj.m1551...

7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
https://doi.org/10.1101/2020.04.08.20058... ^-⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹²12. Liebrenz M, Bhugra D, Buadze A, Schleifer R. Caring for persons in detention suffering with mental illness during the COVID-19 outbreak. Forensic Science International: Mind and Law. 2020; 1:100013. DOI:10.1016/j.fsiml.2020.100013.
https://doi.org/10.1016/j.fsiml.2020.100... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... , como el saneamiento del entorno de reclusión ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... ^.

Respecto a la higiene individual y colectiva, se recomienda el suministro de elementos y productos de aseo personal para uso en dormitorios y áreas comunes, tales como jabón, desinfectantes de manos, toallas de papel, entre otros ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30...

6. Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551.
https://doi.org/10.1136/bmj.m1551...

7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
https://doi.org/10.1101/2020.04.08.20058... ^-⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... . De igual forma, se enfatiza en la necesidad de suministrar alimentación adecuada en cuanto a cantidad y valor nutricional para mantener una buena salud y adecuadas defensas inmunológicas ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... . Asimismo, se debe garantizar el suministro de elementos de protección personal, enfatizando en protección respiratoria, visual, facial, corporal y manual ⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹²12. Liebrenz M, Bhugra D, Buadze A, Schleifer R. Caring for persons in detention suffering with mental illness during the COVID-19 outbreak. Forensic Science International: Mind and Law. 2020; 1:100013. DOI:10.1016/j.fsiml.2020.100013.
https://doi.org/10.1016/j.fsiml.2020.100... .

En cuanto al saneamiento del entorno, se sugiere garantizar que en los dormitorios exista espacio libre entre camas que posibilite el movimiento de personas ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... . Además, se debe asegurar la permanente gestión de residuos sólidos con el respectivo suministro de canecas y bolsas ⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... . De igual modo, se aconseja facilitar la limpieza y la desinfección de todas las áreas, dormitorios, equipamientos, menajes, lozas y utensilios ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,⁶6. Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551.
https://doi.org/10.1136/bmj.m1551... ^,⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... .

Línea 3: Manejo epidemiológico

Para el manejo epidemiológico se deben tener en cuenta dos estrategias: el control y seguimiento preventivo a la población que ingresa a los centros de reclusión y sus contactos ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687...

5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^-⁶6. Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551.
https://doi.org/10.1136/bmj.m1551... ^,⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730.
https://doi.org/10.1111/phn.12730... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... ^,¹⁹19. CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI .
https://bit.ly/2CWzcxI... y la evaluación adecuada de sospechosos, junto con el control de la infección ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687...

5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30...

6. Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551.
https://doi.org/10.1136/bmj.m1551...

7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
https://doi.org/10.1101/2020.04.08.20058... ^-⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730.
https://doi.org/10.1111/phn.12730... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... .

Respecto al control y seguimiento preventivo, se recomienda implementar protocolos para limitar tanto la importación y exportación de casos como la transmisión y difusión intramural ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730.
https://doi.org/10.1111/phn.12730... ^,¹⁹19. CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI .
https://bit.ly/2CWzcxI... . De igual forma, se debe propender por desarrollar protocolos para la detección de casos sospechosos en el ingreso y el respectivo reporte a las autoridades sanitarias ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,⁶6. Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551.
https://doi.org/10.1136/bmj.m1551... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... . En este aspecto, resulta fundamental el fortalecimiento de la inteligencia epidemiológica basada en el despliegue de una estrategia de vigilancia activa.

En lo referido a la evaluación de los sospechosos y el control de la infección, se recomienda la realización permanente de pruebas confirmatorias, procediendo al aislamiento y al rastreo de contactos aún por fuera del centro de reclusión en una estrecha colaboración con las autoridades sanitarias de la ciudad, la localidad o la región ^{4-6,8,10, 13,16,18}. En lo concerniente a los casos confirmados, es un imperativo asegurar el manejo médico y el seguimiento epidemiológico bajo aislamiento y/o cuarentena. En caso de requerirse, debe brindarse la atención médica especializada. De igual forma, es necesario recolectar, consolidar y analizar la información epidemiológica referente a los casos confirmados y a los mecanismos de contagio ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
https://doi.org/10.1101/2020.04.08.20058... ^,⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730.
https://doi.org/10.1111/phn.12730... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... .

Línea 4: Carga de enfermedad y gestión de servicios de salud

Esta es una de las líneas que más preocupa a los expertos, ya que es frecuente que en los centros de reclusión se proporcione mala atención de salud a los detenidos. Por ello, se recomienda reorganizar los servicios en función de las vulnerabilidades y el riesgo de contagio ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
https://doi.org/10.1101/2020.04.08.20058... ^,⁹9. Yang H, Thompson JR. Fighting COVID-19 outbreaks in prisons. BMJ; 2020 [citado 2020 24 abril]; m1362. Available from: DOI:10.1136/bmj.m1362.
https://doi.org/10.1136/bmj.m1362... ^,¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730.
https://doi.org/10.1111/phn.12730... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... ^,²¹21. Ministère de la Santé et des Services sociaux du Québec. Procédure pour le milieu carcéral - Admission des personnes incarcérées. Msss. gouv.qc.ca [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2C0zpzw .
https://bit.ly/2C0zpzw... . De igual modo, reforzar la gestión de la salud mental y la intervención del contexto psicosocial ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹²12. Liebrenz M, Bhugra D, Buadze A, Schleifer R. Caring for persons in detention suffering with mental illness during the COVID-19 outbreak. Forensic Science International: Mind and Law. 2020; 1:100013. DOI:10.1016/j.fsiml.2020.100013.
https://doi.org/10.1016/j.fsiml.2020.100... ^,¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730.
https://doi.org/10.1111/phn.12730... ^,²⁰20. Chevance A, Gourion D, Hoertel N, Llorca P-M, Thomas P, Bocher R, et al. Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review. L'Encéphale. 2020;46(3):193-201. DOI: 10.1016/j.encep.2020.04.005.
https://doi.org/10.1016/j.encep.2020.04.... ^,²¹21. Ministère de la Santé et des Services sociaux du Québec. Procédure pour le milieu carcéral - Admission des personnes incarcérées. Msss. gouv.qc.ca [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2C0zpzw .
https://bit.ly/2C0zpzw... , además del manejo integral de las drogodependencias ¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁴14. Fédération Addiction. Addiction au cannabis, confinement et détention. Fédération Addiction [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdIZQO .
https://bit.ly/2EdIZQO... .

