As the more transmissible Omicron variant descends upon the American winter, we will soon see a sharp increase in COVID-19 outbreaks. As this unfolds, those held in the uniquely high-risk settings posed by jails, prisons, and ICE facilities will again suffer from US government refusals to enact preventive policies like mask mandates, vaccine mandates, and publicly provided at-home tests.

Public health studies have shown that, due to overcrowding and unsafe conditions characterized by systematic health care neglect, the coronavirus spreads faster in US carceral institutions than in any other setting in the world. And the risk of death or otherwise severe outcome faced by incarcerated people is far greater than in the general population.

It is in this context that refusals earlier this year by the Centers for Disease Control and Prevention (CDC) and nearly all state public health departments to prioritize incarcerated people for initial vaccination stood in blatant contradiction with basic bioethical and epidemiological principles. These were not innocuous bureaucratic decisions. No one can say how many people have died or been permanently disabled as a consequence, but it is certain to have been a large number.