Public health experts who watched with horror as COVID-19 ripped through United States jails, prisons, and immigration detention facilities are sounding the alarm about monkeypox. Overreliance on incarceration and punishment has created settings in which infectious diseases easily spread. It is frustrating that medical experts were largely ignored as they called for the release of incarcerated people with medical conditions, those nearing the ends of their sentences, or those who pose little risk to public safety. As a result, jails, prisons, and immigration detention facilities were rampant breeding grounds for COVID-19, harming incarcerated people and who worked in facilities and circulated the virus among their communities.

The best way to stop the preventable spread of infectious diseases is to free people from these dangerous, dirty settings. As monkeypox continues to spread as a public health emergency, nearly 2 million people remain unnecessarily confined in inhumane conditions. The virus was first reported in Illinois’s Cook County Jail in July. Since then, other jails and prisons have also reported cases.

The lessons we learned from COVID-19 should be applied here:

Release people

Confining people in tight quarters creates optimal conditions for the spread of viruses, both behind bars and in the wider community. The United States incarcerates people at a higher rate than any other country in the world, unnecessarily. Approximately two-thirds of the people in locally run jails have not been convicted of a crime; they simply cannot afford to buy their freedom through money bail. People should not be detained pretrial for no other reason than because they lack money. Those awaiting court dates on New York City’s Rikers Island, for example, face horrific intake center conditions. There, people are crammed together and forced to sleep on floors with human excrement. This is inhumane and unnecessary to ensure that people return to court.

In cases where people have been convicted of a crime, community-based sentences—including community service, mental health and treatment programs, and restorative justice—offer better alternatives to incarceration. These are sorely underused in the United States, despite research showing that they deliver behavioral change and safety.

Moreover, research has also shown that confining people in prison-like conditions is not necessary to ensure that they show up for their immigration proceedings. This year, President Biden proposed a decrease in Immigration and Customs Enforcement (ICE) beds, but more is needed. All people in immigration detention should be released. Vera’s report, The Hidden Curve, explores how frequently transferring people between detention centers can contribute to the spread of infectious diseases. Constantly moving people to different immigration facilities around the country, as is common practice for ICE, creates health risks for people detained, detention center staff, and surrounding communities. Jails, prisons, and immigration detention facilities also need to provide basic sanitation and basic medical care, and remedy the conditions that lead to rampant claims of medical neglect and abuse.

Stop putting sick people in solitary confinement

Centers for Disease Control and Prevention (CDC) guidance recommends that people who test positive for monkeypox in congregate settings—like in the case of COVID-19—be isolated to avoid the spread of the virus. But over the past two years, many incarcerated people who have tested positive for COVID-19 have been placed in cells designed for punitive solitary confinement—cramped, concrete, windowless, and about the size of a parking space. They report being held in complete isolation and denied access to medical care and basic hygiene. The United Nations has deemed it torture to hold people in such conditions without meaningful human contact for more than 15 days. Medical quarantine needs to include proper medical care, and access to resources that make isolation psychologically bearable, like entertainment and the ability to contact family.

Offer vaccines and quality medical care to incarcerated people

People held in unsafe settings like jails, prisons, and immigration detention facilities should have access to the monkeypox vaccine. Their risk for contracting diseases like monkeypox is greater and they should be prioritized when it comes to vaccine distribution. People who contract monkeypox while incarcerated should also receive quality medical treatment, including access to effective antiviral drugs.

Increase accountability and data reporting

Public reporting on COVID-19 in jails, prisons, and immigration detention centers has been inadequate for understanding the risks and harms faced by incarcerated people. Many jurisdictions report incomplete information, or have stopped updating their COVID-19 statistics altogether. And despite Vera’s efforts to track ICE’s COVID-19 statistics—which are overwritten regularly—the agency does not report complete and accurate data, and, by Vera’s estimates, has underreported the true number of cases.

The government needs to require better and ongoing reporting about infectious diseases like COVID-19 and monkeypox, including prevention plans, case and test counts, vaccine access, and care for people who have tested positive, in all facilities. Passing federal legislation—such as the COVID-19 in Corrections Data Transparency Act and the COVID-19 in Immigration Detention Data Transparency Act—requiring agencies to provide comprehensive data to the CDC and to the public would be an important step toward understanding the scope of the problem.

Mass incarceration and immigration detention have no place in a society that should value public health. As monkeypox continues to remain a threat, elected officials need to take lessons from our experience with COVID-19 to prevent suffering and unnecessary spread. Our collective health and lives depend on it.