Establishing prison-led contact tracing to prevent outbreaks of COVID-19 in prisons in Ireland.

BACKGROUND Preventing transmission of COVID-19 within prisons is both important and challenging. The confined conditions in prisons can encourage person-to-person spread with the potential for outbreaks occurring. Contact tracing is an important contributor to the longer-term management strategy for COVID-19 in prisons as well as in the community but is highly resource-intensive. This paper describes the approach to contact tracing taken by the Irish Prison Service (IPS). METHODS The IPS National Infection Control Team, in collaboration with the National Quality Improvement (QI) team and Health Service Executive (HSE) in Ireland, implemented a programme to develop and train in-prison contact tracing teams (CTTs). CTTs were run by prison staff with experience of working with detainees, prison IT systems and CCTV. Protocols for undertaking contact tracing for both detainee and staff cases of COVID-19 were established. RESULTS All prisons, and two support agencies, within the IPS now have fully functional in-prison CTTs. Every CTT has responded to at least one case COVID-19, undertaken contact tracing and instigated quarantine of contacts. CONCLUSIONS A partnership approach with development of prison-led CTTs can provide an effective mechanism for contact tracing of COVID-19 cases within the prison setting

Principles for making prisons and places of detention resilient to infectious diseases, including epidemic and pandemic threats

This document aims to provide national and subnational authorities involved in prison health and prison health-care services with practical principles and actions for addressing five management phases: prepare, prevent, detect and respond to infectious diseases, further strengthened by building connectedness of prisons with wider health systems. This document also aims to enhance capacity to tackle social determinants of health and to accelerate progress towards achieving the sustainable development goals, including universal health coverage. The document was developed through evidence review, remote expert consultation and interaction with experts during a dedicated international conference. The evidence review focused on the five management phases applied to the prison setting, leading to a draft collating the evidence, which was then used to identify key questions to be addressed and discussed during an international conference of stakeholders in prison health and global experts in infectious diseases in June 2023. A second evidence review was conducted during which identified evidence gaps were further searched. Although this document is primarily intended for policy-makers and policy-makers, it is expected that the document is also useful for the health-care workforce in prisons and other places of detention. Thus, all core principles presented are supported by recommendations for implementatio

Global prison health care governance and health equity: a critical lack of evidence

The large and growing population of people who experience incarceration makes prison health an essential component of public health and a critical setting for reducing health inequities. People who experience incarceration have a high burden of physical and mental health care needs and have poor health outcomes. Addressing these health disparities requires effective governance and accountability for prison health care services, including delivery of quality care in custody and effective integration with community health services. Despite the importance of prison health care governance, little is known about how prison health services are structured and funded or the methods and processes by which they are held accountable. A number of national and subnational jurisdictions have moved prison health care services under their ministry of health, in alignment with recommendations by the World Health Organization and the United Nations Office on Drugs and Crime. However, there is a critical lack of evidence on current governance models and anurgent need for evaluation and research, particularly in low- and middle-income countries. Here we discuss why understanding and implementing effective prison health governance models is a critical component ofaddressing health inequities at the global level