Arresting the Spread: Fighting COVID in Jails

When the CDC Foundation put out the call for seasoned public-health experts in response to the COVID-19 pandemic, Anna Gonzales answered, and joined a team of 10 senior advisors tasked with building capacity among community-based organizations (CBOs) and others to further the on-the-ground fight. Like Gonzales, a former regional health administrator for the U.S. Department of Health and Human Services, these longtime professionals also serve as strategic connectors between CBOs, health departments and other partners.

Before the pandemic, the Chicago-based Gonzales had been working with contacts in her region’s public-health circles to aid those with opioid-use disorders. And after joining the CDC Foundation, a colleague from the Michigan Health Endowment Fund alerted her to a community-based organization working on a COVID-19 outbreak at Detroit’s Wayne County jail. “Detroit was one of the big cities where it hit early,” said Gonzales. “By April, three of their jail system’s medical providers had died.” One of the doctors who died was actually the facility’s medical director, which brought needed attention to the crisis. According to The Guardian, by July 2020, more than 200 staffers and at least 80 inmates had tested positive for the virus.

With correctional facilities across the country accounting for more than 80% of the largest COVID-19 outbreaks—even surpassing nursing homes and food-processing plants—the need for guidance was great. But the CDC’s early work was more focused on long-term congregate facilities like prisons, not a transient county-jail population.

Wayne State University's Center for Behavioral Health and Justice (pictured before the pandemic)

Senior Advisor Anna Gonzales

Nearby Wayne State University, however, has a Center for Behavioral Health and Justice (CBHJ) at their School of Social Work. Gonzales was then introduced to Dean Sheryl Kubiak and Dr. Brad Ray, the director. “We’re one of the only centers explicitly focused on the intersection of behavioral health, public health and justice,” said Ray. “We have more than 40 full-time staff and do translational research and technical assistance across the Midwest.” So they were well-positioned to meet the challenge of the outbreak and well-versed in the contrasts between jails and prisons.

Kubiak, Ray and their colleagues translated that knowledge into a more specific COVID-19 mitigation guide. “The center used CDC guidance, their own experience and partnerships across corrections, law enforcement, the courts and public health to create a toolkit for jails to use throughout Michigan,” explained Gonzales.

The resulting 13-page document and five-part appendix lay out a solid plan of action broken down into four categories—testing, contact tracing, information sharing and discharge planning—with samples of forms, resource lists, checklists, protocols and more. The guide also calls decarceration the “most effective and most preferred strategy,” allowing justice-involved individuals to move back to their community as a public-health precaution, due to decreased space for social distancing and quarantine, along with COVID-related staffing shortages.

Our expectation is that this initiative will grow and help health departments and local jails across the nation make the connections they need to keep their staffs and justice-involved individuals safe from the pandemic and beyond.

With a strategy guide now in hand, Gonzales and Andrea Malloy, a CDC Foundation COVID-19 Corps senior advancement officer, identified an important opportunity to help not just Detroit or even the state, but other jail facilities across the country. “When Anna said that they wanted it to be bigger than just Michigan we were excited about the opportunity to share what we learned,” said Ray.

Malloy added, “What has been accomplished in the Wayne County jails is a remarkable example of what can happen when our public institutions partner with private community organizations, particularly in populations that have been hit the hardest. The need is great, so we are very happy to have a toolkit that can be shared and built on by other communities facing similar challenges.” As of December 2020, the guide’s been accessed online more than 700 times.

Gonzales and Malloy also helped the center realize that they had a continuing role to play beyond the toolkit. They’ve helped the center set up a “community of practice” monthly webinar, where key stakeholders, like health department and judicial leaders, jail administrators, corrections workers and medical experts can come together to share new and rising strategies to eliminate the virus and promote vaccinations for justice-involved individuals and staff.

Gonzales is hopeful: “Our expectation is that this initiative will grow and help health departments and local jails across the nation make the connections they need to keep their staffs and justice-involved individuals safe from the pandemic and beyond.”



This article was supported by Cooperative Agreement number NU38OT000288, funded by the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC or the Department of Health and Human Services. The CDC Foundation’s support from CDC included full project funding of $45,939,536.86.

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