The American economy was booming prior to the lockdowns stemming from the current pandemic. Similarly, many of our nation’s prisons and jails were beginning to improve conditions of confinement, in ways ranging from ending the shackling of pregnant women to reining in the use of solitary confinement.

However, the trend away from prolonged solitary confinement is under threat as lockups from Rikers Island in New York City to the Newberry Correctional Facility in Michigan are reporting cases of COVID-19. Fortunately, there are many alternative approaches for containing COVID-19 in correctional institutions aside from ramping up the use of punitive isolation.

As millions of Americans endure stay-at-home orders in major metropolitan areas or voluntarily quarantine themselves, it may be tempting to draw parallels to the isolation associated with solitary confinement in prisons. Yet being in solitary confinement typically involves spending at least 22 hours a day in a cell that is 65 square feet with no windows, personal items, or sources of stimulation.

Perhaps unsurprisingly, extensive research has found periods of solitary confinement of 15 days or more lead to adverse psychological and physical health consequences. These include depression, paranoia, sleep disturbances, psychosis, and hallucinations. Not only does prolonged solitary confinement increase the risk of suicide and death after release, but it also endangers public safety, as there are much higher rates of recidivism among those released from solitary confinement to society.

In light of these findings, many correctional systems have made significant headway in reducing the use of prolonged solitary confinement. For example, Colorado eliminated this practice while simultaneously reducing violence inside its prisons. Other states from Maine to Mississippi have made significant reductions, and New Jersey and Minnesota are now implementing recently enacted bipartisan legislation to substantially limit solitary confinement. A new model policy adopted by the American Legislative Exchange Council, the national organization of conservative state legislators, also calls for reining in solitary confinement.

COVID-19 threatens to reverse this progress. Indeed, some prisoners are reporting that they are not seeking care when they have symptoms for fear that they will be placed in solitary confinement indefinitely. The Centers for Disease Control has issued guidance for correctional institutions that recognizes quarantining infected prisoners to a single cell may be necessary in some cases but rightly distinguishes “punitive isolation” from “medical solution.”

Accordingly, those isolated because they tested positive for COVID-19, or believed to be positive, should retain opportunities for recreation with proper social distancing and access to personal items. They should also receive enhanced access to phone and email privileges without regard to ability to pay so they can keep in touch with loved ones, as well as video visitation if available. As specified in the CDC guidance, use of medical isolation must end as soon as the symptoms and ability to spread the virus recede.

Most importantly, far broader strategies are needed to stem the tide of COVID-19 in correctional institutions. First, at least until they have greater access to testing, prisons are appropriately suspending in-person visitation and asking staff to stay home if they feel sick or have had contact with someone who is positive. Also, a provision in the new stimulus bill passed by Congress along with an April 3 announcement by U.S. Attorney General Bill Barr expanding the opportunity created in the First Step Act for individualized review to identify those elderly and medical infirm individuals behind bars who can be promptly released without endangering public safety. Many state and local jurisdictions are also taking this sensible step.

Additionally, institutions must strengthen their hygienic practices. Indeed, COVID-19 is a much needed wake-up call for some lockups where soap was only available to those who could afford to purchase it from the commissary. Now, prisons in New York and Texas have begun producing sanitizer, which prisoners themselves should have access to even though it contains alcohol. Masks are also being made at one Texas prison. Furthermore, correctional institutions can train those in prison in professional cleaning protocols, which could lead to an Occupational and Safety Health Administration certification that translates into employment opportunities upon release.

Incarceration is itself an isolating experience, but the use of solitary confinement effectively creates a prison within a prison. While a pandemic can justify brief periods of medical isolation without any loss of privileges, the COVID-19 crisis requires correctional systems to implement more holistic strategies. Just as we seek to rapidly recapture our nation’s economic momentum, we must not allow a temporary outbreak to reverse the long-term trend of safely reining in the use of prolonged solitary confinement.