Recovery, Renewal, Resilience

Factors such as underlying health conditions, confined and over-crowded living spaces, limited facilities (e.g. running water, adequate sanitation), stigma and discrimination mean that Roma, Gypsy, Traveller and Boater communities are particularly vulnerable to the risks and associated impacts of COVID-19. Virus infection and death rates of these communities are currently unknown in the UK meaning formal data collection is needed. People in these communities are also likely to not be registered with a GP, to work in precarious job roles or be self-employed, meaning there is possibility that these communities will fall through the net with regards to COVID-19 vaccine programmes and the business/financial support initiatives provided during the pandemic. Consider:

• Partner with local and national organisations that work with Roma, Gypsy, Traveller and Boater communities to better understand their needs during the pandemic
• Work closely with the owners and managers of all residential sites and waterways for these communities to ensure that they stay open and alternative accommodation is arranged for people who become unwell and are required to self-isolate
• Provide additional temporary water, sanitation and waste disposal facilities to those communities who cannot access public facilities (due to closure of public infrastructure during lockdowns)
• Open additional local authority caravan sites temporarily to prevent overcrowding at designated caravan sites as COVID-19 requires these communities to remain static (e.g. holiday campsites that are not in use and would have basic facilities such as running water already in place)
• Establish a designated helpline in partnership with local health authorities (e.g. HSE Midlands Traveller Health Unit) to deal with COVID-19 queries
• Introduce a temporary moratorium to prevent people from being evicted from unauthorised camp locations
• Relax rules temporarily so those living on canal boats can moor in a safe place for an extended period of time
• Establish a targeted education support programme for children in these communities who are at risk of digital exclusion during periods of school closure
• Communicate with Roma, Gypsy, Traveller and Boater communities and the organisations that represent them to ensure that they are aware of and have access to social support mechanisms provided during the pandemic, e.g. Self-employment Income Support Scheme, vaccine programmes
• Include people who are living in these communities in research and outreach programmes to ensure learning is gained from their experiences and the diversity of impacts of COVID-19 on their lives is taken into account when planning for recovery

Prisons are high risk environments as places of close physical proximity[1]. Persistent overcrowding[2], close living spaces, and staff moving in and out, make social distancing and the isolation and management of any contagion difficult to arrange[3]. National strategies to suppress COVID-19 should focus on reducing outbreaks within prisons, recognising that prison health is public health[4]. Coordinating evidence-based approaches to managing outbreaks of COVID-19 in prison settings can address the spread of the virus in potentially vulnerable people inside prisons and to communities where staff live[5].

In March 2020, WHO published interim guidance on how to deal with COVID-19 in prisons through a whole-of-society approach, with comprehensive guidance in the following key areas[6]:

• Preparation - through collaborative working with health and justice sectors, local and national public health authorities, and civil protection agencies; risk assessment and continuous evaluation; action planning to mitigate risks; assessment of essential infectious control supplies such as PPE, environmental sanitation, hand hygiene and disinfection
• Prevention - through implementation of public health guidelines, such as hand hygiene, social distancing and facemasks; monitoring of staff travelling into prisons from affected communities or who have a history of exposure; reviewing continuity and contingency plans to ensure critical functions can be delivered with reduced numbers of personnel
• Training and Education - planned and targeted at healthcare and custodial staff, including basic disease knowledge, hand hygiene practice, respiratory etiquette, the effective use of PPE and environmental prevention measures such as cleaning and disinfection. WHO have developed several online resources and training that can support this[7]
• Control - through robust prevention strategies; diagnostic strategies, including contact tracing, and interventions, including the environmental cleaning of health-care rooms or cells, where the management of a suspected case has taken place

A recent study identified some core challenges in managing infectious disease in prisons[8], such as:

• Overcrowding and a lack of best practice on managing the early release of prisoners
• Prisoners withholding symptoms for fear of stigma, leading to outbreaks
• Limited capacity of staff and resources to facilitate isolation, quarantine, and contact tracing

Addressing overcrowding, including communicating complex policies, such as an amnesty