En cuanto a la prestación de los servicios de salud, se recomienda su organización en función del riesgo de infección, las comorbilidades y las vulnerabilidades de los detenidos. Asimismo, se precisa relevante adoptar protocolos para reducir el riesgo de infección en los centros de salud que reciben detenidos colocados bajo supervisión judicial, ya sea en hospitalización o servicios ambulatorios ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
https://doi.org/10.1101/2020.04.08.20058... ^,⁹9. Yang H, Thompson JR. Fighting COVID-19 outbreaks in prisons. BMJ; 2020 [citado 2020 24 abril]; m1362. Available from: DOI:10.1136/bmj.m1362.
https://doi.org/10.1136/bmj.m1362... ^,¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730.
https://doi.org/10.1111/phn.12730... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... ^,²¹21. Ministère de la Santé et des Services sociaux du Québec. Procédure pour le milieu carcéral - Admission des personnes incarcérées. Msss. gouv.qc.ca [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2C0zpzw .
https://bit.ly/2C0zpzw... .

Frente a la salud mental, se recomienda capacitar al personal administrativo y de custodia para proporcionar apoyo de salud mental e identificar la agitación de los detenidos; asimismo, reorganizar sus cargas de trabajo y brindarles atención profesional de salud mental ¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,²¹21. Ministère de la Santé et des Services sociaux du Québec. Procédure pour le milieu carcéral - Admission des personnes incarcérées. Msss. gouv.qc.ca [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2C0zpzw .
https://bit.ly/2C0zpzw... . De igual modo, se considera esencial asegurar la continuidad en la provisión de atención psiquiátrica y psicológica a la población detenida de forma intra- y extramural, así como a los detenidos que sufren de enfermedades mentales y que puedan estar infectados; en este sentido, la atención debe priorizar las enfermedades mentales preexistentes, el peligro propio y externo, la violencia y/o comportamiento agresivo, la negativa a comer, el intento o la idea suicida, entre otros ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹²12. Liebrenz M, Bhugra D, Buadze A, Schleifer R. Caring for persons in detention suffering with mental illness during the COVID-19 outbreak. Forensic Science International: Mind and Law. 2020; 1:100013. DOI:10.1016/j.fsiml.2020.100013.
https://doi.org/10.1016/j.fsiml.2020.100... ^,¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730.
https://doi.org/10.1111/phn.12730... ^,²⁰20. Chevance A, Gourion D, Hoertel N, Llorca P-M, Thomas P, Bocher R, et al. Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review. L'Encéphale. 2020;46(3):193-201. DOI: 10.1016/j.encep.2020.04.005.
https://doi.org/10.1016/j.encep.2020.04.... ^,²¹21. Ministère de la Santé et des Services sociaux du Québec. Procédure pour le milieu carcéral - Admission des personnes incarcérées. Msss. gouv.qc.ca [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2C0zpzw .
https://bit.ly/2C0zpzw... . Complementariamente, se manifiesta la necesidad de dar seguimiento al consumo de medicamentos psiquiátricos, garantizando los tratamientos o limitando la ocurrencia de contingencias derivadas de la sobremedicación ¹²12. Liebrenz M, Bhugra D, Buadze A, Schleifer R. Caring for persons in detention suffering with mental illness during the COVID-19 outbreak. Forensic Science International: Mind and Law. 2020; 1:100013. DOI:10.1016/j.fsiml.2020.100013.
https://doi.org/10.1016/j.fsiml.2020.100... ^,¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730.
https://doi.org/10.1111/phn.12730... .

Respecto al manejo de drogodependencias, se aconseja dar atención profesional a drogodependientes y a los reclusos bajo síndrome de abstinencia, además de garantizar un manejo vigilado y controlado de los sustitutivos ¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁴14. Fédération Addiction. Addiction au cannabis, confinement et détention. Fédération Addiction [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdIZQO .
https://bit.ly/2EdIZQO... .

Línea 5: Medidas administrativas

El establecimiento de medidas administrativas debe orientarse a lograr una gestión del riesgo bajo una lógica interinstitucional que privilegie el trabajo colaborativo ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2...

9. Yang H, Thompson JR. Fighting COVID-19 outbreaks in prisons. BMJ; 2020 [citado 2020 24 abril]; m1362. Available from: DOI:10.1136/bmj.m1362.
https://doi.org/10.1136/bmj.m1362...

10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^-¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁷17. Comité Internacional de la Cruz Roja Internacional CICR. Recomendaciones para la Prevención y Control de La COVID-19 en Lugares De Detención [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdKi2a .
https://bit.ly/2EdKi2a... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... . A su vez, debe procurar la gestión del talento humano, administrativo y de custodia, en función del riesgo de infección y de sus vulnerabilidades ¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... . Asimismo, debe fomentar la gestión asertiva de la información y las comunicaciones bajo preceptos de ética, transparencia y veracidad ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... .

En lo concerniente a la gestión del riesgo, se recomienda privilegiar la coordinación y el trabajo armonioso entre las autoridades administrativas, penitenciarias, judiciales y de salud pública. En especial, durante el control de la infección, el traslado de detenidos, el intercambio de información y la disponibilidad de recursos físicos y financieros ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,⁹9. Yang H, Thompson JR. Fighting COVID-19 outbreaks in prisons. BMJ; 2020 [citado 2020 24 abril]; m1362. Available from: DOI:10.1136/bmj.m1362.
https://doi.org/10.1136/bmj.m1362... ^,¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... .

A su vez, se propone la articulación comunitaria durante el proceso de transición hacia la vida en libertad de los detenidos liberados, mediante la participación de las familias, las comunidades y las autoridades, para garantizar, en los casos requeridos, la continuidad del tratamiento y el seguimiento médico ⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹⁷17. Comité Internacional de la Cruz Roja Internacional CICR. Recomendaciones para la Prevención y Control de La COVID-19 en Lugares De Detención [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdKi2a .
https://bit.ly/2EdKi2a... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... .

