Failure to protect the most vulnerable inmates in the UK prison system from coronavirus could result in more than 800 deaths, experts have warned.
Provisional estimates from epidemiologists at University College London suggest that uncontrolled outbreaks of infection could lead to the deaths of up to 1% of the prison population but that this could be substantially reduced if steps are taken to protect elderly prisoners and those with chronic illnesses.
Prisons have been a flashpoint in many countries’ battles against the virus, with several, including Spain, the US and Iran, ordering the release of many inmates to lessen the risk of transmission among detainees and jail staff. In Wuhan, the Chinese city where Covid-19 emerged three months ago, more than 800 prisoners were reportedly infected.
Last Friday the prison population of England and Wales stood at 83,500, the highest in western Europe. So far, two people in UK prisons have tested positive for the virus, one at Strangeways in Manchester and another at HMP High Down, Surrey.
This weekend David Gauke, a former justice secretary, called for the suspension of short sentences and the early release of some prisoners to avoid coronavirus spreading through prisons.
“The advantage of not sending people inside for short sentences is that it reduces the churn,” Gauke said. “That is really important. There is a lot of churn in prisons, with people coming in and out. That creates a risk.
“There is a strong case for releasing some of those coming towards the end of their sentence a few months earlier. One should not overstate how significant that could be in reducing risks.”
The UK government’s advice for prisons last Wednesday recommended “protective isolation” for inmates displaying symptoms. However, this has been updated following discussions with Public Health England to introduce “robust contingency plans”.
Andrew Hayward, professor of infectious disease epidemiology at UCL, said: “Isolating suspected cases is important but because some people spread infection before they develop symptoms. Outbreaks can still start easily and spread rapidly through overcrowded prisons.
“Moving the most vulnerable prisoners to less-crowded parts of the prison system, where outbreaks are easier to prevent and contain, and reducing mixing with other prisoners could save many lives.”
Hayward, who is also on a government national advisory committee for tackling coronavirus, added: “One of my main concerns is that we’ve not really got to grips with the likelihood of big outbreaks in institutional settings.”
Those fears follow the first indications of an outbreak at a UK prison with around 75 officers at HMP Berwyn in Wales currently thought to be either off work sick or self-isolating, and 22 prisoners showing symptoms, who have been isolated.
The provisional modelling used by the UCL epidemiologists was based on figures showing that a fifth of the prison population is aged over 70 or eligible for the flu vaccine. It found that, assuming a 50% coronavirus “attack rate” and a 10% mortality rate in the most vulnerable prisoners, there would be an overall death rate of 1%.
Chantal Edge, of the UCL’s department of epidemiology, added: “We are advocating that to save lives we need to cocoon our vulnerable population.”
Edge said many prisoners had more than one illness or disease, and this meant the death rate could be significantly steeper than in the wider population.
“A lot of people in prison are from deprived backgrounds, have a history of drug use, and may have smoked things that are even more damaging to their lungs than tobacco.”
Nick Davies, programme director of the Institute for Government, warned that prisons also have an ageing population. The disease appears to affect older patients more severely, especially those over 70. “The number of prisoners aged 60 and over has grown dramatically – by two-thirds –in the past decade. That group already has higher levels of illness.”
Edge also questioned the wisdom of continuing to allow prison visits. Current government advice for potential visitors is to cancel the trip if they display any symptoms of the virus.