Researchers to Test Strategies to Limit COVID-19 Spread Among Formerly Incarcerated People

Prisons and jails have been fertile ground for COVID-19 outbreaks, leading to millions of cases in the United States. Individuals released from these facilities often transition to other congregate settings, such as homeless shelters and group homes, where COVID-19 infections can continue to spread. Now, Albert Einstein College of Medicine and Montefiore Health System have been awarded a five-year, $3.4 million grant from the National Institutes of Health (NIH) to test a program aimed at reducing SARS- CoV-2 transmission among people recently released from incarceration.

The study will be led by Matthew Akiyama, MD, associate professor of medicine at Einstein and an internist and infectious disease specialist at Montefiore. Akiyama will collaborate with The Fortune Society, a New York City-based nonprofit serving both incarcerated and formerly incarcerated individuals, to conduct a randomized trial to assess an on-site, or point-of-care COVID-19 testing and education program.

The Centers for Disease Control and Prevention (CDC) reports more than 715,000 total cases in U.S. correctional and detention facilities since March 31, 2020, although many note that is likely an undercount.

“People who are incarcerated face significant health disparities and an increased risk of SARS-CoV-2 infection,” said Dr. Akiyama, whose work focuses on illness among marginalized members of society. “Upon their release, many live in homeless shelters or congregate settings that are ripe for coronavirus transmission. Given the likelihood of COVID-19 remaining an endemic disease among high-risk populations, it’s important to test and establish effective strategies to reduce the virus’ spread in communities.”

The study will involve 250 people who have been released from prison or jail. All will receive education about the importance of testing for the virus. Half will be referred to offsite testing; the other half of participants will be offered rapid PCR tests every three months at The Fortune Society offices in Long Island City and Harlem. During the 30-minute wait for test results, justice-involved individuals trained as community health workers will provide one-to-one counseling about the importance of social distancing, proper hygiene, and mask-wearing. Travel to vaccine sites will be arranged and facemasks will be provided, if needed. People who test positive will be directed to single-room supportive housing offered by The Fortune Society to maintain social distancing.

All participants will fill out questionnaires throughout the year. They also will receive smartphones to use for web-based surveys about their activities and how they are protecting themselves and others from the virus.

Akiyama is also partnering with the Einstein and Montefiore department of pathology to perform analyses that will indicate the specific variant of COVID-19 in those testing positive.

“As variants like Omicron emerge, we’ll also have a system in place to monitor the variants that are circulating in the community,” said Akiyama. “I am thrilled to be collaborating with The Fortune Society as well as my colleagues in the division of general internal medicine, including Drs. Aaron Fox and Chenshu Zhang, and the department of pathology including Drs. Amy Fox and Yitz Goldstein to implement this study.”

The grant, “Leveraging community health workers to improve SARS-CoV-2 testing and mitigation among criminal justice-involved individuals accessing a corrections-focused community-based organization,” is funded by the National Institute on Minority Health and Health Disparities, part of the NIH (1R01MD016744).

Source: Albert Einstein College of Medicine