Prisons are a public health hazard at the best of times. And during COVID-19, we are so past the best of times; we are now on the brink of crisis akin to a lit match in a room full of gasoline.

As a nation, we are about to see the outcome of the interdependence between prisons, poor public health and public safety. We don’t know much about COVID-19, but what we do know is that it is highly contagious and spreads aggressively in enclosed, overcrowded spaces where it is a struggle to maintain basic hygienic requirements. One infected person in such an environment will infect others like an explosion. The only reasonable solution is for the government to consider decarceration: reducing the number of persons currently in prison.

We know COVID-19 has devastating impacts on people who are immuno-compromised and who are elderly or who have underlying conditions, including mental illnesses and addictions. That includes individuals in Indigenous and other marginalized communities, nursing homes and shelters.

Imagine taking the most vulnerable individuals from all these communities – the individuals with the most comorbidities, the most mental illnesses, the least coping skills – and putting them all under one roof, a dirty, overcrowded, unhygienic roof, that lacks a functional healthcare system and proper nutrition.

That’s exactly what’s happening in our prison system. One infected person in such an environment will be the lit match in a room drenched in gasoline. The result could not just blast that room, but also the entire house, and start fires in the adjacent houses and probably the entire community.

Research has shown that on average, any incarcerated individual has the health problems of someone 10 to 15 older than them in the community, due in part to previous lifestyle, but also due to incarceration itself. Right now, in federal prisons alone, 25 percent of individuals are deemed “elderly.” Twenty-seven percent are Indigenous. Rates of communicable and non-communicable diseases are generally higher than those in the community. Some examples include a tuberculosis (TB) rate of 22 percent compared to almost 5 percent in the community and a rate of hepatitis C that is 39 times higher than in the community. The HIV/AIDS rate is 15 times higher.

While many individuals enter prisons with these conditions, there is also evidence suggesting that people contract diseases, including blood-borne illnesses, while in prison. Many incarcerated people report using drugs at the time of admission and 1 in 10 report injecting drugs in the months prior to incarceration. Data from the Office of the Correctional Investigator shows that slightly more than 52 percent of incarcerated people show signs of substance dependency. In addition, a study of men by the Correctional Service of Canada in 2015 indicated that over 70 percent lived with mental illnesses and addictions.

Finally, people in prison die earlier and faster from common diseases compared with those in the general population. This includes cancer, heart disease and respiratory illnesses. Numerous reports have indicated that it’s a struggle just to provide basic healthcare and a clean environment, and the rates of illness are indicative of that battle.

COVID-19 has entered prisons and it is now spreading quickly in an enclosed and dirty environment where social isolation is not possible. Prisoners need to be brought food, taken out for showers and escorted to health professionals. Thus, the chances of prisoners and those who work with them becoming sick are significant.

The rate of people developing serious, life threatening symptoms as a result of COVID-19 is about 10 percent and it tends to be associated with certain predispositions. Most incarcerated people tend to have those predispositions. It’s anticipated prisoners will also experience higher morbidity and mortality rates from COVID-19. And when some of them are taken to community hospitals or as staff get infected, COVID-19 will also increase in the communities.

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This is why decarceration is a viable response. Some provinces have already done so. Canada’s Minister of Public Safety, Bill Blair, has ordered the Correctional Service and Parole Board to work together to release as many prisoners as safely possible. There are many examples of people who fit this definition:   the elderly, those who have very little time left on their sentences, the sick and the pregnant. One prisoner is set for release this week on medical grounds, and the release of two others has been expedited.

At this point, even if half of the prisoners are removed, it may be too late – like calling the firefighters to respond to the emergency in the room that caught fire after being drenched in gasoline. We should not have drenched that room in gasoline to begin with.

The government must commit to never doing this again under the false promise of keeping us safe.  Public safety is not enhanced by overcrowding the prisons with people who have committed petty crimes against a backdrop of poverty, mental illness and addictions or with people who have breached their administrative conditions of release or with people who are terminally ill and bedridden.

If it wasn’t clear before, there should be no doubt left now. The risk averted by incarcerating those people is not proportional to the risk to public safety that comes from the spread of an infectious disease like COVID-19.

For this pandemic, all we can do now is react to the greatest extent possible. We must decarcerate and we must take measures to protect those inside, and, by extension, those outside.

Then, as we start healing, we must take responsibility for the fact that, as a country, through our carceral practices, we have drenched the room in gasoline. We are responsible for arson. Let’s not let it escalate to murder.

This article is part of the The Coronavirus Pandemic: Canada’s Response special feature.

Photo: Shutterstock, by Cuson.

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Adelina Iftene
Adelina Iftene is a law professor at Schulich School of Law at Dalhousie University, where she teaches criminal law and prison law. She is also associate director of Dalhousie's Health Law Institute, and is the author of the book Punished for Aging: Vulnerability, Rights, and Access to Justice in Canadian Penitentiaries (University of Toronto Press, 2019).

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