COVID-19 in NSW Prisons

80% Vaccination Rates in Prisons 

Last edited: 25/10/2021

This document has been created to summarise the potential risks for prisoners in the event that the targeted 80% vaccination rate is reached in NSW prisons.

Table of Contents

Introduction 2

Increased COVID-19 Transmissibility in Prisons 2

Recognising prisons as a vulnerable place for COVID to attack and the issue of compliance and reaching vaccination targets in prisons. 3

Depopulation strategy and benefits 6

Non-fatal burdens of COVID 8

Effects of ‘Long COVID’ 8

Mental health impacts and breach of human rights for extended isolation/ segregation of prisoners 9

Added risk for Comorbid inmates 10

Additional Issues With Detention During COVID 10


  • There have been emerging reports in the media detailing that there have been no new cases in Correctional Facilities such as Parklea. This has been used as evidence to suggest that COVID in prisons no longer is an issue. This approach is entirely flawed as it is evident that COVID still plagues the prison population and does not account for the lasting effects COVID possesses.  
  • This has not prevented a new inquiry into COVID in prisons to assess the risk it still has on inmates.
  • The courts have recently released a man detained on weapons charges for fear they would not be properly medically treated in custody and reduced the sentence of another who was forced to bunk with a known COVID positive inmate.
  • It is important to recognise the import of depopulating prisons during a pandemic and potentially a post-covid world and the dangers COVID still imposes on inmates once the vaccination target of 80% is reached. 
  • Prisons still maintain an increased rate of transmission in prisons, the inmates are more vulnerable to negative effects, and the extended impact of non-fatal implications of COVID can have lasting adverse impacts on inmates. 
  • The recommendation is still to depopulate prisons in the face of reaching the vaccination goal to reduce transmissions and the impact on prisons who are already a vulnerable group of people.

Increased COVID-19 Transmissibility in Prisons 

  • Prisons are a public health response issue.  Australian gaols  are deemed the COVID ‘epicentres’, and are being investigated for their potential impact on prison-specific interventions, and that  ‘prisons are therefore a high priority setting in the public health response’ & develop ‘applicable to prison setting’. These prison ‘epicentres’ are so significant that NSWCS & JH&FMHNe are developing Modelling Research for Australia and overseas.
  • The Covid-19 Delta strain has spread inside NSW prisons. State authorities told Human Rights Watch that as of August 27, 2021. 
  • Incarcerated typically have underlying burden of disease and weak immunity defence due to stress, poor nutrition, or prevalence of coexisting diseases
  • The increasing prevalence of the Delta variant and the inability to social distance in the current prison structure only serves to exacerbate the likelihood of COVID spreading.
    • It is currently impossible to properly implement social distancing in prisons as inmates are either forced to be in confined cells or are being transported between different facilities, these environments pose greater risk of ‘superspreaders’ infecting large quantities of closely confined people.
    • A Scottish study of 20,000 patients found that the risk of COVID-19 related hospital admissions were almost doubled in individuals with the Delta variant.
  • Poor airflow, no universal masking, no autonomy over close contacts, waning vaccination immunity, and greater infection rates in prisons all contribute to increased infection rates. 
    • It is extant that these issues are contributing to lower overall health in Australian inmates despite an increase in the vaccinated population in prisons.
    • Case studies in other jurisdictions like the US indicated that inmates were 5.5 times more likely to catch a deadly disease in a prison vs the general population.
  • Conclusively, transmissibility will still be an issue in prisons despite an increase in vaccinations.

Recognising prisons as a vulnerable place for COVID to attack and the issue of compliance and reaching vaccination targets in prisons.  