De igual forma, se aconseja garantizar la formación, educación y entrenamiento de toda la comunidad penitenciaria para la preparación, prevención y control de la coviD-19 ⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,⁹9. Yang H, Thompson JR. Fighting COVID-19 outbreaks in prisons. BMJ; 2020 [citado 2020 24 abril]; m1362. Available from: DOI:10.1136/bmj.m1362.
https://doi.org/10.1136/bmj.m1362... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... . A su vez, se aconseja diseñar protocolos para el manejo de emergencias, tensiones, disturbios o motines en función del riesgo de contagio ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... .

En cuanto a la gestión del staff administrativo y del cuerpo de custodia, se plantea la necesidad de controlar la exposición a través de la caracterización y aislamiento del personal susceptible, por edad y condición de salud, y la identificación de funciones críticas y trabajos cruzados. Además, es necesario suministrar elementos de protección personal y disponer de personal adicional para atender contingencias de salud o de orden público ¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... . En lo referido a la gestión de las comunicaciones y la información, es importante establecer un plan de comunicaciones para permitir el contacto entre los internos, las familias y los defensores; asimismo, permitir la difusión de información de forma clara y veraz desde y hacia la prisión ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
https://doi.org/10.1016/S2468-2667(20)30... ^,⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 .
https://bit.ly/2CFPYl2... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... .

Línea 6: medidas jurídicas

El establecimiento de medidas jurídicas resulta un asunto sensible ya que su acción se concentra en la descongestión del sistema de prisiones, lo que en algunos casos podría tener un impacto sobre la seguridad pública. En este orden, los expertos aconsejan emprender medidas de reducción ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁶6. Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551.
https://doi.org/10.1136/bmj.m1551... ^,⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
https://doi.org/10.1101/2020.04.08.20058... ^,¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁵15. Rubin R. The Challenge of Preventing COVID-19 Spread in Correctional Facilities. JAMA. 2020. DOI:10.1001/jama.2020.5427.
https://doi.org/10.1001/jama.2020.5427... ^,¹⁷17. Comité Internacional de la Cruz Roja Internacional CICR. Recomendaciones para la Prevención y Control de La COVID-19 en Lugares De Detención [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdKi2a .
https://bit.ly/2EdKi2a...

18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... ^-¹⁹19. CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI .
https://bit.ly/2CWzcxI... y control de la densidad poblacional ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁹9. Yang H, Thompson JR. Fighting COVID-19 outbreaks in prisons. BMJ; 2020 [citado 2020 24 abril]; m1362. Available from: DOI:10.1136/bmj.m1362.
https://doi.org/10.1136/bmj.m1362... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁷17. Comité Internacional de la Cruz Roja Internacional CICR. Recomendaciones para la Prevención y Control de La COVID-19 en Lugares De Detención [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdKi2a .
https://bit.ly/2EdKi2a...

18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... ^-¹⁹19. CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI .
https://bit.ly/2CWzcxI... . De igual forma, consideran relevante la adecuación y/o transformación tecnológica de las diligencias judiciales ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... ^,²⁰20. Chevance A, Gourion D, Hoertel N, Llorca P-M, Thomas P, Bocher R, et al. Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review. L'Encéphale. 2020;46(3):193-201. DOI: 10.1016/j.encep.2020.04.005.
https://doi.org/10.1016/j.encep.2020.04.... y la modulación del proceso de judicialización ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
https://doi.org/10.1101/2020.04.08.20058... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... , sin olvidar el fortalecimiento de las acciones de respeto y garantía de los derechos humanos ¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁹19. CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI .
https://bit.ly/2CWzcxI... .

Inicialmente, las medidas de reducción de la densidad poblacional se deben concentrar en las excarcelaciones o libertades en función de la viabilidad jurídica, la seguridad pública, la vulnerabilidad del detenido y su riesgo de contagio. Para ello, se recomienda la libertad condicional o la detención transitoria en el hogar o en lugares alternativos al centro de reclusión ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁶6. Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551.
https://doi.org/10.1136/bmj.m1551... ^,⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
https://doi.org/10.1101/2020.04.08.20058... ^,¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁵15. Rubin R. The Challenge of Preventing COVID-19 Spread in Correctional Facilities. JAMA. 2020. DOI:10.1001/jama.2020.5427.
https://doi.org/10.1001/jama.2020.5427... ^,¹⁷17. Comité Internacional de la Cruz Roja Internacional CICR. Recomendaciones para la Prevención y Control de La COVID-19 en Lugares De Detención [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdKi2a .
https://bit.ly/2EdKi2a...

18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... ^-¹⁹19. CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI .
https://bit.ly/2CWzcxI... . Por su parte, las medidas de control de la densidad poblacional deben enfocarse en el encarcelamiento transitorio en lugares alternativos a la prisión ¹⁷17. Comité Internacional de la Cruz Roja Internacional CICR. Recomendaciones para la Prevención y Control de La COVID-19 en Lugares De Detención [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdKi2a .
https://bit.ly/2EdKi2a... , la emisión de sentencias con medidas no privativas de la libertad por delitos menores ⁹9. Yang H, Thompson JR. Fighting COVID-19 outbreaks in prisons. BMJ; 2020 [citado 2020 24 abril]; m1362. Available from: DOI:10.1136/bmj.m1362.
https://doi.org/10.1136/bmj.m1362... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁹19. CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI .
https://bit.ly/2CWzcxI... , la suspensión de condenas o el retraso sentencias contra delitos menores ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... y la suspensión de traslados de internos entre centros de reclusión ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... .

Respecto al proceso de judicialización del delito, se aconseja realizar audiencias virtuales o adecuar espacios bajo preceptos de bioseguridad, evitando la exposición de los funcionarios judiciales ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q .
https://bit.ly/2CFiN0q... ^,²⁰20. Chevance A, Gourion D, Hoertel N, Llorca P-M, Thomas P, Bocher R, et al. Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review. L'Encéphale. 2020;46(3):193-201. DOI: 10.1016/j.encep.2020.04.005.
https://doi.org/10.1016/j.encep.2020.04.... . En cuanto a la modulación del proceso judicial, se debe fortalecer la prevención del delito y reducir en lo posible los arrestos en función de la gravedad de la conducta penal ⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
https://doi.org/10.1101/2020.04.08.20058... ^,¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
https://doi.org/10.1056/NEJMp2005687... ^,¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... . Finalmente, se manifiesta la necesidad de adoptar mecanismos para garantizar los derechos fundamentales de los detenidos y demás integrantes de la comunidad penitenciaria, evitando la estigmatización de los infectados ¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
https://doi.org/10.1016/j.amepre.2020.04... ^,¹⁹19. CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI .
https://bit.ly/2CWzcxI... .

