What Can We Learn from the Coronavirus in Prisons – The New York Times

As political leaders across the United States seek to make informed decisions about when to reopen based on inadequate scientific information, 2,500 men in an Ohio prison may hold the key to releasing the rest of the country from coronavirus lockdown.

Such widespread infection in our crowded prisons is a reminder of why we need decarceration. At the same time, it has created an opportunity for research that, if conducted ethically, could shed light on this disease at a time when testing of the general population remains limited and unreliable.

Some research has been conducted already. For example, an ongoing study by Harvard researchers and the National Commission on Correctional Health Care has measured the prevalence of Covid-19 among incarcerated people and correctional staff and revealed a lack of access to testing and personal protective equipment.

But much more is needed. A comprehensive health evaluation of a huge group like the Marion residents who have been universally exposed to the virus but arent necessarily showing symptoms, would provide data that is sorely lacking in existing studies that focus primarily on very sick people or death tolls. The findings could provide government officials, businesses and universities some of the answers they need in order to reopen safely.

In addition, this research could make more Americans recognize the humanity and potential of incarcerated people, which could ultimately help to end mass incarceration and the very conditions that allowed the spread of the coronavirus behind bars.

The very idea of conducting research on vulnerable populations has a deeply troubled history, most notably with the 1932 Tuskegee experiment, in which African- American men with syphilis were not treated for 40 years, long after treatment became available, so researchers could study the progression of the disease. The Nazis conducted ghastly experiments on prisoners, and U.S. medical researchers intentionally infected prisoners in Guatemala with sexually transmitted diseases.

Given this, any study based on prisoners must be conducted transparently and voluntarily, without exploitation, mistreatment, coercion or risks to the participants. It should also include monitors from prisoner advocacy and civil rights organizations. And it should seek to improve incarcerated peoples well-being by providing them with medical attention and care which are abysmal in most prisons and creating awareness about inhumane prison conditions.

This humanitarian crisis could have been prevented if officials had heeded warnings about the danger of contamination in overcrowded and unsanitary prisons. But this devastating reality also now allows scientists to better understand the effects of the coronavirus within a population that was overwhelmingly and recently exposed to it.

Researchers should therefore study and treat medically residents of the Marion Correctional Institution or a similar prison. This population is large enough to draw statistically significant conclusions, and their exposure was both recent and synchronous, which helps to overcome the problem of asymptomatic people not showing up in the testing data.

It seems a thorough study and analysis of incarcerated people could help to establish the proportions of these groups: 1) people who have not been infected (but still may be vulnerable, unless they are somehow immune or not susceptible); 2) people who are infected and asymptomatic (though likely carriers); 3) people with mild symptoms who have made or will make a full recovery; 4) people with severe symptoms that may result in lasting health damage; and 5) people who have died of Covid-19.

As of now, in society overall, there is no reliable way to estimate the percentage of people who would fall into these five categories, as most of the attention has focused on tracking the raw numbers in Categories 4 and 5. Yet Categories 1, 2, and 3 and especially a better understanding of the proportions across all five represent the key to a national recovery.

One remarkable observation already emerging from the prison data shows how beneficial such a study could be: an analysis by Reuters revealed that 96 percent of those who tested positive in prisons in four states did not experience any symptoms. Of course, it is perhaps early in the infection cycle, and health problems may still emerge. But even if, say, 60 percent of prisoners were in Categories 1 and 2, while most of the others were in Category 3, this would seem to support an earlier reopening. If, however, the final proportions showed that only 30 percent were in Categories 1 and 2, another 30 percent in Category 3, but a full 40 percent in Categories 4 and 5, then the findings would justify much greater caution and a delayed reopening until a vaccine materializes.

True, the U.S. prison population is not fully representative. But since Covid-19 seems to have more harmful effects on men, African-Americans and people with chronic health problems, the findings from a prison study might slightly overestimate and certainly wouldnt underestimate Covid-19s negative health consequences.

I recognize the irony that the countrys failure to protect prisoners now enables research that could protect non-prisoners. But any research on the Covid-19 health responses of incarcerated people should also draw attention to their humanity and desire to contribute, while further accelerating bipartisan criminal justice reform policies.

In this way, incarcerated people could not only help to guide an effective national liberation from the Covid-19 lockdown, but also contribute to much-needed decarceration.

Marc M. Howard (@marcmhoward) is professor of government and law at Georgetown University, and the founder and president of the Frederick Douglass Project for Justice.

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What Can We Learn from the Coronavirus in Prisons - The New York Times