  • While COVID safe plans are arranged for Apartment buildings, there is a poor recognition of outbreaks outside of major cities, and there is greater ‘collateral damage  to health from lockdowns.’
  • NSW has not heeded the many warnings of the high risk personal and ‘dire’ public health damages that  need to be averted.  As outlined recently by the World Health Organsiation, this is a matter of prisoner rights, human rights, and public safety.
  • Six critical points were raised in a recent NSW Report that focussed on Delta Variant of Covid in  prisons: LgA’s of concern; 
  • ‘…moderate to high host susceptibility’ (eg mental health, older aged, young people more susceptible); problems of staff compliance; 
  • requirement for staff to use full PPE;  
  • the absence of NSW data on staff compliance and non mandatory requirement for incarcerated persons and mask wearing ; 
  • quality of air ventilation indoor spaces, and where 1 in 5 people maybe ‘super-emitters’;  
  • spatial density/overcrowding ( and is even more important where is poor ventilation quality); 
  • high transmissibility and health impacts of Delta Variant.  
  • Questions about inadequate policies and protocols that can result in issues of staff compliance and breaches remain a concern.  To date, the staff low vaccination is already deemed a breach of prisoner human rights & risks widespread infections.   
  • This was highlighted in a Parklea COVID outbreak where NSW parliament was told by Department of Communities and Justice secretary Michael Coutts-Trotter in a budget estimates session on 1 May 2021 that of the  “two inmates who were out of their quarantine pod tested positive on August 27” 2021,  ‘he did not know why this breach in protocol occurred’, and that ‘ staff compliance to such measures will likely remain an issue’. 
  • COVID Testing Regime only at Receptions is inadequate and relies on inmates to recognise symptoms.
  • Vaccination coverage of incarcerated persons and prison-based staff is a critical factor. The World Health Organization and advisory committees of various governments have recommended prison-based staff and incarcerated persons be prioritised for COVID-19 vaccination programs. 
  • Yet there are claims of breaches to prisoner human rights due to the comparatively low Vaccination Rates of NSW prisoners, & ‘lagging behind’ most states, Human Rights Watch recorded that on August 27, 2021, only 21 percent of prisoners in the state’s government-run adult facilities were fully vaccinated, with 42 percent having received at least one dose.
  • This is despite it being known that the risk of high hospitalisation & death due to Delta Variant’s higher risk, especially for the unvaccinated; the ATSI risk of outbreak in prison; and the prison-to-community-transmission.  This was most concerning following ‘The release of a COVID-19 infectious person from the Bathurst Correctional Centre in the first week of August 2021 to Walgett, and community transmission from infected Bathurst Correctional Centre staff.
  • There are potentially ‘dire’ consequences for not testing people unless they are symptomatic or considered a known close contact.  Justice Health stated that “Patients are not provided a COVID-19 test on release unless they are symptomatic or considered a close contact of known cases.” Measures reliant on the identification of persons who are infected through syndromic surveillance (fever, sore throat, cough etc) and isolation of such cases will not stop prison-to-community-transmission. 
  • Less than the ‘absolute minimum’,  ‘sentinel testing [or] survellience’ was proposed by NSWCS which the Kirby Report criticised NSWCS regime as it would not avert ‘residual risk’ of and the ‘imperfect quarantine measures’ ie test some people some of the time in some places.
  • Given that asymptomatic cases represent a substantial proportion (70%) of Delta variant transmissions, this has significant implications for people and health agencies in the wider community. 
  • Additionally, as of 1 September 2021, two-dose vaccination rates for the western NSW Aboriginal population ranges from 13.8% (Far West and Orana) to 18.9% (Murray).59 The surrounding Central West region of the Bathurst Corrections Centre – which as of 1 September 2021, nine prison staff tested COVID-19 positive  – has a two-dose vaccination rate of 17.8% among the Aboriginal population. If we assume that a proportion of those released from western NSW prisons go on to reside, or frequent family and loved ones, in western NSW, then it is our opinion that if a prison-to-community seeding event occurred, the cost to Aboriginal families and community members (with low vaccination rates due to delays in the vaccine roll out) could be dire.’
  • Most inmates already suffer from one or more illnesses or disabilities. This gives inmates an added risk of infection as it has been identified that comorbid individuals are more at risk.

Depopulation strategy and benefits  

Despite the prospect of the prison population reaching the 80% vaccination target it is important to recognise that inmates are still at risk. Vaccinated people can still contract the virus. It has been highlighted that the conditions in prisons create a perfect breeding ground for the virus with spatial density issues, forced proximity to potential COVID positive inmates and staff, reduced quality of healthcare or inability to choose a doctor, lack of airflow, comorbidities and so forth…, depopulation is the main strategy to relieve these issues.  

  • Relaxed spatial density coupled with an increase in vaccinations would rapidly reduce the risk of outbreaks, transmission, severe disease and added impacts of comorbid inmates.
  • It is vital that if depopulation of prisons is implemented that it be supported with adequate health, social and economic support for inmates and their close contacts.
  • It has been recommended that persons with mental illness and cognitive impairment who are in a parole period should be reviewed for release.
  • Instead of opening and building more prison spaces, the Honorable Michael Kirby said of the COVID ‘catastrophe’, that Australia essentially has a need for Law Reform to address over-crowding, & scarcity of facilities post release:
  • Kirby Report Reactive approach by Govt rather than a ‘managed approach’ ie Govt should prioritise prisoners because of problems of spatial separation, & lack of detail of Australian Govt preparation plans for prisoners & staff safety.
  • Call for Parole’ nor ‘vulnerable’ not mentioned, but can consider it part of broader reference to a ‘depopulation strategy’  to ‘decrease spatial density within the prison estate’  ( p12)
  • Depopulation strategy or ‘managed approach’ should be prioritised as criminological literature evidence is that there is no correlation between length of confinement and risk of reoffending on release at a group level eg forensic patients, especially to provide rehabilitation – ‘Longer periods under supervised care in the community are likely to have longer term benefits for reducing re-offending, rather than waiting until sentences expire and release does not encourage participation in treatment.’ 
  • Fear of Prisoner’s rioting & resistance, eg prisoner reacting to the ‘deadly virus.’ 
  • WHO Europe on COVID refers to Human Rights breach if prisoners are isolated for more than 15 consecutive days eg investigate breach where governor baker stated the protocol is MRCC & Parklea 14 & 7 day consecutive isolation of prisoner.s 
  • Extended isolation measures for COVID positive inmates have negative mental health effects including suicide risk.
  • COVID’s heightened impact on prisoners with co-morbidities who contract COVID – the personal heightened risk,  infection plus the ‘long covid’ burden of disease public health and cost impacts 
  • Spatial density issues would be relieved 
  • A ‘reactive’ or poorly/delayed Proactive ‘managed approach’ is a public health risk that can have a deleterious effect in the community for staff and/or prisoners that are asymptomatic of COVID. 
  • Additional measures such as inmate health education for those not eligible for release and mandatory vaccinations for staff and contractors at prisons should also be applied concurrently with depopulation strategies.

