COVID-19: Impact and long-term recovery in prisons

Brief report prepared for Practitioner and Stakeholder Group (PSG) and other interested parties

August 2021

As PSG colleagues are aware, for almost 18 months people have been confined in a prison within a prison. Since the start of the pandemic, 149  people in prison have died within 28-days of being diagnosed with COVID-19. While deaths from COVID-19 in prison have been far lower than the initial modelling and worst-case projections made by Public Health England (PHE), the protracted lockdown measures imposed to prevent the spread of the virus are having a profound impact on mental and physical health. Since August 2020 over 17,000 prisoners and over 13,000 prison staff have contracted the virus. It is not yet known how many are suffering from Long COVID.

In this brief report, we have outlined some of the work done to protect lives as well as IAPDC evidence-based advice offered. Further information can be found on our dedicated COVID-19 Information Hub.

It is important to acknowledge that the initial, disciplined response to the virus by HMPPS, guided by PHE, saved lives. The IAPDC provided advice on ways to mitigate the impact of isolation and restrictive regimes - ranging from improved communication and reassurance to increased use of IT to maintain family contact.

During the course of the pandemic, there were two strategic opportunities to meet human rights obligations to keep people safe. In April 2020, the End of Custody Temporary Release scheme, announced by the Lord Chancellor, could have led, on his estimation, to the temporary release of up to 4,000 vulnerable people and those serving short sentences. Reducing overcrowding and risk in this way would have enabled the prison service to ease some of the severe restrictions it had imposed. The panel supported the introduction of the scheme and regretted that, mired in bureaucracy, it faltered and failed (including correspondence with the Lord Chancellor on 25 March 2020 and 24 April 2020, response 13 May 2020), plus the Prisons and Probation Minister and her co-chairs of the Ministerial Board).

The launch of the widescale vaccination programme later in 2020 presented a second important opportunity to keep prisoners and staff safe. Given the high risk of transmission within and around poorly ventilated, overcrowded, closed environments, the panel has consistently advised on the adoption of a whole institution approach to vaccinations, rather than just the priority cohorts, an approach recommended by, amongst others, PHE, the Scientific Advisory Group on Emergencies (SAGE) and a number of members of the Ministerial Board and of the PSG.

The Panel wrote to Professor Wei Shen Lim, Chair of the Joint Committee on Vaccinations and Immunisation (JCVI) on 22 December 2020 advising that, following the successful roll-out of vaccinations to care home residents and staff, his committee consider recommending prioritisation of people in closed institutions for COVID-19 vaccines to protect against infection and prevent further spread of the disease. The panel followed this up with a letter to Vaccines Minister Nadhim Zahawi MP (8 January 2021; response 8 February), the Health Secretary (20 January and 10 March; response 23 March 2021), the Lord Chancellor (15 March 2021; response 12 April), Minister Chris Philp MP on people held in immigration detention (23 March), and a further letter to Professor Wei Shen Lim (24 February; response 16 March).

The production of the SAGE report on the transmission of COVID-19 in prison settings, which was presented to the Group on 25 March and published 23 April, could have proved a turning point. SAGE, the Government’s own scientific advisors, stated that “increasing early vaccination of all prisoners and staff would allow faster lifting of severe restrictions, reduce outbreaks and decrease mortality, and benefit the wider community’. Since then the panel has raised clinical, ethical and justice concerns with Jeremy Hunt MP, chair of the Health and Social Care Committee (29 April), the Health Secretary (30 April), and Sir Bob Neill MP, chair of the Justice Select Committee (17 May).

Media coverage of the case for universal vaccination includes: IAPDC letters published in The Times, most recently as a joint initiative with the Prison Governors’ Association (PGA) and Prison Officers’ Association (POA), and articles in The Telegraph and Evening Standard.

Focus on recovery
In 2020 the panel organised two widescale consultations with people in prison in partnership with Prison Radio and Inside Time. Reports produced  (‘Keep Talking, Stay Safe’ and ‘Just One Thing’) have helped to inform the response to people held in extreme imprisonment, identify what prisoners value most in straitened times and point towards steps to recovery.

Attention must now turn to the safe, and necessarily painstaking, emergence from restrictions. To that end, the IAPDC has broadcast a series of interviews with National Prison Radio and invited views from people in prison to understand what measures should be put in place to support prisoners during the recovery period. These will be available shortly.

Recovery briefing
We are publishing with this newsletter a briefing prepared by Dr Kimmett Edgar, head of research at the Prison Reform Trust and PSG member, on what HMPPS can learn from evidence on the impact of, and safe emergence from, other forms of extreme isolation in custody such as solitary confinement and quarantine for some infectious diseases.  

Invitation to members of the PSG:

We warmly welcome your views on specific measures that the IAPDC should suggest to ministers and senior officials to ensure the safety of everyone in custody as restrictions are eased and attention turns to long-term recovery and reform.