Caracterización de respuestas nacionales

Con el fin de ilustrar el enfoque de las medidas gubernamentales, a continuación, se reseñan algunos lineamientos implementados por autoridades de Canadá, Bélgica, Francia y Estados Unidos.

Canadá

El Ministerio de la Salud y Servicios Sociales de Quebec emite documento ²²22. Ministère de la Santé et des Services sociaux du Québec. COVID-19: Recommandations pour les populations en collectivites residentielles. Prisons, centres d'accueils des demandeurs d'asile et sans-abris, ou équivalent. 2020 [cited 2020 Apr 24]. Available from: Available from: https://bit.ly/32ohH4i .
https://bit.ly/32ohH4i... orientado a la admisión, manejo de infectados y la gestión de contactos. Dentro de estos lineamientos pueden resaltarse:

En el proceso de admisión, es un imperativo la higiene de manos y la aplicación de cuestionario de prediagnóstico a fin de establecer la presencia de factores de riesgo asociados a la coviD-19.
Para el manejo de casos sospechosos, se requiere el suministro de protección respiratoria, su aislamiento y la articulación del servicio de salud intramural con la agencia regional de salud para su manejo y diagnóstico.
En caso de confirmación de casos, se precisa aislamiento estricto en celda y manejo médico.
En la identificación de contactos de los casos confirmados, se contempla el seguimiento a todo el personal que interactúe con el infectado.

Bélgica

Algunas medidas, acciones y recomendaciones gubernamentales ²³23. MSPF Santé publique, Sécurité de la Chaîne alimentaire et Environnement. Recommandations pour les populations en collectivités résidentielles. Prisons, centres d’accueils des demandeurs d’asile et sansabris, ou équivalent. Covid-19.sciensano.be [Internet]. 2020 [citado 24 de abril de 2020]. Disponible en: Disponible en: https://bit.ly/3giUPqK .
https://bit.ly/3giUPqK... ^,²⁴24. Geens K. Mesures de protection du personnel pénitentiaire et des détenus, Vice-Premier ministre, ministre de la Justice et ministre des Affaires européennes. [Internet]; 2020 [citado 25 de abril de 2020]. Disponible en: Disponible en: https://bit.ly/33frCcK .
https://bit.ly/33frCcK... se orientan a...

Prohibir la salida y movilidad de los detenidos, por lo cual se revocan licencias y permisos especiales, incluidos los permisos concedidos para trabajar y capacitarse fuera de la prisión (los permisos humanitarios se mantienen).
Fijar medidas de preparación con el objetivo de aumentar las capacidades locativas y de albergue. Además de identificar sitios de cuidado alternativo donde se pueda recibir a las personas que sufran problemas respiratorios y se puedan separar los detenidos enfermos de los sanos.
Promocionar y reforzar las medidas de higiene personal.
Disminuir el riesgo de introducción del virus, mediante la prohibición de visitas y la autorización exclusiva de ingresos considerados esenciales, tales como agentes de policía, servicios de inteligencia, abogados, autoridades judiciales y personal médico.
Efectuar pruebas y test de diagnóstico coviD-19 con alcance al personal médico, de custodia y los detenidos.
Proteger la población en riesgo, mediante la prohibición del trabajo y voluntariado, en especial el realizado por personas enfermas. También se considera el uso de protección respiratoria durante la duración de la jornada de exposición y la identificación de personas que pueden tener complicaciones derivadas de una posible infección por coviD-19.
Establecer manejo de sospechosos o confirmados, donde se privilegie su aislamiento intra- o extramural y el manejo médico-clínico.

Francia

La organización de la respuesta se da en varios niveles e incluye los establecimientos penitenciarios, sus unidades sanitarias y las agencias sanitarias del nivel regional e interregional ²⁵25. Ministère des solidarités et la sante. Etablissements pénitentiaires : organisation de la réponse sanitaire par les Unités sanitaires en milieu pénitentiaire en collaboration avec les services pénitentiaires. [Internet]. Abril de 2020 [citado 26 de abril de 2020]. Disponible en: Disponible en: https://bit.ly/3gcotOx .
https://bit.ly/3gcotOx... ^,²⁶26. Ministère des solidarités et la sante. Organisation de la prise en charge sanitaire des patients détenus nécessitant des soins psychiatriques. [Internet]. Abril de 2020 [citado 26 de abril de 2020]. Disponible en: Disponible en: https://bit.ly/2Xf5kUR .
https://bit.ly/2Xf5kUR... . La respuesta gubernamental incluye lineamientos para.

La preparación de inventarios de materiales médicos y elementos de protección.
La sensibilización y capacitación de la comunidad frente a la coviD-19.
La identificación de vulnerabilidades relacionadas con morbilidades prexistentes y reforzamiento de la vigilancia a poblaciones de detenidos en riesgo.
La vigilancia epidemiológica y médica de la población y manejo de sospechosos y confirmados.
La preparación para la fase epidemiológica y control de la infección.
La gestión y seguimiento a las salidas anticipadas de detenidos vulnerables.
El manejo de detenidos con problemas psiquiátricos, priorizando continuidad de servicios, el seguimiento somático y la articulación con el servicio psiquiátrico.
La precisión de medidas generales de higiene y saneamiento.
La preparación y capacitación del personal penitenciario.

Estados Unidos

El Departamento de Salud y Servicios Humanos y los Centros para el Control y la Prevención de Enfermedades (CDC) han estructurado una guía ²⁷27. CDC. Enfermedad del coronavirus 2019 (COVID-19). Centers for Disease Control and Prevention [Internet]. 2020 [citado 26 de abril de 2020]. Disponible en: https://bit.ly/33jShW1.
https://bit.ly/33jShW1... para garantizar la protección de la salud y seguridad de los detenidos, del personal del servicio penitenciario y los visitantes. Dentro de estas recomendaciones se hace énfasis en.

