key: cord-0878054-mocdr5yb authors: Gorman, Geraldine; Ramaswamy, Megha title: Detained during a pandemic: A postcard from the Midwest date: 2020-04-15 journal: Public Health Nurs DOI: 10.1111/phn.12730 sha: 4b20119de623dbf2de470ab2216c34d69167bbf9 doc_id: 878054 cord_uid: mocdr5yb The last time I was on the veterans' tier in Cook County Jail, one of the men detained sitting on the aluminum benches reached up to shake my hand. "Next time you come, can you bring me a container of fresh air?" That was before we all became wary of the air we breathe, in the days when we still grasped extended hands. The last time I was on the veterans' tier in Cook County Jail, one of the detained men sitting on the aluminum benches reached up to shake my hand. "Next time you come, can you bring me a container of fresh air?" That was before we all became wary of the air we breathe, in the days when we still grasped extended hands. Of the 2.3 million people incarcerated in the United States, 76,000 of them are in Illinois. Of that number, 41,000 are in state prisons and 23,000 are in local county jails. Here in Chicago, in the center of America's heartland, Cook County Jail remains the country's largest single site facility. As of April 10, there were 289 positive tests for COVID-19 among its detained population. This number went from single to triple digits within a week. As of this writing, 203 Sheriff's Office staff have also tested positive. The United States leads the world in the global pandemic of COVID-19 and the national epidemic of mass incarceration (del Guidice, 2019; World Health Organization, 2020). People housed in jails and prisons in the United States will bear a high burden of COVID-19, unless drastic measures are taken to curb the pandemic inside the walls of these facilities (Sawyer & Wagner, 2019; Williams, 2020) . Two-thirds of the people we see in jails and prisons have at least one chronic health condition -perhaps one of the most important risk factors for COVID-19 mortality. The criminal justice population is a "graying" one, as well, with 11% of inmates in the high risk age category of over 55 (Miller, 2018) . They also represent the fastest growing age group among prisoners. The public health consensus for those of us working behind bars as volunteers, nurses, researchers, and teachers is plain: release those at greatest risk for COVID-19 who are also at lowest risk for criminal justice problems (Holpuch, 2020) . "Jails in this country are petri dishes. They are the government equivalent of nursing homes or cruise ships," stated Cook County Board president Toni Preckwinkle. In an example of stunning understatement, she then observed, "It's very difficult in a jail to maintain social distancing." Cook County has been identified by the White House coronavirus task force as at high risk for becoming another hot spot for viral outbreak in the United States. In partial response to the spread within the jail, Cook County Sheriff Tom Dart initiated a "quarantine camp" on the jail compound. Hastily constructed as the numbers mounted, the camp will isolate the Covid-19 infected detainees, and those at risk of testing positive, from the rest of the population. Dart admits that they are scrambling. "There isn't even close to a playbook, there's nothing," he lamented. "I tried to find one, whether it was from the feds or the locals. Everyone basically said, 'hey, you are on your own.'" During the week that the confirmed number of cases hit triple digits, the jail released 400 detainees after Cook County judges conducted case by case bond reviews. We offer the following recommendations to public health nurses and to all health care workers: • Don't forget about the people inside jails and prisons. They are not isolated from COVID-19, nor are they protected. If you have personal or professional connections, use those to advocate for keeping people behind bars safe during this global pandemic. • Pay attention to the news in your community about whether local jurisdictions are taking action to release low security risk, but high health risk detainees. If you don't hear about such actions, contact your local policymakers and press them for rapid changes. • Know that community agencies and public health nurses have an essential role to play in the safe transition of people leaving jails into communities. Forge new partnerships and nurture old ones to ensure that community agencies benefit from public health expertise and infrastructure. According to Moss, St. Leonard's success at managing in this time of crisis "is an illustration of how public health nurses deploy their knowledge and expertise to keep the public safe." While the pandemic is rife with the frightening unknown, Moss maintains that "intensity has a silver lining. Crisis amplifies the beautiful… the human interaction of people helping one another." She urges us to focus on that beauty until we can once again breathe freely and grasp the extended hand. Prison Reform Advocates Call Mass Incarceration an 'Epidemic Calls mount to free low-risk US inmates to curb coronavirus impact on prisons Johns Hopkins Bloomberg School of Public Health faculty letter COVID-19 New York plan puts spotlight on graying of U.S. prison population Mass Incarceration: The Whole Pie Correctional Facilities In The Shadow Of COVID-19: Unique Challenges And Proposed Solutions