Page - 371 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

371COVID-19 in Canadian Prisons: Policies, Practices and Concerns the risks posed to health by prison environments, incarcerated indi- viduals have higher rates than those in the community for most of the illnesses identified by preliminary studies as COVID-19 risk fac- tors.12 These include cardiovascular disease, cancer, diabetes, asthma, other respiratory diseases, HIV, hepatitis C, tuberculosis,13 and men- tal illnesses.14 Substance use and addiction rates are also high, while harm reduction measures remain limited in prisons.15 Moreover, the prison demographic in Canada has been aging over the last decade. Currently, in federal prisons, 25% of people are considered elderly,16 which has also been deemed a risk factor for COVID-19.17 In addition, there are barriers to accessing satisfactory health care in custody. In federal prisons, for instance, these include a lack of adequate training for first responders (generally correctional officers) for identifying and managing health crisis, overcrowding, a lack of escorting officers (resulting in difficulties taking people to community Treated  as  a  Human  Being, (Ottawa: Senate Committee on Human Rights, February 2019) (Chair: The Honourable Wanda Elaine Thomas Bernard); Office of the Correctional Investigator, News Release, “Indigenous People in Federal Custody Surpasses 30%” (21 January 2020), online: Office  of  the  Correctional  Investigator <perma.cc/48HK-TDP2>; Canada, Office of the Correctional Investigator, A Case Study  of  Diversity  in  Corrections:  The  Black  Inmate  Experience  in  Federal  Penitentiaries, (Ottawa: Office of the Correctional Investigator, 2013) at 22. 12. Nancy Chow et al, “Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019” (2020) 69:13 MMWR 382 at 382 [Chow et al]. For a list of peer-reviewed papers that detail the interactions of these risk factors with COVID-19, see “COVID-19 Risk Factors” (last visited May 28 2020), online: Nature <perma.cc/B8AA-T6H2>. 13. See e.g. Fiona Kouyoumdjian et al, “Health Status of Prisoners” (2016) 62 Can Family Physician 215 at 216 [Kouyoummjian]; Adelina Iftene, Punished  for  Aging:  Vulnerability,  Rights  and  Access  to  Justice  in  Canadian  Penitentiaries, (Toronto: University of Toronto Press, 2019) at 34–77; Correctional Service Canada, Summary  of  Emerging  Findings  from  the  2007  National  Inmate  Infectious  Diseases  and  Risk-Behaviours  Survey, by Dianne Zakaria et al, Research Report, R-211 (Ottawa: Correctional Service Canada, March 2010) at iii. 14. Correctional Service Canada, National  Prevalence  of  Mental  Disorders  among  Incoming  Federally-Sentenced  Men, by JN Beaudette et al, Research Report, R-357 (Ottawa: Correctional Service Canada, February 2015). 15. Senate Committee on Human Rights, supra note 11; Emily van der Meulen et al, “On Point: Recommendations for Prison-Based Needle and Syringe Programs in Canada” (January 2016), online: <perma.cc/YWT5-7P4N>. 16. Public Safety Canada, Corrections and Conditional Release Statistical Overview, (2018 Annual Report), (Ottawa: Public Works and Government Services Canada, August 2019) at 47. 17. Stephanie Bialek et al, “Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19)” (2020) 69:12 MMWR 343 at 344 [Bialek et al].