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October 25, 2021

"A crisis of undertesting: how inadequate COVID-19 detection skews the data and costs lives"

The title of this post is the title of this new report authored by Erika Tyagi, Neal Marquez, and Joshua Manson of the UCLA Law COVID Behind Bars Data Project. Here is part of the report's introduction:

Earlier this month, our team co-authored an article in the Journal of the American Medical Association on our findings that, during the first year of the pandemic, the COVID-19 infection rate for people incarcerated in state and federal prisons was 3.3 times higher than the rate for the U.S. population as a whole, and the COVID-19 death rate was 2.5 times higher.

These disparities are stark but not surprising — in an earlier study, we found that, in the first months of the pandemic, incarcerated people faced even more disproportionate infection and death rates.

There is reason to believe, however, that actual outcomes have been far worse than these data reveal.  That is because calculating infection rates that reflect the true prevalence of COVID-19 requires adequate testing.  If tests are not widely administered in prisons and jails, and, by many accounts, they have not been, then infections will go undetected.  As a result, infection and death rates will appear lower than they actually are....

The Centers for Disease Control and Prevention has issued guidance recommending testing “at least weekly” of unvaccinated, asymptomatic employees of all workplaces, even those without known or suspected exposures.  Even before vaccines became available, many schools, universities, nursing homes, and other workplaces mandated weekly — or even daily — testing.

In nearly all jails and prisons, however, officials have been conducting orders of magnitude fewer tests than congregate settings with much lower risks of transmission. This provides strong evidence that more testing behind bars would reveal many more infections.

Similarly, COVID-19 deaths are often only recorded as such if individuals test positive before dying.  Because undertesting for COVID-19 results in many infections going undetected, it also increases the likelihood that individuals in prison may have died of COVID-19 without the cause of death being accurately recorded.  As a result, the true number of people who died from COVID-19 behind bars may be higher than the figures officially reported.

In the following pages, we break down three important public health metrics — testing rates, test positivity rates, and case fatality rates — that provide critical context to officially reported infection and death data and reveal just how unreliable reported infection and death data may be.  These three metrics suggest that, in many places, true infection and death numbers may be much higher than those officially reported.

October 25, 2021 at 11:52 PM | Permalink


Across America, jail and prison officials were caught unprepared for the wildfire of infectious disease, CV-19. The indifference of jail and prison officials is stark. There are many reports that once CV-19 broke out, Wardens and managers of prisons hid out in their offices and refused to mix with the inmates and talk with them, as they had routinely done before the pandemic. I recall one point where more than half of all CV-19 cases in Ohio were among staff and inmates inside the state's prisons. Alabama's prisons also had huge problems dealing with CV-19; at one point, state officials had a plan to replace sick guards with National Guardsmen. I am still waiting to see the class action lawsuits against prisons and prison officials for violating the 8th Amendment against cruel and unusual punishment. I fear that the responsible parties will probably get away with their deliberate indifference and escape accountability. There are many tragic cases of inmates dying. It is not surprising that most jails and prisons are now understaffed and are having problems hiring to replace those who have quit or died.

Posted by: Jim Gormley | Oct 26, 2021 7:28:42 AM

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