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Principal Investigator: Lauren Brinkley-Rubinstein
Organization: YALE UNIVERSITY
Fiscal Year: 2020
Award: $3,829,777
Funding agency: National Institute on Drug Abuse
PROJECT SUMMARY
Correctional settings account for 39 of the 50 largest outbreaks of COVID-19 in the US to date. Transmission
of the COVID-19 virus (SARS-CoV-2) is amplified in correctional settings due to restricted access to sanitizing
supplies, personal protective equipment and diagnostic tests, close congregant living conditions, and exposure
to correctional staff who unknowingly transmit the infection from the community. Incarcerated people are also
more likely to die from COVID-19 compared to the general population. Therefore, there is an urgent need for
the development and implementation of long-term COVID-19 testing and prevention strategies targeting
incarcerated populations and correctional staff. However, there are also long-standing ethical and pragmatic
concerns unique to corrections, which may present as barriers to the successful implementation of prevention
strategies. Prior work has not explored the ethical, legal, and social barriers to COVID-19 testing and vaccine
administration in corrections, especially centered around the values, preferences, and needs of those who
work and live in correctional facilities. Until this knowledge gap addressed, it will be difficult to reduce COVID-
19 morbidity and mortality in correctional facilities. In response to NOSI-20-121, and as a supplement to a
NIDA Justice Community Opioid Innovation (JCOIN) consortium’s grant (1UG1DA050072-01), the overall
objective of our study, “COVID-19 Testing and Prevention in Correctional Settings,” is to increase the reach,
access, uptake, and impact of COVID-19 testing and mitigate the impact of COVID-19 among incarcerated
people and staff. Our specific aims are to: (1) Identify ethical concerns and potential solutions for COVID-19
testing and vaccine strategies in correctional facilities using a community-engaged strategy; and (2)
Characterize baseline COVID-19 incidence, disease progression and related-outcomes among incarcerated
individuals and correctional staff. At the core of this work is a long-standing multidisciplinary team, including
people with histories of incarceration, correctional policymakers, public health scientists, historians, legal
scholars, and ethicists, which will identify ethical concerns and potential solutions to testing and vaccine
implementation in correctional settings. We have partnered with the Florida, Rhode Island, and Minnesota
state departments of corrections and the Yakima County jail in Washington, to implement mass testing to
characterize COVID-19 incidence, risk factors, and long-term outcomes in a diverse set of jails and prisons in
rural and urban geographies. Together, the knowledge produced by this proposal will have a positive impact by
providing feasible and ethical solutions for corrections to prevent COVID-19 morbidity and mortality through
testing and vaccine distribution.
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