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Jails and prisons across the USA are at the epicentre of the COVID-19 pandemic. Most of the largest, single-site cluster outbreaks of COVID-19 in the country have occurred in jails and prisons.1 Much attention has focused on the need for testing, masks, and robust access to vaccination; however, calls to increase access to treatment are largely absent. In November, 2020, the US Food and Drug Administration (FDA) authorised the use of monoclonal antibodies (mAbs) for the treatment of mild to moderate COVID-19 because these treatments prevent progression to severe disease and considerably reduce hospitalisations and emergency room visits.2 However, uptake of these treatments has been slow, including in the correctional setting.

authorised the use of monoclonal antibodies (mAbs) for the treatment of mild to moderate COVID-19 because these treatments prevent progression to severe disease and considerably reduce hospitalisations and emergency room visits.2 However, uptake of these treatments has been slow, including in the correctional setting. In response to the COVID-19 pandemic, as well as implementing widespread surveillance testing of residents and staff, universal mask wearing, small group cohorting, and vaccination of detained individuals at high risk, the Rhode Island Department of Corrections (RI, USA) administered an anti-SARS-CoV-2 mAb approved by the FDA and Emergency Use Authorization to a symptomatic, incarcerated person with COVID-19 on Jan 22, 2021, for the first time. The individual met criteria on the basis of timing of symptoms, age, and presence of comorbidities. There were no complications, and the individual did not require hospitalisation. To our knowledge, mAbs have been sparsely used in correctional settings across the USA. This treatment, and any other approved treatment that has the potential to reduce serious disease and death from COVID-19, should be made widely available to individuals who are incarcerated or detained and meet eligibility criteria.

o our knowledge, mAbs have been sparsely used in correctional settings across the USA. This treatment, and any other approved treatment that has the potential to reduce serious disease and death from COVID-19, should be made widely available to individuals who are incarcerated or detained and meet eligibility criteria. Incarcerated individuals are at high risk of infection and death from COVID-193 and are often overlooked in this pandemic. However, they can have a major role in statewide outbreaks.4 MAb treatments not only benefit individuals at high risk of disease but can also decrease the burden on over-run community medical centres and hospitals. In the current environment, where implementation of mAbs has proven challenging and many doses of medication go unused nationally,5 correctional facilities offer the unique opportunity to efficiently identify and administer this evidence-based intervention. Health departments, hospital systems, policy makers, and correctional administrations should collaborate to ensure access to evidence-based treatments, such as mAb therapy, as quickly as possible. In this way, society can not only treat a marginalised population at high risk but also efficiently decrease community burden on the local health-care infrastructure. © 2021 Reuters/Maranie R Staab2021