Mass Incarceration, Public Health, and COVID-19 in the US

By Glenda Xu.

Covid-19 is the defining health crisis of our time. In the US, a formidable – and rapidly deteriorating – challenge lies in the mass populations incarcerated in correctional facilities. In UCL Bioethics and Medical Law Society’s most recent event, Dr Meghan Novisky, assistant professor of Criminology at Cleveland State University, explores these problems by sharing her research on the specific public health consequences arising from mass incarceration in the US. 

Recent months have notoriously underscored unprecedented figures of over two million incarcerated individuals in US correctional facilities (1). With only half of the states mandating correctional facility staff to wear masks and less than a third of the states requiring inmates to wear masks, these facilities have become predictable Covid-19 hotspots. The 75% Covid-19 positive inmates and staff in Ohio Prison (2) accounts for over 20% of cases in Ohio state, and this has only been found out due to their mass testing scheme – which many other prisons concerningly lack. 

During this talk, Dr Novisky illuminates the deadly predicament that prisoners face: with the severe lack of infrastructure to ensure correction facilities are able to take recommended precautions, masses of prisoners are left exceptionally exposed and defenseless to the deadly virus. Her research, which collects information from all fifty state prison system websites in addition to the federal bureau of prisons for prison response, outlines four major contributing factors that exacerbate the crisis (1): 

  1. Prison overcrowding 
  2. Decreased hygiene access, owing to safety regulations limiting alcohol content 
  3. An ageing prison population in which 25% are at least fifty years old 
  4. Covid-19 entering facilities via mobile and fluid staff 

The impact of such severe infrastructure deficits is not limited to the prisoners – Dr Novisky further highlights the psychological impact on family members of those incarcerated in her family study. With over three hundred participants, including spouses, parents, and children, a 90% concern rate for the safety of their loved ones in prison was found. Many of these family members reported increased incidence of loneliness, depression, anxiety, stress, and worry; much of this being attributed to the prohibition of in-person visitation and lack of transparent prison data sharing (1).

“there is no transparency with what is going on; they are not provided enough masks and food in there, and not being able to see or hear his voice regularly makes him feel even more farther away”(1)

Although there have been efforts to address these issues, bottlenecks in the prison system significantly reduces efficacy. Federal orders to release vulnerable inmates (i.e. those with who are elderly or have severe comorbidities), have faced huge opposing federal appeal resistance, requiring escalation to the supreme court. Lagging system responses in providing adequate PPE have resulted from stringent prison risk assessments which fear the misuse of alcohol gels and masks within prisons. Despite the rapid integration of Covid-19 dashboards on prison websites, the sheer population of prisons have also overwhelmed accurate data and information sharing to the public.

Call to Action

This is highly concerning as the  Covid-19 infection rate is five times higher in prisons than in the general population. As evidenced by by the 58% of family members who are dissatisfied with how correctional facilities are handling their health and safety protocols (1), there is a desperate plea for prison structure to reform and realign with our modern-day public health framework. There must be initiatives to reduce prison population density, to provide unrestricted access to sanitation and PPE, to increase mass testing schemes, and to enhance data transparency and supplementary communication options for families to stay informed and in touch with their loved ones. 

When the government ‘takes a person into its custody and holds him there against his will, the Constitution imposes upon it a corresponding duty to assume some responsibility for his safety and general well being’ DeShaney v Winnebago Cty. Dep’t of Soc. Servs., 489 U.S. 189, 199-200 (1989) (3). Prisoners who are ‘constrained from their liberty to care and meet their own basic human needs on their own behalf’ Estelle v. Gamble, supra, 429 U.S., at 103, 97 have no choice but to rely on prison authorities to ensure an appropriate ceiling standard of their wellbeing (3). With this rationale in mind, Dr Novisky leaves us audience with a final pressing thought: prison systems have the judicial and societal duty to protect those incarcerated individuals who are left at high risk and vulnerable from communicable infectious disease in our present and future. Ensuring public health standards should remain a public health issue, and not a narrative of moralistic deservingness (1). 


  1. Novisky, Meghan A. “Mass Incarceration, Public Health, and Covid-19 in the US.” UCL Bioethics & Medical Law Society. Mass Incarceration, Public Health, and COVID-19 in the US, 2 Feb. 2021, London, Online. 
  2. Chappell, Bill, and Paige Pfleger. “73% Of Inmates At An Ohio Prison Test Positive For Coronavirus.” NPR, NPR, 20 Apr. 2020, 
  3. “W. J. ESTELLE, Jr., Director, Texas Department of Corrections, Et Al., Petitioners, v. J. W. GAMBLE.” Legal Information Institute, Legal Information Institute, 
  4. “California’s Overcrowded Prisons.” California’s Overcrowded Prisons: The Challenges of “Realignment,” The Economist, 19 May 2012, 

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s