Intended for healthcare professionals


Covid-19, prison crowding, and release policies

BMJ 2020; 369 doi: (Published 20 April 2020) Cite this as: BMJ 2020;369:m1551

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  1. Paul L Simpson, research fellow,
  2. Tony G Butler, professor
  1. Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, New South Wales, Australia
  1. Correspondence to: P Simpson psimpson{at}

Safe release of prisoners could reduce community transmission

The emergence of covid-19 has again raised the issue of prisons as incubators of infectious diseases, highlighting that “prison health is public health.”1 As far back as the 16th century typhus (“gaol fever”) was responsible for high mortality in English prisons and community outbreaks when it “jumped the fence.”2 Russian prison amnesties in 1997 and 2001 to relieve overcrowding released many prisoners with tuberculosis, contributing to an upturn in incidence that was subsequently linked to the disease’s global re-emergence.345

The World Health Organization’s guidelines on responding to covid-19 in prisons recommend that custodial and health agencies jointly engage in risk management, prevention and control, treatment, and information sharing.6 To prevent covid-19 outbreaks in our prisons and to protect those in custody, staff, and the wider community we also need more immediate …

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