Propuesta de Protocolo para el Enfrentamiento de la COVID-19 en Centros Penitenciarios

Objectives

The protocol provides a COVID-19 prevention and response framework for penitentiary centres. Its overarching purpose is to mitigate the pandemic’s impact in these settings by preventing local transmission, protecting the health of people deprived of liberty, who are identified as a vulnerable population, and training penitentiary personnel in epidemic-containment measures.[1][2]

• Prevent and control infection through infection-prevention and control measures, including environmental hygiene, cleaning, disinfection, waste management, and safe handling of crockery and bedding.[3][4]
• Protect people deprived of liberty through healthcare access, respiratory-symptom reporting, medical referral, daily temperature checks, mask use, hygiene information, and reduced overcrowding to maintain at least one metre between people.[5]
• Manage suspected and confirmed cases, their close contacts, quarantine arrangements, clinical monitoring, psychological support, referral, and release procedures.[3][6][7]
• Safeguard healthcare and non-healthcare workers through training, hand hygiene, personal protective equipment, physical distancing, infection-risk signage, and procedures for managing symptomatic staff.[8][5]
• Regulate entry, visits, external professionals, admissions, releases, and personnel movements in order to reduce opportunities for introduction and spread of COVID-19 within prisons.[2][8]

Implementation

Implementation combines restrictions on access and movement with clinical case management, quarantine, protective measures, environmental controls, and multi-sectoral oversight. The protocol is directed at centre directors, prison personnel, healthcare services, people deprived of liberty, visitors, legal representatives, collaborating organisations, and non-governmental organisations.[1]Operational responsibility is assigned to the Ministry of Justice, Worship and Penitentiary Institutions, also referred to as the Ministry of Justice, Religious Affairs and Penitentiary Institutions, with supervision and advice from the Technical Committee for COVID-19 Surveillance and Response.[4][9]

• Restrict family and friend visits, require a negative polymerase chain reaction test obtained within the previous 48 hours for authorised visits, regulate external professionals, require masks and temperature checks at entry, and increase authorised telephone calls to mitigate the consequences of reduced visits.[2]
• Quarantine new admissions for up to 14 days, organise outdoor access in small groups based on admission date, and individually isolate symptomatic entrants with surgical masks pending polymerase chain reaction testing.[2][8]
• Train staff in infection prevention, provide soap, paper towels, alcohol-based or disinfectant hand-rub and prevention materials, conduct staff testing every 15 days, apply mask requirements in line with the Technical Committee for the Fight against COVID-19, and arrange individual medical assessment for symptomatic workers.[8]
• Limit personnel entering isolation cells, maintain a 1 to 2 metre safety distance where possible, avoid group gatherings, use biological-risk signage, and provide separate containers for biosanitary waste.[5]
• Isolate suspected or confirmed cases not requiring hospitalisation in individual, well-ventilated cells with closed doors, private bathrooms where available, and restricted access to communal areas; establish dedicated isolation space and quarantine the relevant cell block for up to 14 days, with testing for co-residents.[6]
• Use cohort isolation or quarantine where individual space is unavailable while maintaining 1 to 2 metres between people, and manage mild cases in prison in accordance with national technical guidance for home management of COVID-19 patients.[6][7]
• Arrange regional specimen collection and laboratory transport, avoid transfers and court appearances for suspected or confirmed cases unless medically necessary, and transfer released suspected or confirmed cases to an isolation centre in Malabo or the mainland region until discharge under national case-management procedures.[6]
• Provide psychological first aid and further psychological intervention when required, monitor warning signs, and transfer patients who develop warning signs to a designated referral hospital.[6][7]
• Identify direct and indirect contacts, quarantine identified contacts, test those who develop symptoms, maintain records of personnel exposed to suspected or confirmed cases, and assess exposure risk individually.[7][4]
• Apply hand hygiene at specified care points, use surgical masks for escorts, and require disposable gowns, FFP2 or FFP3 masks, double gloves, and eye protection for personnel caring for suspected or confirmed cases.[7]
• Clean patient-contact surfaces with 0.5% sodium hypochlorite, train cleaning personnel, provide appropriate protective equipment, separate ordinary and hazardous waste, undertake weekly general disinfection, and treat contaminated biological waste as special healthcare waste for incineration.[4]