Governments and judiciaries globally are considering strategies to tackle overcrowding and reduce prison populations through early release and alternative incarceration for vulnerable detainees and low-risk offenders[9]. Although strongly supported by human rights groups[10] and recommended by the UN[11], COVID-19 amnesties in the Ukraine were however rejected by legislators, media, and the public. This highlights that the explanation and communication of complex policies are just as vital as their design[12]. When communicating amnesties, consider:

• Work closely with civil society, particularly NGOs directly engaged with the public, to assess views and perceptions of amnesties, using this information to inform policy design and implementation
• Establish a clear communication strategy to accompany all elements of the process of transitioning incarcerated persons back into society, with a tailored approach to different social and regional groups
• Communicate informed and factual information through government and trusted civil society organisations, explaining the different elements of amnesties and their place in the larger reintegration framework to help the public feel more informed, secure and resilient

Inmate Volunteers

Irish Red Cross inmate volunteers are trained annually in Infection Control as part of the Community Based Health and First Aid Programme[13]. The activities of the inmate volunteers helped to contribute to zero positive cases amongst prisoners across the country for more than six months. Consider supporting a targeted inmate volunteer training programme to aid the management of infectious disease in prisons:

• As part of preparation and contingency planning, train inmate volunteers and staff on infectious disease and contact tracing to support the education of prisoners and custodial staff, and efforts to control transmission
• Train volunteers to support inmates who face mental health challenges/fears of stigma, e.g., distributing information and education packs, and supplementing support from psychologists, teachers, chaplains, and family visitation services, where these lack capacity
• Inmate volunteers can support the establishment of prison communication strategies on COVID-19, e.g. volunteers can write newsletters that can be distributed throughout prisons each week to provide updated information and educational material regarding COVID-19. Newsletters can include services that are available for inmates, and instructions for exercises and other activities that inmates can do while isolating and in quarantine

References:

[1] Redondo, S. et al. (2020) Corrections and Crime in Spain and Portugal during the Covid-19 Pandemic: Impact, Prevention and Lessons for the Future, Victims & Offenders, 15:7-8, 1156 – 1185, doi: 10.1080/15564886.2020. 1827108

[2] https://www.amnesty.org/en/latest/news/2020/12/pakistan-overcrowding-in-pakistans-prisons-is-a-ticking-time-bomb/

[3] Pagano, M. (2020). COVID-19 Risk Management and Screening in the Penitentiary Facilities of the Salerno Province in Southern Italy. International journal of environmental research and public health, 17(21), p.8033.

[4] https://www.unodc.org/documents/middleeastandnorthafrica//2020/COVID19/COVID_19_Egypt_Final.pdf

[5] https://www.psych.ox.ac.uk/news/people-in-prison-must-be-part-of-public-health-response-to-covid-19

[6] https://apps.who.int/iris/bitstream/handle/10665/336525/WHO-EURO-2020-1405-41155-55954-eng.pdf?sequence=1&isAllowed=y

[7] Emerging respiratory viruses, including COVID-19: methods for detection, prevention, response and control [OpenWHO online course]. Geneva: World Health Organization; 2020 (https://openwho.org/courses/introduction-to-ncov)

[8] Beaudry, G., Zhong, S., Whiting, D., Javid, B., Frater, J. and Fazel, S., 2020. Managing outbreaks of highly contagious diseases in prisons: a systematic review. BMJ global health, 5(11), p.e003201 https://gh.bmj.com/content/5/11/e003201

[9] Amnesty International (2020) https://www.amnesty.org/en/latest/news/2020/12/pakistan-overcrowding-in-pakistans-prisons-is-a-ticking-time-bomb/

[10] https://uacrisis.org/uk/amnistiya-ye-realnym-sposobom-borotby-z-poshyrennyam-koronavirusu-u-mistsyah-nesvobody-pravozahysnyky

[11] https://www.unian.info/society/human-rights-un-recommends-ukraine-grant-amnesty-to-certain-convicts-amid-covid-19-pandemic-11155589.html

[12] https://www.chathamhouse.org/2020/11/covid-19-holds-lessons-ukraines-amnesty-policy

[13] https://www.redcross.ie/national-news/irish-red-cross-responds-to-covid19/