Diseases do not
respect walls, fences, or borders and do not discriminate based on race,
sex, nationality, or religious beliefs. In the 20th century, the world
experienced three global pandemics, of which 500,000 people in the U.S.
died as a result and between 20 to 50 million people worldwide during
the most severe of these pandemics in 1918. 
Correctional institutions are uniquely susceptible to the
rapid spread of disease. The proximity of offenders to one another and
correctional staff increases the potential for the spread of infectious
Infectious disease response
No doubt, the current COVID-19 pandemic
has correctional facilities re-evaluating policies and procedures
surrounding responses to such events. One area of consideration
especially critical is the creation of an Infectious Disease Rapid
Response Team (IDRT). These teams would consist of specially trained
members who can react and deploy quickly to facilities that have
The IDRT, at a minimum, should consist of members from:
All members should be trained in area-specific operations
during an outbreak and how to operate in a high-risk zone or “hot-zone”
with different types of equipment.
Additional training should include but is not limited to:
Underlying infectious disease pathology
Epidemiological concepts such as the functions of contact tracing, disease vectors, clinical symptoms and transmission routes
Both classroom and hands-on instruction on how to set up
and operate a decontamination zone between the high-risk zone and the
low-risk zone is essential in curbing disease spread.
Modify policies, procedures
The development of such a team must occur in conjunction
with the modification of existing policies and implementing new
procedures to strengthen response efforts. For example, a plan on where
to isolate positive cases makes it easier for the response team to
identify cases and quickly move them to a pre-established isolation
area. Likewise, teams can provide continuous monitoring of suspected
cases in quarantine.
Infectious disease outbreaks do not absolve us in
corrections from our responsibility to provide security and healthcare.
We have to do it smarter and more deliberate while protecting ourselves,
other offenders and the public.
Simple things like delivering meals and medications require
modification in a high-risk zone. A specially trained team can perform
these tasks while minimizing further contamination and spread.
Responding to high-risk offenders who require restraint
within a high-risk zone requires being able to complete the security
aspects of the job while maintaining a somewhat sterile environment.
Equipment will become contaminated, such as duty belts, cuffs and keys.
Frequently cleaning this equipment will aid in disease spread, or
modifying the type of equipment can reduce the risk further. For
example, it may be easier to utilize flex-cuffs
and dispose of them rather than attempting to disinfect steel cuffs and
all of their intricate grooves and openings without the need of having
to submerge them in disinfectant completely.
Furthermore, arrangements for the disposal of contaminated
waste must be made. Does it go in ordinary trash, or does it have to be
handled appropriately to prevent further disease spread? Specially
trained environmental services personnel assigned to the team can ensure
that waste is dealt with and disposed of correctly. Disposal methods
may be governed by policy and local, state and federal regulations
surrounding biological waste.
During the Ebola outbreak in 2014, for example, the Federal
Department of Transportation had to issue special permits for the
transport of Ebola-associated waste from the hospital and a patient’s
apartment. This action was due to the agency’s packaging requirement not
being designed for the massive amounts of infectious material. 
Everything mentioned is crucial and time-sensitive in
responding to an infectious disease outbreak. Figuring it out as we go
deprives us of precious time to curb the spread. We must be more
proactive and prepared to respond, to reduce staffing issues due to
illness or fear, moderate medical costs associated with widespread
offender illness, and, most importantly, save lives. This pandemic will
not be our last. We will get through this with lessons learned. Stay
safe, think smart and wash your hands.
1. Spaulding AC, McCallum VA, Walker D, Reeves A, Drenzek
C, Lewis S, Berkelman RL. How Public Health and Prisons Can Partner for
Pandemic Influenza Preparedness: A Report from Georgia. Journal of
Correctional Health Care, 2009, 15(2), 118–128.
Joshua Mjolsness, PhD, works in state corrections and
is very passionate about staff wellness and emergency management
preparedness. He currently holds a PhD in health services, a master’s in
healthcare administration, and a bachelor's in criminal justice and is
currently pursuing a master’s in information technology. Dr. Mjolsness
has experience and training in corrections, law enforcement, emergency
management, emergency medical services, and fire service. His interests
include infectious disease, epidemiology, public health,
preparedness and devotion to line staff.