Una respuesta en tres fases, definidas como de preparación operativa, prevención y manejo de la coviD-19.
La fase de preparación operativa busca la planeación y el fortalecimiento de capacidades, incluyendo la disponibilidad de los suministros médicos, de limpieza e higiene.
La fase de prevención busca retrasar, limitar o evitar el ingreso del virus a través de prácticas personales y colectivas bajo responsabilidad de los detenidos, del personal de prisiones y de los visitantes. Además, se contempla la realización de acciones continuas de higiene y saneamiento.
La fase de manejo se concentra en la implementación de los protocolos médicos, de protección, de aislamiento y de cuarentenas aplicables a casosR presuntos o confirmados de coviD-19, incluyendo sus contactos. De igual forma, se contemplan acciones para los detenidos en curso de liberación, tales como toma de temperatura y evaluación de síntomas. Además, se contemplan acciones de limpieza y desinfección para disminuir la carga viral presente en el ambiente.

DISCUSIÓN

En la literatura disponible, se sugiere que la prevención y control de la coviD-19 en centros de reclusión debe contemplar tanto la implementación de medidas convencionales como medidas jurídicas y de seguridad pública. Sin duda, esto resulta complejo, ya que emprender la reducción y control de la densidad poblacional puede generar un rechazo social y político. Incluso, pueden requerir un debate más amplio respecto a su viabilidad y conveniencia.

A su vez, la adopción e implementación de estas medidas pueden enfrentar varias dificultades, entre ellas, la apatía social y política, la limitada articulación entre la sanidad penitenciaria y la salud pública más amplia, los deficientes servicios de salud, la insalubridad intramural, la falta de recursos, la corrupción, la fragmentación de los sistemas de prisiones, las asimetrías de poder, la reducida articulación entre las políticas penal y penitenciaria, la limitada acción en materia de prevención del delito y la resistencia para trascender de una justicia retributiva a una restaurativa.

En las cuatro respuestas nacionales analizadas, se identificó que las respuestas iniciales privilegiaron la implementación de acciones de carácter higiénico, sanitario, médico y epidemiológico. Sin embargo, no se identificó la implementación de medidas jurídicas respecto a procesos de excarcelamiento masivo o modulación del proceso judicial.

En conclusión, esta pandemia se convierte en una oportunidad para humanizar la vida en prisión y repensar su utilidad social. La falta de control de la infección no solo acarrea efectos lesivos sobre las personas privadas de la libertad o los trabajadores de los centros de reclusión, sino que también se constituye como un problema con repercusiones para la salud pública de la sociedad. Sin duda, un fracaso en la prisión conducirá a un fracaso en la sociedad ⁘

REFERENCIAS

¹
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» https://bit.ly/2BsDoVK
²
Instituto Nacional Penitenciario y Carcelario. No. 3 Informe estadístico población privada de la libertad, marzo 2020 [Internet]. Bogotá: INPEC; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/3eVLfsm
» https://bit.ly/3eVLfsm
³
Gómez IT, Llerena CR, Zabaleta AP. Tuberculosis y tuberculosis farmacorresistente en personas privadas de la libertad. Colombia, 2010-2012. Rev. salud pública (Bogotá). 2015; 17(1):97-105. DOI:10.15446/rsap.v17n1.50937.
» https://doi.org/10.15446/rsap.v17n1.50937
⁴
Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
» https://doi.org/10.1056/NEJMp2005687
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Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
» https://doi.org/10.1016/S2468-2667(20)30058-X
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» https://doi.org/10.1136/bmj.m1551
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Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
» https://doi.org/10.1101/2020.04.08.20058842
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» https://doi.org/10.1056/NEJMp2005687
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Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
» https://doi.org/10.1016/j.amepre.2020.04.001
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Liebrenz M, Bhugra D, Buadze A, Schleifer R. Caring for persons in detention suffering with mental illness during the COVID-19 outbreak. Forensic Science International: Mind and Law. 2020; 1:100013. DOI:10.1016/j.fsiml.2020.100013.
» https://doi.org/10.1016/j.fsiml.2020.100013
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Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
» https://doi.org/10.1016/j.amepre.2020.04.002
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Fédération Addiction. Addiction au cannabis, confinement et détention. Fédération Addiction [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdIZQO
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Rubin R. The Challenge of Preventing COVID-19 Spread in Correctional Facilities. JAMA. 2020. DOI:10.1001/jama.2020.5427.
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European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q
» https://bit.ly/2CFiN0q
¹⁹
CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI
» https://bit.ly/2CWzcxI
²⁰
Chevance A, Gourion D, Hoertel N, Llorca P-M, Thomas P, Bocher R, et al. Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review. L'Encéphale. 2020;46(3):193-201. DOI: 10.1016/j.encep.2020.04.005.
» https://doi.org/10.1016/j.encep.2020.04.005
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Ministère de la Santé et des Services sociaux du Québec. Procédure pour le milieu carcéral - Admission des personnes incarcérées. Msss. gouv.qc.ca [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2C0zpzw
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Ministère de la Santé et des Services sociaux du Québec. COVID-19: Recommandations pour les populations en collectivites residentielles. Prisons, centres d'accueils des demandeurs d'asile et sans-abris, ou équivalent. 2020 [cited 2020 Apr 24]. Available from: Available from: https://bit.ly/32ohH4i
» https://bit.ly/32ohH4i
²³
MSPF Santé publique, Sécurité de la Chaîne alimentaire et Environnement. Recommandations pour les populations en collectivités résidentielles. Prisons, centres d’accueils des demandeurs d’asile et sansabris, ou équivalent. Covid-19.sciensano.be [Internet]. 2020 [citado 24 de abril de 2020]. Disponible en: Disponible en: https://bit.ly/3giUPqK
» https://bit.ly/3giUPqK
²⁴
Geens K. Mesures de protection du personnel pénitentiaire et des détenus, Vice-Premier ministre, ministre de la Justice et ministre des Affaires européennes. [Internet]; 2020 [citado 25 de abril de 2020]. Disponible en: Disponible en: https://bit.ly/33frCcK
» https://bit.ly/33frCcK
²⁵
Ministère des solidarités et la sante. Etablissements pénitentiaires : organisation de la réponse sanitaire par les Unités sanitaires en milieu pénitentiaire en collaboration avec les services pénitentiaires. [Internet]. Abril de 2020 [citado 26 de abril de 2020]. Disponible en: Disponible en: https://bit.ly/3gcotOx
» https://bit.ly/3gcotOx
²⁶
Ministère des solidarités et la sante. Organisation de la prise en charge sanitaire des patients détenus nécessitant des soins psychiatriques. [Internet]. Abril de 2020 [citado 26 de abril de 2020]. Disponible en: Disponible en: https://bit.ly/2Xf5kUR
» https://bit.ly/2Xf5kUR
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» https://bit.ly/33jShW1

Conflicto de intereses:
Ninguno.

