Speaker
Description
Prisons present a unique environment for the spread of infectious diseases such as influenza, tuberculosis, and SARS-CoV-2, as prison residents are generally confined in close proximity of each other, with regulated movements and interaction with staff often physical in nature. Although logistically difficult to manage, non-pharmaceutical interventions have been used during the COVID-19 pandemic. Inspired by this, I will investigate a potential intervention that has not been used before, namely asymptomatic testing and isolation of the entire prison population (“pulse testing”) early on, to interrupt an outbreak before it becomes large. I will compare it with the more common approach of isolating cases based on symptoms, for a range of pathogen and implementation scenarios. Symptom-based isolation is relatively easy to implement even with minimal public health support, but requires substantial isolation facilities and its effectiveness quickly degrades with a growing fraction of asymptomatic cases. Instead, pulse testing can be effective even if most cases are asymptomatic and requires isolating substantially fewer individuals. However, it presents unique implementation challenges, so to make it effective logistic support would need to be in place to allow prisons to declare an outbreak as soon as possible, initiate multiple rounds of testing immediately and secure high levels of adherence, as any delay or partial implementation would quickly render the policy ineffective.
