With a growing number of people suffering from COVID-19, the National Security Committee on Friday decided to ban public gatherings in an effort to halt its spread, the social distancing advice that health practitioners are giving people may not be possible for the vast incarcerated population in 25 prisons across Sindh.

Health professionals say prisons could be a hotspot for a coronavirus outbreak. “Overpopulation, crowding in small spaces, poor ventilation, limited access to basic hygiene and a compromised health make the inmates more vulnerable to catching the disease which may go out of control,” said Dr Naseem Salahuddin, head of infectious diseases at the Indus Hospital. But, she said, they may face the same situation in communities they belong to, and “if that is the case, they may well be better off inside than outside”.

According to Inspector General of Prisons, Sindh, Nusrat Hussain Mangan, there “has been no known positive case” in the 17,000 prisoners and the authorities are doing as much as they can to keep it at bay.

But that does not mean there is room for complacency. Dr Bushra Jamil, professor of infectious diseases at the Aga Khan University Hospital said washing the surfaces like cell walls, floors, bed rail, chairs, doorknobs and any other metallic surfaces would be most helpful in curtailing the virus. And, she said, it may be a godsend opportunity to educate and inculcate good hygiene practices among the inmates.

‘Fumigation is not helpful; actual physical cleaning with soap/detergent and water is absolutely essential!’

On the Sindh High Court’s order to fumigate the prisons and the courts, Dr Jamil said: “Fumigation is not helpful; actual physical cleaning with soap/detergent and water is absolutely essential!”

“Spraying streets and pavements randomly as seen in Chinese cities did nothing to contain the virus,” said Dr Salahuddin. She suggested: “Since the virus is present in human nasal and lung secretions, it may be better to start a campaign to discourage spitting paan and phlegm and blowing your nose, as well as provide spittoons.”

Asked if any special measures, the IGP said they put up posters across prisons “in English, Sindhi and Urdu explaining about hand-washing” last week. And to assuage their anxiety, the authorities are orienting the inmates about good hygiene — “to wash their hands before and after meals, after using the toilet”. These lectures are given to the inmates by their peers,” he said as that would be more effective.

“We are doing as much as we can to keep the virus away but we are not able to improve on the hygienic practices,” said Mr Mangan. “If Justin Trudeau’s wife can get the virus, who I would assume lived in an extremely sanitised and clean environment, how can we possibly ensure this in our prisons?”

However, he said because the prisoners have zero contact with the outside world, their chances of catching the virus is minimal. However, the jail staff are the only outside contact and run the risk of bringing the infection from home to the prisoners whose immune system is already compromised. “We have minimised their contact with the prisoners,” assured Mr Mangan. In addition, the IGP said the visitors did not have any physical contact as there is glass between the prisoners and the visitors. “They can see and hear but no possibility of contact,” he said.

Dr Salahuddin said while she did not know the legality of it, the one step that can be taken by the state is to reduce the number of prisoners. “Because once it gets there, it is going to spread like wildfire,” she said. In countries hard-hit by coronavirus, like Iran, 70,000 prisoners have been released.

Mr Mangan said he had suggested to the home department and the courts that “inmates above 65, who were medically fragile or terminally ill, minors and low-risk offenders should be given priority for release, of course after due judicial process.” In addition, he said he had suggested to the authorities to halt court productions of prisoners for the time being and where it was impossible, to hold the trial proceedings through video. New inmates to be brought into the prison after they have been screened and passed the 14 day incubation period and are cleared.

“Prisoners who have committed non-heinous crimes and cannot provide bail money, should be released and their bail money forgiven or temporarily overlooked,” said Maliha Zia, of the Legal Aid Office, a government-funded but privately managed committee for the welfare of prisoners. “We are already doing it and the idea behind this is to reduce the prison population. They are languishing there not because they are a risk to society, but too poor to leave the prison and do not have the means to do so,” she said, adding that if things turn worse, this may later place a burden on our already collapsing healthcare system.

Published in Dawn, March 16th, 2020