When COVID-19 struck, many jails and prisons were poorly equipped to provide even basic medical care. Yet, the onset of the pandemic found the country’s mass incarceration system shamefully well-equipped with punitive solitary confinement cells.

As it became clear that incarcerated people were in grave danger, public health experts recommended decreasing population density in prisons and jails by releasing people who had medical conditions, were nearing the end of their sentences, or posed a minimal risk to public safety. Although some municipalities freed people during the pandemic, far too many people were left behind in unsafe facilities that have used solitary confinement cells and implemented solitary confinement conditions in regular cells in a way that has caused great harm.

“Prisons are not health care providers, yet they were tasked with keeping people safe during a global pandemic,” said Clinique Chapman, associate director for Vera and MILPA’s Restoring Promise initiative, which creates prison housing units grounded in dignity. “They leaned on what they know, and they know how to lock people down.”

Cells designed for punitive solitary confinement—cramped, concrete, windowless, and about the size of a parking space—are no place for ethical medical isolation. In fact, the United Nations has deemed it torture to hold people in such conditions for more than 15 days without meaningful human contact. Yet solitary confinement is a widespread and common punishment in U.S. jails and prisons, for infractions as minor as profane language.

Due to poor reporting and monitoring, data surrounding the use of solitary confinement is incomplete, but various surveys have shown more than 60,000 people being held in isolation in United States jails and prisons at points in time before the pandemic. In mid-April of 2020, at least 300,000 people were experiencing some form of solitary confinement, restrictions to quarters, or lockdown as jails and prisons faced COVID-19. People have reported being locked in freezing solitary confinement cells while infected with COVID-19, with little to no medical care. In Connecticut, incarcerated people who had COVID-19 were held in isolated cells in a maximum security prison and denied the opportunity to shower. Many incarcerated people have experienced extended periods of precautionary lockdown—being kept in small cells for nearly 24 hours a day with little meaningful activity or contact—with devastating consequences to their physical and mental health.

David Sell, who contracted COVID-19 while incarcerated in 2020, wrote that his time spent in “medical quarantine” was by far the worst of his time in prison. “I wore the same clothing for 14 days, lacked any personal property or hygiene products. Medical treatment was nonexistent and so was communication with my family.”

No one should be treated like this. Decades of research show that solitary confinement causes serious and sometimes irreversible harm. Quarantine and medical isolation are necessary to prevent the spread of COVID-19, but the inhumane use of solitary confinement must end. The best way to stop the spread of COVID-19 in prisons and jails is to decarcerate. When people contract COVID-19 while in jail or prison, they should be medically isolated in a humane way, with clear standards for ethical quarantine. People in quarantine or medical isolation due to COVID-19 should:

• Have free access to resources that can make their separation psychologically bearable—for example, television, tablets, radio, reading materials.
• Have vital family support, including free video chatting, phone, or email.
• Have sanitary living space with sufficient ventilation and temperature control.
• Have easy access to medical and mental health professionals through phone or telemedicine.
• Be supervised by medical staff rather than corrections officers.
• Be removed from isolation when medical staff deem it is appropriate.
• Have family involved in their medical care, including regular updates on their progress and health status as they face COVID-19 exposure or infection.

It is possible to medically isolate people in prison or jail without subjecting them to the torturous conditions of solitary confinement. People who have experienced solitary confinement or extended lockdown during the pandemic should receive mental health treatment and other support to address the trauma resulting from severe isolation. Ultimately, the United States must take steps to decrease the number of people who are behind bars. Mass incarceration hurts all efforts to build a healthy society.