Oversight involves the Technical Committee for COVID-19 Surveillance and Response and subcommissions covering epidemiological surveillance, clinical laboratory services, infection prevention and control, case management, communication and advocacy, and rapid response and the green line.[4]The protocol includes practical monitoring measures, including entry temperature checks, daily temperature checks for the prison population, periodic staff testing, clinical monitoring for warning signs, and contact records.[2][8][5][6][4]It does not specify formal performance indicators, reporting schedules, evaluation methods, accountability procedures, budgets, financing sources, or resource-mobilisation arrangements.[4]

Monitoring & Evaluation

Monitoring and surveillance centre on active screening, case detection, contact tracing, clinical observation and oversight of COVID-19 control measures in penitentiary centres. Entry screening includes temperature checks for visitors, new admissions and staff, while people deprived of liberty are subject to daily temperature checks; staff are tested every 15 days.[2][8][5]

• Conduct daily temperature checks among the prison population and use infrared thermometers where available.[6][7]
• Monitor suspected and confirmed cases for clinical warning signs and transfer patients developing such signs to designated referral hospitals.[6][7]
• Identify direct and indirect contacts of suspected or confirmed cases, maintain records of personnel exposed to cases, assess exposure risk individually, quarantine contacts and test those who develop symptoms.[7][4]
• Apply screening and diagnostic measures to admissions, including individual isolation of symptomatic entrants pending polymerase chain reaction testing and testing of co-residents when a case is identified.[2][8][6]
• Maintain infection-control observation through requirements for respiratory-symptom reporting, medical referral, mask use, hand hygiene, physical distancing and reduced cell overcrowding.[8][5]

Accountability and technical oversight are assigned across justice-sector and health-sector structures. Implementation is the responsibility of the Ministry of Justice, Worship and Penitentiary Institutions, also referred to in the extract as the Ministry of Justice, Religious Affairs and Penitentiary Institutions.[4][9]Supervision and advice are provided by the Technical Committee for COVID-19 Surveillance and Response.[3][4]The protocol was prepared by that Committee's Case Management Subcommittee and reviewed and accepted by the Minister of Health.[3]

• Coordinate technical oversight through subcommissions covering epidemiological surveillance, clinical laboratory services, infection prevention and control, case management, communication and advocacy, and rapid response and the green line.[4]
• Use the identified rapid-response and hotline subcommittee as part of the governance structure described in the extract.[9]
• Provide supervision and advice for operational measures addressing cases, contacts and contact identification.[3][4]

No comprehensive monitoring and evaluation framework is specified. The available material does not set out formal performance indicators, quantitative surveillance targets, reporting schedules, evaluation methods or broader formal accountability procedures beyond the designated implementing and supervisory institutions.[3][2][8][5][4]

Costing & Financing

No explicit costing or financing framework is provided for the penitentiary COVID-19 protocol. The available material does not specify programme budgets, costed activities, funding allocations, financing sources, resource-mobilisation arrangements, funding gaps or economic assumptions.[2][8][5][6][7][4]

The protocol nevertheless identifies resource-dependent operational inputs, including polymerase chain reaction testing, infrared thermometers where available, masks, personal protective equipment, hand-hygiene supplies, isolation space, waste containers, cleaning materials, laboratory sample transport and referral arrangements.[2][8][6][7][4]These inputs are described as implementation measures rather than as funded budget lines, and no unit costs, quantities, funding sources or time-bound financial commitments are given.[2][8][6][7][4]

• Provide soap, paper towels, alcohol-based or disinfectant hand-rub, masks and prevention materials for prison personnel and incarcerated people.[8][5]
• Provide protective equipment for staff managing suspected or confirmed cases, including disposable gowns, FFP2 or FFP3 masks, double gloves and eye protection.[7]
• Maintain cleaning, disinfection and hazardous-waste arrangements, including sodium hypochlorite, protective equipment for cleaners, separate waste containers and incineration of contaminated healthcare waste.[4]
• Support testing, isolation, contact management, laboratory transport and clinical referral, without any stated budget or financing mechanism.[6][7]