DAEGU, South Korea – Prisons and detention centers are vulnerable to the risk of new coronavirus (COVID-19) outbreaks. When new confirmed cases surged in Daegu and North Gyeongbuk Province, correctional facilities reported several confirmed cases and medical workers who took care of them had to quarantine themselves. The healthcare void was filled by public health doctors urgently dispatched to Daegu.

Korea Biomedical Review recently met with two public health doctors, Choi Se-jin and Jeon Hyeong-jin, in Daegu. They were sent to Daegu Correctional Institution and Daegu Detention Center, respectively, for medical support. Choi arrived in Daegu on March 9, and Jeon, March 11. The two are the only public health doctors dispatched to correctional institutions in Daegu.

Two public health doctors working at a prison and a detention center in Daegu -- Choi Se-jin (left), vice president of the Korean Association of Public Health Doctors, and Jeon Hyeong-jin. (Credit: Choi Se-jin, Jeon Hyeong-jin)

Choi and Jeon used to work at the Seoul Detention Center and Yeoju Correctional Institution, respectively. However, after the outbreak of COVID-19, they decided to work at Gimcheon Juvenile Correctional Institution near Daegu, and later at Daegu Correctional Institution and Daegu Detention Center. The doctors thought they were the right ones to go to correctional facilities in Daegu because they knew how to take care of prion officers and inmates.

“I was supposed to be sent to Incheon International Airport. I booked my lodges and arrived in Incheon. Just one day before working at the airport, I got a phone call and was asked if I could go to Gimcheon because the prison had a confirmed case and doctors there had to be quarantined,” Jeon said.

“With my working experience at a prison, it sounded right. So, I immediately drove my car to Gimcheon.” After learning that Choi was also heading to Gimcheon, Jeon felt more encouraged.

Choi, vice president of the Korean Association of Public Health Doctors, said correctional institutions need to consider the characteristics of prisoners.

“Prisoners often exaggerate or rarely express how they feel when they receive medical consultation. So, you need to watch them steadily and have a hunch to notice the difference,” Choi said. “That's why the government placed us here. I think it was the right choice.”

Their job is to operate the isolated examination rooms and protect inmates from any additional COVID-19 outbreak within the prison and the detention center. The jail in Daegu has 2,200 people, including inmates and staff, and the detention center, 900. The two institutions require more prudent disease control because just one new case could spark group infections easily.

Recently, Daegu Correctional Institution’s two guards tested positive for COVID-19. At Daegu Detention Center, one guard and four cooks were also confirmed with the virus infection. Fortunately, inmates who contacted with the confirmed patients at the detention center tested negative on Tuesday. The results relieved the fear of the virus spreading among prisoners.

If a confirmed case occurs, the public health doctors have to quarantine the confirmed patient in a single room and check symptoms daily to prevent group infections. The prison and the detention center in Daegu suspended all the movements and activities, including cell moving, visits, labor, and outdoor activities that can cause transmissions.

The public health doctors should persuade inmates to remain calm because they could be stressed out by the banning of outdoor activities.

“When several prisoners are locked up in a cell, stress builds up, and it leads to increased fights and incidents. I was concerned about possible violence, but I had to limit their activities in such a dire situation,” Choi said. “To prevent an incident, I have no other option but to explain the situation to inmates well. Luckily, they are also in an alert state, and there was no big trouble until now.”

Public health doctors Jeon Hyeong-jin (left) and Choi Se-jin interview with Korea Biomedical Review in Daegu recently.

Jeon said he had the same concern when he was at Gimcheon Juvenile Correctional Institution. “I visited cells every day to tell them to be patient a little bit more. As I took the trouble to go there to say so, the children understood and endured well.”

Not only prisoners but guards, who used to commute from home, are staying within the institutions due to COVID-19 infection concerns.

Unlike public health centers, correctional institutions are short of healthcare workers.

At the juvenile prison in Gimcheon, doctors had to go home for self-quarantine immediately after confirmed cases were reported, and they could not provide education on prevention of infectious disease for Justice Ministry officials, according to Jeon.

“As soon as I arrived at the Gimcheon prison, I taught them how to put on and take off protective clothing and the protocols when facing confirmed patients or people who contacted them,” he said.

Choi noted that at the prison, he was the only medical worker, except for the quarantined jail doctor and employees at the medical department. Therefore, he had to actively voice his opinions on epidemiological investigations and disease control strategies.

His work at the prison was different from that at the public health center in that he made decisions by taking the characteristics of guards and inmates into account, Choi added.

The two public health doctors expressed a strong commitment to their workplaces, despite difficulties during the unprecedented pandemic.

“We both hope that we could keep the prison from the virus spread,” Choi said. “Inmates in correctional facilities are mostly socially and economically marginalized. No matter how well we fight outside, it will reveal the limits of our social capability if we fail here. So, we are doing our best here.”

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