Fechas de Publicación

Publicación en esta colección
06 Feb 2023
Fecha del número
Mar-Apr 2020

Histórico

Recibido
24 Abr 2020
Revisado
27 Abr 2020
Acepto
30 Abr 2020

Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons

[1] ¹
Institute for Criminal Policy Research. 12th World Prison Population List. [Internet]. 2018 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2BsDoVK
» https://bit.ly/2BsDoVK

[2] ²
Instituto Nacional Penitenciario y Carcelario. No. 3 Informe estadístico población privada de la libertad, marzo 2020 [Internet]. Bogotá: INPEC; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/3eVLfsm
» https://bit.ly/3eVLfsm

[3] ³
Gómez IT, Llerena CR, Zabaleta AP. Tuberculosis y tuberculosis farmacorresistente en personas privadas de la libertad. Colombia, 2010-2012. Rev. salud pública (Bogotá). 2015; 17(1):97-105. DOI:10.15446/rsap.v17n1.50937.
» https://doi.org/10.15446/rsap.v17n1.50937

[4] ⁴
Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687.
» https://doi.org/10.1056/NEJMp2005687

[5] ⁵
Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X.
» https://doi.org/10.1016/S2468-2667(20)30058-X

[6] ⁶
Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551.
» https://doi.org/10.1136/bmj.m1551

[7] ⁷
Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842.
» https://doi.org/10.1101/2020.04.08.20058842

[8] ⁸
World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2
» https://bit.ly/2CFPYl2

[9] ⁹
Yang H, Thompson JR. Fighting COVID-19 outbreaks in prisons. BMJ; 2020 [citado 2020 24 abril]; m1362. Available from: DOI:10.1136/bmj.m1362.
» https://doi.org/10.1136/bmj.m1362

[10] ¹⁰
Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687.
» https://doi.org/10.1056/NEJMp2005687

[11] ¹¹
Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001.
» https://doi.org/10.1016/j.amepre.2020.04.001

[12] ¹²
Liebrenz M, Bhugra D, Buadze A, Schleifer R. Caring for persons in detention suffering with mental illness during the COVID-19 outbreak. Forensic Science International: Mind and Law. 2020; 1:100013. DOI:10.1016/j.fsiml.2020.100013.
» https://doi.org/10.1016/j.fsiml.2020.100013

[13] ¹³
Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002.
» https://doi.org/10.1016/j.amepre.2020.04.002

[14] ¹⁴
Fédération Addiction. Addiction au cannabis, confinement et détention. Fédération Addiction [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdIZQO
» https://bit.ly/2EdIZQO

[15] ¹⁵
Rubin R. The Challenge of Preventing COVID-19 Spread in Correctional Facilities. JAMA. 2020. DOI:10.1001/jama.2020.5427.
» https://doi.org/10.1001/jama.2020.5427

[16] ¹⁶
Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730.
» https://doi.org/10.1111/phn.12730

[17] ¹⁷
Comité Internacional de la Cruz Roja Internacional CICR. Recomendaciones para la Prevención y Control de La COVID-19 en Lugares De Detención [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdKi2a
» https://bit.ly/2EdKi2a

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European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q
» https://bit.ly/2CFiN0q

[19] ¹⁹
CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI
» https://bit.ly/2CWzcxI

[20] ²⁰
Chevance A, Gourion D, Hoertel N, Llorca P-M, Thomas P, Bocher R, et al. Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review. L'Encéphale. 2020;46(3):193-201. DOI: 10.1016/j.encep.2020.04.005.
» https://doi.org/10.1016/j.encep.2020.04.005

[21] ²¹
Ministère de la Santé et des Services sociaux du Québec. Procédure pour le milieu carcéral - Admission des personnes incarcérées. Msss. gouv.qc.ca [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2C0zpzw
» https://bit.ly/2C0zpzw

[22] ²²
Ministère de la Santé et des Services sociaux du Québec. COVID-19: Recommandations pour les populations en collectivites residentielles. Prisons, centres d'accueils des demandeurs d'asile et sans-abris, ou équivalent. 2020 [cited 2020 Apr 24]. Available from: Available from: https://bit.ly/32ohH4i
» https://bit.ly/32ohH4i

[23] ²³
MSPF Santé publique, Sécurité de la Chaîne alimentaire et Environnement. Recommandations pour les populations en collectivités résidentielles. Prisons, centres d’accueils des demandeurs d’asile et sansabris, ou équivalent. Covid-19.sciensano.be [Internet]. 2020 [citado 24 de abril de 2020]. Disponible en: Disponible en: https://bit.ly/3giUPqK
» https://bit.ly/3giUPqK

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Geens K. Mesures de protection du personnel pénitentiaire et des détenus, Vice-Premier ministre, ministre de la Justice et ministre des Affaires européennes. [Internet]; 2020 [citado 25 de abril de 2020]. Disponible en: Disponible en: https://bit.ly/33frCcK
» https://bit.ly/33frCcK

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Ministère des solidarités et la sante. Etablissements pénitentiaires : organisation de la réponse sanitaire par les Unités sanitaires en milieu pénitentiaire en collaboration avec les services pénitentiaires. [Internet]. Abril de 2020 [citado 26 de abril de 2020]. Disponible en: Disponible en: https://bit.ly/3gcotOx
» https://bit.ly/3gcotOx

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Ministère des solidarités et la sante. Organisation de la prise en charge sanitaire des patients détenus nécessitant des soins psychiatriques. [Internet]. Abril de 2020 [citado 26 de abril de 2020]. Disponible en: Disponible en: https://bit.ly/2Xf5kUR
» https://bit.ly/2Xf5kUR

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CDC. Enfermedad del coronavirus 2019 (COVID-19). Centers for Disease Control and Prevention [Internet]. 2020 [citado 26 de abril de 2020]. Disponible en: https://bit.ly/33jShW1
» https://bit.ly/33jShW1

