COVID Testing within Prisons

As of June 23rd, 12 states have yet to report any testing information within their correctional institutions. These data are critical for understanding the prevalence of COVID. For instance, if states are testing very few inmates, we cannot know the true prevalence of COVID within these facilities.

At the same time, many states have started mass testing, with Maryland, Massachusetts, Michigan, Minnesota, New Jersey, Rhode Island, Tennessee, Texas, Vermont, West Virginia, and Wisconsin having administered more than 500 COVID tests per 1,000 inmates. In these states, testing prevalence surpasses that of the general population. However, these states claim to have expanded testing to all inmates, which has yet to happen and has been slow to scale up. States that have experienced outbreaks, such as Ohio, have expanded mass testing in certain facilities but not systematically throughout the state, resulting in lower testing prevalence overall than their counterparts.

Many prison systems, even those that have not engaged in mass testing, have a testing prevalence per 1,000 that exceeds that of the general population. However, there remains a need to continue to increase testing given that communal living sites are the epicenter of the pandemic and multiple prisons across the country have experienced outbreaks. In particular, 11 prison systems that have released testing information are testing fewer inmates per 1,000 than their state is testing in their general population. For example, Hawaii has tested only 16 of its inmates, resulting in a testing prevalence of 3.76/1,000.

As the pandemic continues, there is a dire need to increase testing in correctional facilities, as it is the only way to detect cases and prevent further spread.

COVID-19 Test Transparency among Prison Systems

As we work to create accurate COVID case counts, it is critical to know the types of tests used by each prison system. Different tests have different information quality (i.e., how good they are at identifying those with COVID and without COVID) and have different types of information (i.e., detecting current COVID infection or those who have had COVID at any point). Both the quality and type of information are needed for us to know how accurate the data are and what story they tell.

From the information we have gleaned, we have various levels of detail. Fortunately, all prison systems we have heard from are using polymerise chain reaction (PCR) tests, which detect current infection rather than ever infection. PCR tests allow for more reliable information for individuals than antibody tests. While antibody tests help track the spread of COVID in a population, given the number of outbreaks in communal living settings, specifically in prisons, PCR tests are crucial. Beyond the fact that most prison systems are using PCR tests, additional information is scattered. Some states have been able to tell us the exact test brand and name (i.e., Georgia, Illinois, Maine), while others have said they don’t have more information than ‘nasal PCR swabs’ or generally ‘PCR tests.’ Still others have said that they work with too many labs to keep track or that they simply do not have the requested testing information.

In sum, 18 states have provided no information, 2 have said that this information is unavailable or unknown, 15 have provided us with some information (i.e., a PCR test is used), 5 states and both the BOP and ICE say they use multiple tests and labs, and 10 have provided full information including the type, name, and brand of test. Making testing information available that is both accurate and precise is critical as we and others track the spread of COVID in prisons. Without it, our information and knowledge is incomplete.