COVID-19 Pandemic
The role of housing infrastructure in facilitating SARS-CoV-2 infection in the carceral environment, California State Prisons, March 2020-2022 Helena Archer* Helena Archer Sandra McCoy David Sears Ada Kwan
Background:
Environmental vulnerability through congregate, crowded housing places incarcerated people at higher risk of acquiring COVID-19, and may limit effective response policy. However, the relative importance of housing type and housing features within prisons (e.g., dormitory vs cell living, open door or bars) on COVID-19 risk is poorly described.
Methods:
Using daily housing and healthcare records, we identified a longitudinal cohort of 150,633 California state prison (CDCR) residents between March 2020 and March 2022. We collected facilities and administrative data to evaluate density of residential buildings and their features relating to transmission of respiratory pathogens, categorizing units by relative occupancy within rooms (cells, multi-room dorms (“pod”), or standalone, single room dorms), and door type (solid door or barred/partial door (“open”)). We assessed daily housing location and type, COVID-19 outcomes, and other relevant covariate data. We estimated the relative rate of testing positive for SARS-CoV-2 in different housing types using generalized estimating equations for Poisson regression.
Results:
At baseline, more than half of residents lived in solid-door celled housing. Across the study period, residents of solid-door pod dorms, open-door cells, open-door pod dorms, and standalone dorms had 1.49 (95% CI: 1.45,1.52), 1.59 (95% CI: 1.54,1.64), 2.54 (95% CI: 2.48,2.6), and 1.86 (95% CI: 1.82,1.9) times the rate of testing positive respectively when compared to residents of solid-door cell housing and after adjustment for individual risk factors (e.g. age, sex, underlying health conditions, vaccinations) and out-of-housing activities (e.g. classes, legal or medical appointments).
Conclusion:
Differences in infection rates across housing types can inform the safe movement of people who are incarcerated between and within facilities, and in maximizing safety and minimizing the consequences of COVID-19, even in high risk settings such as prisons.