Abstract
PurposeIn this work, the authors present some of the key results found during early efforts to model the COVID-19 outbreak inside a UK prison. In particular, this study describes outputs from an idealised disease model that simulates the dynamics of a COVID-19 outbreak in a prison setting when varying levels of social interventions are in place, and a Monte Carlo-based model that assesses the reduction in risk of case importation, resulting from a process that requires incoming prisoners to undergo a period of self-isolation prior to admission into the general prison population.Design/methodology/approachPrisons, typically containing large populations confined in a small space with high degrees of mixing, have long been known to be especially susceptible to disease outbreaks. In an attempt to meet rising pressures from the emerging COVID-19 situation in early 2020, modellers for Public Health England’s Joint Modelling Cell were asked to produce some rapid response work that sought to inform the approaches that Her Majesty’s Prison and Probation Service (HMPPS) might take to reduce the risk of case importation and sustained transmission in prison environments.FindingsKey results show that deploying social interventions has the potential to considerably reduce the total number of infections, while such actions could also reduce the probability that an initial infection will propagate into a prison-wide outbreak. For example, modelling showed that a 50% reduction in the risk of transmission (compared to an unmitigated outbreak) could deliver a 98% decrease in total number of cases, while this reduction could also result in 86.8% of outbreaks subsiding before more than five persons have become infected. Furthermore, this study also found that requiring new arrivals to self-isolate for 10 and 14 days prior to admission could detect up to 98% and 99% of incoming infections, respectively.Research limitations/implicationsIn this paper we have presented models which allow for the studying of COVID-19 in a prison scenario, while also allowing for the assessment of proposed social interventions. By publishing these works, the authors hope these methods might aid in the management of prisoners across additional scenarios and even during subsequent disease outbreaks. Such methods as described may also be readily applied use in other closed community settings.Originality/valueThese works went towards informing HMPPS on the impacts that the described strategies might have during COVID-19 outbreaks inside UK prisons. The works described herein are readily amendable to the study of a range of addition outbreak scenarios. There is also room for these methods to be further developed and built upon which the timeliness of the original project did not permit.
Highlights
On 5 February 2020, the cruise ship Diamond Princess was quarantined in the port of Yokohama, Japan, following a series of passengers being positively diagnosed with COVID-19
We present an idealised in-prison disease model that has been used to simulate the dynamics of an outbreak occurring in a prison setting, and another model that uses Monte Carlo simulation to estimate the impact that requiring new prisoners to undergo a period of self-isolation might have on the probability of case importation
In this paper we have reconstructed models which were produced to provide early insights into the possible COVID-19 situation in UK prisons. These included a model that considered the in-prison disease dynamics of a COVID-19 outbreak and a model that simulated the process of isolating new prison arrivals prior to releasing them into the prison population
Summary
On 5 February 2020, the cruise ship Diamond Princess was quarantined in the port of Yokohama, Japan, following a series of passengers (past and present) being positively diagnosed with COVID-19. In light of these events, concerns were raised about the severity of possible outbreaks should COVID-19 enter into confined populations, or “closed communities” (Koshkouei et al, 2020; WHO, 2020), which have historically been susceptible to outbreaks of influenza-like infectious diseases (Finnie et al, 2012; Finnie et al, 2014; Lansbury et al, 2017). Prisons and detention centres have long been known to be vulnerable to epidemics (Young et al, 2005; Reid et al, 2012) This is predominantly due to the fact that such institutions are typically densely populated, with incarcerated populations living within close proximity with high degrees of mixing. High turnover rates and an elevated rate of respiratory illness, immunosuppression and other chronic disease among prisoners are other key contributing factors (Public Health England, 2019)
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