Línea de respuesta recomendada	Síntesis del enfoque	Referencias consolidadas
	Control de acceso, restricción de movimiento	⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X. https://doi.org/10.1016/S2468-2667(20)30... ⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 . https://bit.ly/2CFPYl2... ¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001. https://doi.org/10.1016/j.amepre.2020.04... ¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002. https://doi.org/10.1016/j.amepre.2020.04... ¹⁵15. Rubin R. The Challenge of Preventing COVID-19 Spread in Correctional Facilities. JAMA. 2020. DOI:10.1001/jama.2020.5427. https://doi.org/10.1001/jama.2020.5427... ¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730. https://doi.org/10.1111/phn.12730... ¹⁷17. Comité Internacional de la Cruz Roja Internacional CICR. Recomendaciones para la Prevención y Control de La COVID-19 en Lugares De Detención [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdKi2a . https://bit.ly/2EdKi2a... ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q . https://bit.ly/2CFiN0q...
Medidas físicas	y reorganización del espacio de reclusión.
Medidas físicas	Control del distanciamiento y limitación de la	⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842. https://doi.org/10.1101/2020.04.08.20058... ⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 . https://bit.ly/2CFPYl2... ¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001. https://doi.org/10.1016/j.amepre.2020.04... ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q . https://bit.ly/2CFiN0q...
	interacción social.
Medidas de higiene y salubridad	Fomento de la higiene individual y colectiva Saneamiento del entorno intramural.	⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X. https://doi.org/10.1016/S2468-2667(20)30... ⁶6. Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551. https://doi.org/10.1136/bmj.m1551... ⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842. https://doi.org/10.1101/2020.04.08.20058... ⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 . https://bit.ly/2CFPYl2... ¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001. https://doi.org/10.1016/j.amepre.2020.04... ¹²12. Liebrenz M, Bhugra D, Buadze A, Schleifer R. Caring for persons in detention suffering with mental illness during the COVID-19 outbreak. Forensic Science International: Mind and Law. 2020; 1:100013. DOI:10.1016/j.fsiml.2020.100013. https://doi.org/10.1016/j.fsiml.2020.100... ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q . https://bit.ly/2CFiN0q... ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X. https://doi.org/10.1016/S2468-2667(20)30... ⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 . https://bit.ly/2CFPYl2... ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q . https://bit.ly/2CFiN0q...
	Control y seguimiento preventivo de la población.	⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X. https://doi.org/10.1016/S2468-2667(20)30... ⁶6. Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551. https://doi.org/10.1136/bmj.m1551... ⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 . https://bit.ly/2CFPYl2... ¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002. https://doi.org/10.1016/j.amepre.2020.04... ¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730. https://doi.org/10.1111/phn.12730... ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q . https://bit.ly/2CFiN0q... ¹⁹19. CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI . https://bit.ly/2CWzcxI...
Manejo epidemiológico	Control y seguimiento preventivo de la población.
Manejo epidemiológico	Evaluación de sospechosos y control de la infección.	⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X. https://doi.org/10.1016/S2468-2667(20)30... ⁶6. Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551. https://doi.org/10.1136/bmj.m1551... ⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842. https://doi.org/10.1101/2020.04.08.20058... ⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 . https://bit.ly/2CFPYl2... ¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001. https://doi.org/10.1016/j.amepre.2020.04... ¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730. https://doi.org/10.1111/phn.12730... ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q . https://bit.ly/2CFiN0q...
	Reorganización de los servicios de salud en	⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X. https://doi.org/10.1016/S2468-2667(20)30... ⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842. https://doi.org/10.1101/2020.04.08.20058... ⁹9. Yang H, Thompson JR. Fighting COVID-19 outbreaks in prisons. BMJ; 2020 [citado 2020 24 abril]; m1362. Available from: DOI:10.1136/bmj.m1362. https://doi.org/10.1136/bmj.m1362... ¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730. https://doi.org/10.1111/phn.12730... ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q . https://bit.ly/2CFiN0q... ²¹21. Ministère de la Santé et des Services sociaux du Québec. Procédure pour le milieu carcéral - Admission des personnes incarcérées. Msss. gouv.qc.ca [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2C0zpzw . https://bit.ly/2C0zpzw...
Carga de enfermedad y gestión de	función del riesgo y las vulnerabilidades. Gestión de la salud mental e intervención del contexto psicosocial.
servicios de salud		⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X. https://doi.org/10.1016/S2468-2667(20)30... ¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001. https://doi.org/10.1016/j.amepre.2020.04... ¹²12. Liebrenz M, Bhugra D, Buadze A, Schleifer R. Caring for persons in detention suffering with mental illness during the COVID-19 outbreak. Forensic Science International: Mind and Law. 2020; 1:100013. DOI:10.1016/j.fsiml.2020.100013. https://doi.org/10.1016/j.fsiml.2020.100... ¹⁶16. Gorman G, Ramaswamy M. Detained during a pandemic: A postcard from the Midwest. Public Health Nurs. 2020. DOI:10.1111/phn.12730. https://doi.org/10.1111/phn.12730... ²⁰20. Chevance A, Gourion D, Hoertel N, Llorca P-M, Thomas P, Bocher R, et al. Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review. L'Encéphale. 2020;46(3):193-201. DOI: 10.1016/j.encep.2020.04.005. https://doi.org/10.1016/j.encep.2020.04.... ²¹21. Ministère de la Santé et des Services sociaux du Québec. Procédure pour le milieu carcéral - Admission des personnes incarcérées. Msss. gouv.qc.ca [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2C0zpzw . https://bit.ly/2C0zpzw...
	Manejo de drogodependencias.	¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002. https://doi.org/10.1016/j.amepre.2020.04... ¹⁴14. Fédération Addiction. Addiction au cannabis, confinement et détention. Fédération Addiction [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdIZQO . https://bit.ly/2EdIZQO...
