ATTN: Minnesota Department of Health, Minnesota COVID Ethics Collaborative, Governor Tim Walz, Lieutenant Governor Peggy Flanagan, Commissioner of Corrections Paul Schnell
Dear Kris Ehresmann and Members of MDH,
We, the undersigned organizations and individuals, write this letter to strongly urge you to prioritize people who are incarcerated or detained1 in Minnesota within the state’s COVID-19 vaccination rollout plans. Minnesota has an ethical and legal obligation to safeguard the health of incarcerated and detained individuals.
Within the past year, prisons, jails, and detention centers across the country have been hotspots for COVID-19 outbreaks.2,3,4,5 Minnesota is no exception to this. As of December 2020, over 1 in 3 incarcerated people in the state have contracted COVID-19, and six individuals have already died from COVID-19. 6,7 ICE has reported 53 confirmed COVID cases amongst detainees in Minnesota, including four of the five county jails that have contracts to hold detainees. These case numbers will only continue to grow with the COVID-19 surge in the state.8
Incarcerated people are at high risk for COVID-19 infection. They are more likely to have pre-existing conditions than the general population9 and cannot social distance effectively while incarcerated.10 Studies have found that people in jail or prison are 4 to 5.5 times as likely to be infected with COVID-19 as the general population and three times as likely to die (when adjusted for age and sex).11,12
Furthermore, infections within a jail or prison do not remain there. One study13 found that more than 15% of all COVID-19 cases in Illinois could be traced back to one county jail (through April 19, 2020). Even besides our ethical and moral duty to provide medical care to incarcerated people, public health measures and common sense dictate priority access to vaccination will protect our communities from uncontrolled spread.
This is also an issue of racial justice and equity. Minnesota incarcerates Black, Hispanic, and Native American people at dramatically higher rates than it does white people.14 These communities of color are the same groups at disproportionate risk for COVID-19 due to historical and current inequities15—including here in Minnesota.16 Thus, it is even more urgent to protect these Minnesotans as much as possible.
In November 2020, The Centers for Disease Control and Prevention (CDC)’s Advisory Committee on Immunization Practices recommended inclusion of residents and staff of nursing homes and other long-term care facilities, adults with pre-existing conditions, and adults over the age of 65, among other groups, as part of Phase 1 of the vaccine rollout.17
Given the degree of outbreak in the Minnesota carceral facilities as well as the high risk of increased COVID-19 cases within an already marginalized population and for further community spread, we strongly recommend the Collaborative also ensure priority, voluntary vaccine access for incarcerated and detained people, particularly those with pre-existing conditions and those over the age of 65.
Specifically, we urge you to treat everyone living in congregate facilities equitably by giving the highest-risk prisoners and detainees the same priority level as long-term care residents in Phase 1. This is consistent with the National Academies of Sciences, Engineering and Medicine’s equitable vaccine allocation framework that ranked people 65 and older in prisons and jails, and those of like age in nursing homes and assisted-living facilities, after health care workers and emergency medical workers on the suggested Phase 1 priority list.18
Even with widespread vaccination, current high levels of SARS-COV-2 community spread suggest that outbreaks may continue at a high level for some time.19 Given that context and the intense spread within congregate living facilities, we also urge the Collaborative to, where possible, push forward other multi-fold recommendations to ensure the health and well-being of our incarcerated and detained community members, including but not limited to population reduction by releasing people into the community, stopping the intake of new admissions, and immediately ceasing all ICE transfers and deportations that are responsible for further spreading COVID-19 to other countries.
No Cages MN (statement initiator)
Affiliations are for identification only