Non-fatal burdens of COVID 

Effects of ‘Long COVID’

  • Far more a burden is the burden of ‘non-fatal disease’ or  ‘Long Covid’ that includes the serious long damage to health  from asymptomatic illness, from resultant disability and permanent impairment. The likely risk of contracting COVID is of living fewer years with disability as a result of permanent functional impairment from asymptomatic COVID symptoms,  and need to address & ‘focus on chronic disease management’.
  • Carvalho-Schneider et al. (2021) confirmed that two-thirds of adults with non-critical COVID-19 had complaints 2 months after symptom onset, mainly anosmia/ageusia, dyspnoea or fatigue.
  • Garrigues et al. (2020) found that patients with COVID- 19 discharged from hospital experienced persistent symptoms, most commonly fatigue and dyspnoea, for up to 3 months after diagnosis.
  • Huang et al. (2021) presented the results of a large study with long-term follow-up, and reported that fatigue or muscle weakness, sleep difficulties, and anxiety or depression were common, even 6 months after symptom onset.
  • More severely ill patients had higher risk of pulmonary diffusion ab normality, fatigue or muscle weakness, and anxiety or depression. In addition, lung function was altered, with reduced diffu-sion capacity and long-term lung abnormalities shown on imaging, mainly represented by ground glass opacities (GGOs) and in- terstitial lung abnormalities ( Guiot et al., 2020).
  •  Lung function was altered, with reduced diffusion capacity and long-term lung abnormalities shown on imaging, mainly represented by ground glass opacities (GGOs) and in- terstitial lung abnormalities ( Guiot et al., 2020b , c ).
  • Ayoubkhani et al. (2021) quantified rates of organ-specific dysfunc- tion in individuals with COVID-19 after discharge from hospital compared with a matched control group from the general population. 
  • Mean follow-up in the study by Amenta et al. (2020) was 140 days. Admission to hospital for COVID-19 was associated with increased risk of readmission and death after discharge. Rates of multi-organ dysfunction after discharge were higher in individuals with COVID-19 compared with those in the matched control group, suggesting extrapulmonary pathophysiology. 

Mental health impacts and breach of human rights for extended isolation/ segregation of prisoners  

  • According to current policies, new arrivals are required to undergo 14 days of quarantine in single cells and prisoners who test positive for COVID-19 are similarly placed in isolation.  However, by increasing isolation beyond the 15 consecutive days, is against the ‘WHO Guidance’ for COVID policies, and risks.
  • Single cell isolation is a risk factor for self harm and suicide in custodial settings
  • The effect of isolation in a prison or detention cell alone is likely more aversive than quarantine alone at home. 
  • It is essential to note that people with existing psychiatric conditions may experience a worsening of their condition while subject to quarantine. 
  • The delivery of mental health care in custodial facilities is difficult at the best of times.
  • Reduction in mental health care to persons subject to quarantine measures, and to the general population of a facility is to be expected. letter = ‘psychiatric report to assist solicitors in advocating for clients/submissions to court’

Letter by Forensic Psychiatrist Dr Andrew Ellis, to Legal Aid NSW, ‘: COVID – 19 AND MENTAL HEALTH ISSUES FOR NSW PRISONERS’ p3, 8

Added risk for Comorbid inmates 

  • Justice Health NSW practices should comply and adopt practices in line with the 2020, WHO’s Guidance on COVID they helped develop including reducing infection in prisons; not increasing the burden of disease for prisoners with comorbidities; concern of compounding restrictive measures to incarcerated people; and the need for strong infection prevention or risk of failure to control in community.
  • Around one out of every five people who are infected with COVID-19 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems such as high blood pressure, heart problems or diabetes, are more likely to develop serious illness.
  • Most inmates already suffer from one or more illnesses or disabilities. This gives inmates an added risk of infection as it has been identified that comorbid individuals are more at risk.
    • Hospital admission is 5 times more likely for people with comorbidities.
  • Comorbid youth risk a higher death rate.

Additional Issues With Detention During COVID 

  • Need for education material or information to reduce vaccine hesitancy (p11) and to promote safe Covid-19 Hygiene and other messages to be provided.
  • Education lack of access worsens mental function for prisoners, ‘Boredom coupled with lack of access to education or vocational activities worsens mental function’.
  • Obligations for communication to families and friends about prisoners and COVID
  • Aboriginal Legal Services denied access to Clarence CC – legal access rights denied during COVID