• David H Cloud, Cyrus Ahalt, Dallas Augustine, David Sears, and Brie Williams.
• Division of Geriatrics, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA. david.cloud@ucsf.edu.
• J Gen Intern Med. 2020 Sep 1; 35 (9): 2738-2742.

AbstractIn the face of the continually worsening COVID-19 pandemic, jails and prisons have become the greatest vectors of community transmission and are a point of heightened crisis and fear within the global crisis. Critical public health tools to mitigate the spread of COVID-19 are medical isolation and quarantine, but use of these tools is complicated in prisons and jails where decades of overuse of punitive solitary confinement is the norm. This has resulted in advocates denouncing the use of any form of isolation and attorneys litigating to end its use. It is essential to clarify the critical differences between punitive solitary confinement and the ethical use of medical isolation and quarantine during a pandemic. By doing so, then all those invested in stopping the spread of COVID-19 in prisons can work together to integrate medically sound, humane forms of medical isolation and quarantine that follow community standards of care rather than punitive forms of solitary confinement to manage COVID-19.

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