Introduction by Croakey: Since news broke about the novel coronavirus several months ago, public health officials in Australia have given many hundreds of media briefings.
None have sounded anything remotely like what follows in the article below – in which critical public health concerns about the pandemic are raised.
The “transcript” is provided by Associate Professor Megan Williams, Wiradjuri justice health researcher and educator, and contributing editor and board member of Croakey Health Media.
Transcript of press briefing by “Chief Medical Officer” ***
Given the highest ever daily increases of COVID-19 being recorded in Australia and Melbourne particularly, I must provide you with an update about some of our most vulnerable community members, who to date have not been the focus of reporting in Australia.
However, data from around the world reminds us of the great risk they face from outbreaks that will be extremely difficult to address.
I am talking particularly about adults in Australian prisons. As you know, I am an epidemiologist, and it is my role to look at risks that specific populations face, to identify how to prevent or address these, beyond the general population.
To date we have avoided outbreaks of COVID-19 in Australian prisons, due to several effective strategies. However, we must be realistic about potential risks at this time, and we must be proactive.
Many people in prison have multiple risks for COVID-19 infection and are at increased risk of poorer outcomes if infected – they already have higher rates of viral infections, chronic diseases, smoking and poor mental health. It is important to acknowledge that Australian prisons contain disproportionately high numbers of Aboriginal and Torres Strait Islander people compared to the community, and they face multiple COVID-19 risks.
While healthcare is available in prison, it is not designed to cope with infection outbreaks or COVID-19. The international experience says prevention is an absolute necessity.
In recent years, and just prior to the COVID-19 pandemic, prison rates had been increasing in Australia and have been at an all-time high. Victoria has one of the fastest growing prison populations in Australia and rates of deaths of prisoners generally.
Here, I am particularly thinking through ramifications of outbreaks in Melbourne, and I must be clear I am not conflating the lockdown of public housing in metropolitan Melbourne in any way with prisoners.
However, it is my responsibility to acknowledge that people in prison, as with any people experiencing social and economic hardships, must receive all the supports required at this time to prevent COVID-19.
The hard lockdowns currently in place in Melbourne have police involved. I would like to take this opportunity to reiterate that they are working for community adherence to public health law and have no mandate to carry out routine or targeted criminal history checks. They must facilitate – not prevent – access to healthcare and social support.
I urge all community members to adhere to the orders you have been given to reduce risks of COVID-19 infection. Stay at home (this will also help reduce your risk of exposure to police). You will be provided with all you need to maintain your wellbeing.
Examples of COVID-19 infections in prisons overseas are nothing short of disastrous. Australia has done exceptionally well thus far but we must ask, ‘Is it time to redouble rather than relax our efforts?’.
Usually prisons are the responsibility of each state and territory. However, the Federal Government has produced COVID-19 guidelines for detention and correctional facilities to follow.
Personal visits to prisons throughout Australia have been suspended, with easing in some jurisdictions soon – South Australia will see Stage 1 visits recommence on 13 July and stage 2 on 27 July. Increased access to telephone calls, video visits and in some instances email are being trialled; however these remain very limited, despite increased demand.
The small number of infections in Australian prisons to date have been among staff. Prisons have their own infection control protocols including routine screening, temperature testing, personal protective equipment (PPE), additional cleaning and remote service delivery and staffing. Many centres have had periods of lockdown to contain prisoners, to make system changes and respond to risks.
Physical distancing is a challenge in prisons generally. Overcrowding has been reported in some Australian prisons, which presents a great risk for infection spread. Further, prisoners share bathroom, laundry and food preparation facilities.
Prisoner health experts have warned of the negative impacts of disrupted healthcare, lockdowns, minimal family and social contact, and fears of infection. Prisoners must not be held in solitary confinement as an infection control measure.
Our national data indicates that people in prison already have a risk of death higher than the general population, from natural causes and suicide, particularly among Aboriginal and Torres Strait Islander people. I must acknowledge an important point made in Black Lives Matter campaigning during the pandemic: the need to see prisons as part of our community not separate.
New entrants from the community to prisons are an important focus. Prison staff are deployed to manage quarantined sections of prisons for entrants and those in contact with diagnosed or potential sources of infection. Prisoner education programs and their access to personal hygiene items have improved but require further attention.
Reducing new and overall prisoner numbers, however, and the high turnover of people between prisons and the community are what we must action to prevent COVID-19 in prisons.
I commend jurisdictions such as NSW in its temporary Crimes Act 1999 measure to grant parole to some prisoners at higher risk and with an impending release date. I understand the use of such legislation has been slow; we have not yet heard outcomes from prisoner release programs overseas, such as 600 on temporary release in Ireland.
I call on other jurisdictions to amend legislation to enable the release of prisoners most at risk, those with a short time until release, and those sentenced or on remand for offences able to be addressed through community corrections orders.
Recent NSW data has indicated a reduction in some types of crime, which may see a decline in prisoner numbers.
However, there is also a reported increase in domestic violence, with experts linking this to the pressures of pandemic-related community lockdowns. I am currently in discussions with the various jurisdictions to identify trauma-informed, culturally-safe services to urgently invest in, to support the wellbeing and safety of families during lockdown.
There is an expectation crime rates will return to pre-pandemic rates and that prison numbers may rise due to pandemic-related increases in risk factors: poverty, homelessness and poor mental health playing out in illegal drug use, theft and violence.
So, we must think ahead and be prepared for potential outbreaks. Our pandemic response should also be aiming to address and prevent poverty and homelessness, and ensure access to drug treatment services, as part of our strategy for reducing prisoner numbers.
Public drunkenness, a major risk for police contact, must be treated as a health issue; diversions for this and less-serious offences from police custody to community corrections are required at this time to protect the public’s health and health systems. I understand jurisdictions are working to ensure that those released from prison have supports to remain COVID-19-free.
It is my responsibility to champion and coordinate efforts to protect the health of the community, and I reiterate the need to view prisons as part of the community. Being imprisoned must not come with increased risks of infection or death from COVID19.
Experts and international experiences highlight this reality.
Without continued effort, Australia risks further outbreaks that will be much harder and more expensive to contain than prevention in the first place.
** ICYMI, this is not an actual transcript, although it is published in the hope that it might help inform public health officials’ priorities and messaging, and encourage journalists to ask more questions about these issues. It is available for use by federal, state and territory health officials.
This article was supported by the Judith Neilson Institute for Journalism and Ideas.