	Gestión interinstitucional del riesgo.	⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X. https://doi.org/10.1016/S2468-2667(20)30... ⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 . https://bit.ly/2CFPYl2... ⁹9. Yang H, Thompson JR. Fighting COVID-19 outbreaks in prisons. BMJ; 2020 [citado 2020 24 abril]; m1362. Available from: DOI:10.1136/bmj.m1362. https://doi.org/10.1136/bmj.m1362... ¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001. https://doi.org/10.1016/j.amepre.2020.04... ¹⁷17. Comité Internacional de la Cruz Roja Internacional CICR. Recomendaciones para la Prevención y Control de La COVID-19 en Lugares De Detención [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdKi2a . https://bit.ly/2EdKi2a... ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q . https://bit.ly/2CFiN0q...
	Gestión del personal administrativo y de	¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001. https://doi.org/10.1016/j.amepre.2020.04...
Medidas administrativas	custodia en función del riesgo.
	Gestión de la información y las
	comunicaciones en función del riesgo y del	⁵5. Kinner SA, Young JT, Snow K, Southalan L, Lopez-Acuña D, Ferreira-Borges C, et al. Prisons and custodial settings are part of a comprehensive response to COVID-19. Lancet Public Health. 2020; 5(4):e188-e189. DOI: 10.1016/S2468-2667(20)30058-X. https://doi.org/10.1016/S2468-2667(20)30... ⁸8. World Health Organization WHO. Preparedness, prevention and control of COVID-19 in prisons and other places of detention, Interim guidance. Geneva: WHO; 2020 [cited 2020 Apr 23]. Available from: Available from: https://bit.ly/2CFPYl2 . https://bit.ly/2CFPYl2... ¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q . https://bit.ly/2CFiN0q...
	desarrollo de la crisis.
	Medidas de reducción de la densidad poblacional.	⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ⁶6. Simpson Paul L, Butler Tony G. COVID-19, prison crowding, and release policies BMJ. 2020; 369:m1551. DOI:10.1136/bmj.m1551. https://doi.org/10.1136/bmj.m1551... ⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842. https://doi.org/10.1101/2020.04.08.20058... ¹¹11. Montoya-Barthelemy A, Lee CD, Cundiff D, Smith E. COVID-19 and the Correctional Environment: The American Prison as a Focal Point for Public Health. American Journal of Preventive Medicine. 2020; 58(6):P888-91. DOI: 10.1016/j.amepre.2020.04.001. https://doi.org/10.1016/j.amepre.2020.04... ¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002. https://doi.org/10.1016/j.amepre.2020.04... ¹⁵15. Rubin R. The Challenge of Preventing COVID-19 Spread in Correctional Facilities. JAMA. 2020. DOI:10.1001/jama.2020.5427. https://doi.org/10.1001/jama.2020.5427... ¹⁷17. Comité Internacional de la Cruz Roja Internacional CICR. Recomendaciones para la Prevención y Control de La COVID-19 en Lugares De Detención [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdKi2a . https://bit.ly/2EdKi2a... ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q . https://bit.ly/2CFiN0q... ¹⁹19. CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI . https://bit.ly/2CWzcxI...
	Medidas de control de la densidad poblacional.	⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ⁹9. Yang H, Thompson JR. Fighting COVID-19 outbreaks in prisons. BMJ; 2020 [citado 2020 24 abril]; m1362. Available from: DOI:10.1136/bmj.m1362. https://doi.org/10.1136/bmj.m1362... ¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002. https://doi.org/10.1016/j.amepre.2020.04... ¹⁷17. Comité Internacional de la Cruz Roja Internacional CICR. Recomendaciones para la Prevención y Control de La COVID-19 en Lugares De Detención [Internet]. 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2EdKi2a . https://bit.ly/2EdKi2a... ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q . https://bit.ly/2CFiN0q... ¹⁹19. CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI . https://bit.ly/2CWzcxI...
Medidas jurídicas	Adecuación o transformación tecnológica de	⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ¹⁸18. European Prison Litigation Network. COVID-19 in prison: more than 50 European NGOs ask international organisations to take immediate action. European Prison Litigation Network; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CFiN0q . https://bit.ly/2CFiN0q... ²⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687...
	las diligencias judiciales.
	Modulación del proceso judicial y	⁴4. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations COVID-19 in Jails and Prisons. N Engl J Med. 2020; 382(22):2075-7. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ⁷7. Lofgren E, Lum K, Horowitz A, Madubuowu B, Fefferman N. The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19. Epidemiology. 2020. DOI:10.1101/2020.04.08.20058842. https://doi.org/10.1101/2020.04.08.20058... ¹⁰10. Akiyama MJ, Spaulding AC, Rich JD. Flattening the Curve for Incarcerated Populations - COVID-19 in Jails and Prisons. N Engl J Med . 2 de abril de 2020. DOI:10.1056/NEJMp2005687. https://doi.org/10.1056/NEJMp2005687... ¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002. https://doi.org/10.1016/j.amepre.2020.04...
	fortalecimiento de la prevención del delito.
	Garantía de los derechos humanos.	¹³13. Salisbury-Afshar EM, Rich JD, Adashi EY. Vulnerable Populations: Weathering the Pandemic Storm. American Journal of Preventive Medicine . 2020; 58(6):892-94. DOI:10.1016/j.amepre.2020.04.002. https://doi.org/10.1016/j.amepre.2020.04... ¹⁹19. CGLPL. COVID-19: recommandations du CGLPL relatives aux établissements de santé mentale [Internet]. Site du Contrôleur Général des Lieux de Privation de Liberté; 2020 [cited 2020 Apr 26]. Available from: Available from: https://bit.ly/2CWzcxI . https://bit.ly/2CWzcxI...

Saúde Pública

Saúde Pública

Respuestas de salud pública para manejo de la COVID-19 en centros reclusión. Revisión de literatura

Public health responses for the management of COVID-19 in detention centers. Literature review

RESUMEN

Objetivo

Materiales y Métodos

Resultados

Conclusiones

ABSTRACT

Objective

Materials and Methods

Results

Conclusions

MATERIALES Y MÉTODOS

RESULTADOS

Identificación de las líneas recomendadas de respuesta

Caracterización de las estrategias operativas y las acciones recomendadas de respuesta

Línea 1: Medidas físicas

Línea 2: Medidas de higiene y salubridad

Línea 3: Manejo epidemiológico

Línea 4: Carga de enfermedad y gestión de servicios de salud

Línea 5: Medidas administrativas

Línea 6: medidas jurídicas

Caracterización de respuestas nacionales

Canadá

Bélgica

Francia

Estados Unidos

DISCUSIÓN

REFERENCIAS

Fechas de Publicación

Histórico