Amendments to the WHO Interim Guidance on Preventing COVID-19 Outbreak in Prisons: Remarks from Germany

Abstract

Background: Globally, at any given time over 11 million people are held behind bars, while turnover of prisoners may reach up to 30 million. Evidence leaves no doubt that inmates are at a greater risk of acquiring influenza family viruses. This issue highlights the importance of paying extra attention to this vulnerable population. Purpose: The World Health Organization (WHO) Regional Office for Europe responded to this issue by developing a set of guidelines on COVID-19 control in prisons. This manuscript reports some important gaps in the above-mentioned guidelines and some recommendations to bridge these gaps. Findings: A set of important factors including: 1. Information on the special handling of drug-consuming prisoners; 2. Instructions for dealing with prisoners in opioid agonist treatment (OAT); 3. Notes on reducing the number of prisoners and reducing the number of imprisonments; 4. Indications of vaccinations; 5. Information on measures suitable to ensure continuity of care; and 6. Use of rapid tests are important points that have been overlooked by the WHO guidelines to control COVID-19 in prisons. Conclusion: This paper suggests amendments to the guidelines on COVID-19 control in prisons, developed by the WHO. Paying attention to the recommendations of this manuscript would lead to better control of COVID-19 and similar outbreaks in prisons, and mitigate the burden attributable to such infections. Interventions to control COVID-19 in prisons should be done considering the entire ethical aspects.