Publication date: Jun 20, 2024

The physical environment of correctional facilities promote infectious disease transmission and outbreaks. The purpose of this study is to compare the COVID-19 burden between the correctional facility (incarcerated individuals and staff members) and non-correctional facility population in Ontario during the COVID-19 pandemic. All individuals in Ontario with a laboratory confirmation of SARS-CoV-2 between 15 January 2020 and 31 December 2022 and entered into the provincial COVID-19 data were included. Cases were classified as a correctional facility case (living or working in a correctional facility) or a non-correctional facility case. COVID-19 vaccination status was obtained from the provincial COVID-19 vaccine registry. Statistics Canada census data were used to calculate COVID-19 incidence and hospitalization rates for incarcerated cases and the non-correctional facility population. Between 15 January 2020 and 31 December 2022, there were 1,550,045 COVID-19 cases in Ontario of which 8,292 (0. 53%) cases were reported in correctional (63. 8% amongst incarcerated individuals, 18. 6% amongst staff and 17. 7% amongst an unknown classification) and 1,541,753 (99. 47%) were non-correctional facility cases. Most cases in correctional facilities were men (83. 8%) and aged 20-59 years (93. 1%). COVID-19 incidence and hospitalization rates were generally higher among incarcerated individuals compared to the non-correctional facility population throughout the study period. COVID-19 incidence peaked in January 2022 for both the correctional facility population (21,543. 8 per 100,000 population) and the non-correctional facility population (1915. 1 per 100,000 population). The rate of COVID-19 hospitalizations peaked for the correctional facility population aged 20-59 in March 2021 (70. 7 per 100,000 population) and in April 2021 for the non-correctional facility population aged 20-59 (19. 8 per 100,000 population). A greater percentage of incarcerated individuals (73. 0%) were unvaccinated at time of their COVID-19 diagnosis compared to the non-correctional facility population (49. 3%). Deaths amongst correctional facility cases were rare (0. 1%, 6 / 8,292) compared to 1. 0% of non-correctional facility cases (n = 15,787 / 1,541,753). During the COVID-19 pandemic, individuals incarcerated in correctional facilities in Ontario had higher COVID-19 incidence and hospitalization rates compared to the non-correctional facility population. These results support prioritizing incarcerated individuals for public health interventions to mitigate COVID-19 impacts in correctional facilities.

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