Thread by @petermbenglish

Healthcare staff - including those working in @PHE_uk or its successor organisations, and the public health profession has a duty to speak out and challenge the "lock them up [for longer]" view that is so prevalent, particularly in right-wing, populist politics.
0/17

In my >20 year career as a consultant in communicable disease control, prisons have been the setting I've struggled most with.
1/17

As a previous tory home secretary said, "Prisons are an expensive way of making bad people worse".

I've tweeted about this before.

https://twitter.com/petermbenglish/status/1373255368697073664

or threadreaderapp.com/thread/1373255…
2/17

Most prisoners don't need to be in prison. Many have mental health problems. Few are a serious danger to others; and most of those who are will be released anyway, and imprisoning them for a time does little to mitigate this, and might make it worse.

3/17

And prisons are terrible places in infection control terms.

Perhaps if they were less crowded this would be less of an issue. But the reality is that they are crowded.

Prisoners are moved around frequently, with poor record-keeping.
4/17

(Don't get me started with issues when they are released, and the interface with local health services.)
5/17

Detention centres, for people whose only crime is being in the UK when the Home Office (frequently incorrectly) thinks they shouldn't be here, are even more of a challenge, ethically.
6/17

People are sent to prison "as punishment". Or possibly to show how deplorable the public thinks what they did was.

They are NOT (in UK) sent to prison to be punished there - the days of "hard labour" and corporal punishment are, thankfully, in theory at least, behind us.
7/17

We have a duty of care to prisoners. IF we are to imprison people, we should be investing in helping them to live productive lives, contributing to society - and not reoffending. (We are terrible at doing this, by the way.)
8/17

If we cannot protect prisoners from infections, we should release them. (Except those who are judged a serious, unmitigable risk to society.)
9/17

Trying to manage or control an outbreak of an infectious disease in prison often seemed unethical. The right thing to do was to release most of them.
10/17

Any cases of a preventable disease BECAUSE the infected person was in prison, is a culpable failure of the so-called "justice" system.
11/17

Covid-19 has already exacerbated inequalities, with the most privileged suffering far less than the most deprived. And, as this spectrum goes, prisoners are at the bottom of the ladder.
12/17

Guidance has been produced (and updated).

gov.uk/government/pub…
13/17

The guidance is predicated on the presumption that there is nothing that the health sector can do about the fact that prisoners are in prison; we just have to advise as best we can on how to "manage" communicable diseases in this far-from-ideal setting.
14/17

An official briefing papers has discussed the issue:
assets.publishing.service.gov.uk/government/upl…

It starts from the same assumption.
15/17

There have, of course, been outbreaks of Covid-19 in UK prisons; some have even been written up in professional journals, eg
sciencedirect.com/science/articl…
16/17

A quick google search found remarkably little official information on case numbers in UK prisons.

@DrEricDing has tweeted about this situation in the US, starting "At least 2700 inmates have died from #COVID19. None deserved it."

threadreaderapp.com/thread/1381004…
17/17

@DrEricDing @threadreaderapp unroll