Yes, Vaccinate Prisoners. But Decarceration is Better

Martha Paynter reveals the COVID-19 crisis in Canadian prisons, and argues that though priority vaccination of prison populations is needed, decarceration would be an even more humane and effective way to prevent transmission.

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The COVID-19 vaccine rollout is earning hefty criticism across Canada. Freelance journalist Nora Loreto posts daily updates, summarizing that at this rate it will take over three years to vaccinate our population of 38 million.

One of the populations hardest hit by the pandemic are people incarcerated across the country, and many are asking if and when this population will be prioritized.

An aging population with multiple co-morbidities and systemic barriers to health care, prisoners should unquestionably be a priority population for vaccination. The vaccination requires two doses, specific storage and handling requirements, and skilled administrators: these would be particularly challenging in the prison context and require careful and expeditious planning.

Photo Credit: Canadian Register of Historic Places/Creative Commons. Image Description: Dorchester Penitentiary in New Brunswick Canada.

But as a nurse and advocate for the health of people experiencing incarceration, I worry the interest in speedy vaccination distracts from advancing the solution that will have longer and broader positive impact on public health: decarceration.

Last month, over 1,600 people connected to prisons in Canada (over 1,400 prisoners and 200 staff) tested positive for COVID-19. Fourteen hundred prisoners represents over 3.5 per cent of all prisoners in the country. Let me repeat that: in one month, 3.5 per cent of prisoners in the entire country contracted COVID-19. Since the pandemic began 10 months ago, 660,000 people or 1.5 per cent of Canadians have tested positive.

These numbers represent a human rights violation in and of themselves. States have a legislated obligation to protect people in their custody from harm. With numbers like these, Canada and the provinces/territories have placed prisoners at exponential risk of infection, morbidity and death. 

Over two-thirds of prisoners in Canada are remanded in pretrial custody: they have not been tried, convicted or sentenced. These people are getting COVID-19 while in state care. And the public servants working in these spaces are also placed at extremely high risk.

Recently, I was asked by a member of the public if I could help facilitate Zoom education sessions for people in prisons about vaccine safety. Addressing vaccine hesitancy is important, and in years previous, I have volunteered to lead sessions in correctional facilities to answer questions about the annual flu vaccine. 

But volunteers have been banned from prisons since March. Zoom workshops about the vaccine are not possible: prisoners do not have access to the internet. There is no process and no staff to support a socially-distanced, masked group session in, say, a facility gymnasium. 

But more importantly, vaccine hesitancy is not the major concern among people in prison right now: basic living conditions are.

Wednesday January 6 was a day of action of solidarity for over 90 prisoners in Saskatoon and Prince Albert, Sask., who have launched a hunger strike to protest the deteriorating and inhumane conditions they are forced to endure during the pandemic. Saskatchewan has experienced some of the most extreme prison outbreaks: over 200 cases in the Saskatchewan Penitentiary alone. Imagine the courage of these strikers, taking on yet more hardship to make these conditions known: no visitation, solitary-confinement-like segregation, no outdoor time, missed meals, no clean clothes for weeks, and inadequate PPE and cleaning products. 

This deprivation is inequitably experienced because of racism in policing and incarceration: Indigenous people make up 65 per cent of the people in federal prison in Saskatchewan, and 75 per cent of those in provincial jails.

Prisoners should receive the vaccine, yes. It is a public health imperative. But a disproportionate number of prisoners have already contracted COVID-19. The state could not protect them, and the state must stop forcing people into a context of elevated harm. Decarceration prevents not only COVID-19 transmission but all the other public health risks of incarceration (violence, trauma, injury, illness and death). 

It works. Last spring in Nova Scotia, 41 per cent of provincial prisoners were released from custody, with no negative impact on community safety. The decarceration program required funding for three pillars of need be met: housing, basic income, and health services. 

Most criminalization is related to inadequate housing, poverty, and illness or substance use. To prevent recriminalization, you have to prevent those social harms. But since that promising program ended last summer, the prisons filled back up again. So we must vaccinate, yes. But while we call for vaccination, let us remember what would prevent the increased risk these environments pose in the first place. Prisons do not solve homelessness, poverty, and illness.

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Martha Paynter is a registered nurse, a PhD Candidate in Nursing at Dalhousie University, and a Research Scholar at Dalhousie’s Health Law Institute. @marthpaynter

 

This commentary was previously published in the Chronicle Herald.