Table 3

Key papers comparing testing of COVID-19/SARS-CoV-2 in people experiencing incarceration (PEI) versus the general population

StudyKey resultsOverall assessment of the quality of evidenceTesting rates vs general population
A time-series analysis of testing and COVID-19 outbreaks in Canadian federal prisons to inform prevention and surveillance efforts. Blair et al29On average, incarceration facilities tested more than the general population (88 per 1000 population compared with 40 per 1000 in public) however figures may be affected by six facilities which experienced outbreaks and far higher testing rates over the study period—64% of facilities recorded fewer tests per 1000 compared with general population. Six facilities recorded no testing at allLow
Adverse SARS-CoV-2-associated outcomes among people experiencing social marginalisation and psychiatric vulnerability: a population-based cohort study among 4,4 million people. Nilsson et al42Reduced rate of testing in PEI vs Danish national population OR 0.47 (0.46–0.48) p<.0001Medium
COVID-19 cases and testing in 53 prison systems. Lemasters et al3110 states and Puerto Rico reported no testing information, testing numbers varied across states from 6/1000 to 1531/1000 incarcerated people. Majority of prison systems tested more than the public, test positivity on average higher in prison systemsLow
COVID-19 infection among incarcerated individuals and prison staff in Lombardy, Italy, March 2020 to February 2021. Mazzilli et al35The study demonstrated a higher mean weekly testing rate per 1000 individuals vs the general population (first wave: 61.09 range, 0–115.44 vs 6.11 range, 1.16–10.41 second wave: 258.43 range, 123.92–573.08 vs 19.73 range, 11.68–30.09)Low
Testing lags and emerging COVID-19 outbreaks in federal penitentiaries: a view from Canada. Blair et al5312/50 had no testing at all, 36/50 had fewer tests than the general population, those with higher testing levels tended to be those who had a high COVID-19 prevalence. Overall, number of tests in incarceration facilities 34/1000 compared with 16/1000 in general populationLow
  • OR, Odds Ratio.