Contact tracing along with epidemiological and clinical characteristics of Novel corona virus 2019 in prisoners of Camp Jail, Lahore – A prospective case ascertaining study

BACKGROUND & OBJECTIVES: Prisons are reported as hub for communicable disease, as the closed environment, overcrowding, poor hygienic conditions facilitate the disease transmission. This study was conducted to describe contact tracing to identify, educate and manage COVID-19 in camp jail Lahore and to describe clinical and epidemiological features of disease in prisoners. METHODS: After diagnosis of primary case of COVID-19 on 24(th) March, 2020 in camp jail, 527 suspected cases were identified through contact tracing. The health department-initiated case identification through contact tracing, isolation of confirmed and suspected cases, and quarantine of exposed persons and establishment of 100 bedded hospital in jail for infection prevention and control and treatment. Baseline characteristics of primary case and secondary cases were described along with the secondary attack rate of infection. RESULTS: Mean age of secondary cases was 36.9(11.5) years with mean stay of 14.9(13.6) months. Two third of the prisoners were from Punjab. 11 % were illiterate and almost half were under metric. 527 prisoners were labelled as suspected cases through contact tracing and 59 out of 527 suspected prisoners tested COVID positive through RT-PCR with few reporting mild respiratory symptoms. Fifty five out of 59 tested negatives on day-5 and all have uneventful recovery by day-21. Secondary attack rate was 11%. CONCLUSIONS: In order to prevent Covid-19 outbreaks, proactive containment and comprehensive contact tracing to identify monitor and manage cases and contacts, in incarcerated facilities like prisons is a public health solution to prevent and control large scale epidemic. Active monitoring for infected patients, and implementing timely infection prevention and control measures are mandatory for highly infectious Covid-19 in this vulnerable population.