Coping with COVID in corrections: a qualitative study among the recently incarcerated on infection control and the acceptability of wastewater-based surveillance.
Coping with COVID in corrections: a qualitative study among the recently incarcerated on infection control and the acceptability of wastewater-based surveillance.
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DOI：
10.1186/s40352-023-00205-0
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发表时间：
2023-02-07
期刊：
影响因子：
3.5
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中科院分区：
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惩教场所是SARS-CoV-2传播的热点。社会和生物风险因素导致涉及司法的个人的新冠肺炎发病率和死亡率较高。在聚集环境中快速识别新病例对于促进适当的隔离和检疫至关重要。我们询问了在新冠肺炎期间被监禁的个人对如何改善肠道感染控制的看法，以及他们对伴随个人检测的基于废水的监测(WBS)的可接受性的看法。我们对20名自称在2020年3月至2021年5月期间在美国各地被监禁的成年人进行了半结构化采访。我们询问了参与者关于疾病控制和预防中心(CDC)新冠肺炎指南的设施执行情况，以及在他们最新的设施中将WBS纳入SARS-CoV-2监测策略的可接受性。我们使用描述性统计来表征研究样本，并报告WBS的可接受性。我们使用迭代过程对定性数据进行了主题分析。参与者主要是黑人或多种族(50%)和男性(75%)；平均年龄为46岁。大多数人在最近一次监禁期间接受了口罩(90%)，尽管只有40%的人接受了适当佩戴口罩的咨询。四分之一的参与者在进食时接受了SARS-CoV-2检测。大多数人(70%)认为他们在监禁期间接触到了病毒。反复出现的主题包括(1)惩教机构环境导致不安全感，(2)认为惩教机构的惩罚性条件因大流行而加剧；(3)同行作为缓解措施信息来源的重要性；(4)认为惩教环境的安全与大流行期间社区的安全不同；(5)将WBS作为一种合乎逻辑的策略，大多数(68%)认为WBS将在他们所在的最后一个惩教机构工作，79%的人更喜欢通过WBS监测SARS-CoV-2水平，而不是仅仅依赖个人检测。与会者支持常规的WBS监测SARS-CoV-2。将WBS纳入惩教机构现有的监测战略可能会将未来新冠肺炎爆发的影响降至最低，同时节省本已有限的资源。为了增强人们对惩教系统正在最大限度地缓解风险的看法和现实，未来的措施可能包括专注于更紧密地遵守疾控中心的建议，并与居民澄清疾病的发病机制。
Correctional settings are hotspots for SARS-CoV-2 transmission. Social and biological risk factors contribute to higher rates of COVID-19 morbidity and mortality among justice-involved individuals. Rapidly identifying new cases in congregate settings is essential to promote proper isolation and quarantine. We sought perspectives of individuals incarcerated during COVID-19 on how to improve carceral infection control and their perspectives on acceptability of wastewater-based surveillance (WBS) accompanying individual testing. We conducted semi-structured interviews with 20 adults who self-reported being incarcerated throughout the United States between March 2020 and May 2021. We asked participants about facility enforcement of the Centers for Disease Control and Prevention (CDC) COVID-19 guidelines, and acceptability of integrating WBS into SARS-CoV-2 monitoring strategies at their most recent facility. We used descriptive statistics to characterize the study sample and report on acceptability of WBS. We analyzed qualitative data thematically using an iterative process. Participants were predominantly Black or multiple races (50%) and men (75%); 46 years old on average. Most received a mask during their most recent incarceration (90%), although only 40% received counseling on proper mask wearing. A quarter of participants were tested for SARS-CoV-2 at intake. Most (70%) believed they were exposed to the virus while incarcerated. Reoccurring themes included (1) Correctional facility environment leading to a sense of insecurity, (2) Perceptions that punitive conditions in correctional settings were exacerbated by the pandemic; (3) Importance of peers as a source of information about mitigation measures; (4) Perceptions that the safety of correctional environments differed from that of the community during the pandemic; and (5) WBS as a logical strategy, with most (68%) believing WBS would work in the last correctional facility they were in, and 79% preferred monitoring SARS-CoV-2 levels through WBS rather than relying on just individual testing. Participants supported routine WBS to monitor for SARS-CoV-2. Integrating WBS into existing surveillance strategies at correctional facilities may minimize the impact of future COVID-19 outbreaks while conserving already constrained resources. To enhance the perception and reality that correctional systems are maximizing mitigation, future measures might include focusing on closer adherence to CDC recommendations and clarity about disease pathogenesis with residents.