Impact of SARS-CoV-2 Alpha variant (B.1.1.7) on prisons, England

Amoolya Vusirikala*, Joe Flannagan, Maciej Czachorowski, Asad Zaidi, Kate A. Twohig, Emma Plugge, Nicholas Ellaby, Wendy Rice, Gavin Dabrera, Dimple Y. Chudasama, Theresa Lamagni

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Objectives: Prisons are high-risk settings for infectious disease outbreaks because of their highly dynamic and crowded nature. During late 2020, prisons in England observed a surge in COVID-19 infection. This study describes the emergence of the Alpha variant in prisons during this period. 

Methods: Alpha and non-Alpha variant COVID-19 cases were identified in prisoners in England using address-matched laboratory notifications and genomic information from COG-UK. 

Results: Of 14,094 COVID-19-positive prisoner cases between 1 October 2020 and 28 March 2021, 11.5% (n = 1621) had sequencing results. Of these, 1082 (66.7%) were identified as the Alpha variant. Twenty-nine (2.7%) Alpha cases required hospitalisation compared with only five (1.0%; P = 0.02) non-Alpha cases. A total of 14 outbreaks were identified with the median attack rate higher for Alpha (17.9%, interquartile range [IQR] 3.2%–32.2%; P = 0.11) than non-Alpha outbreaks (3.5%, IQR 2.0%–10.2%). 

Conclusion: Higher attack rates and increased likelihood of hospitalisations were observed for Alpha cases compared with non-Alpha. This suggests a key contribution to the rise in cases, hospitalisations and outbreaks in prisons in the second wave. With prisons prone to COVID-19 outbreaks and the potential to act as reservoirs for variants of concern, sequencing of prison-associated cases alongside whole-institution vaccination should be prioritised.

Original languageEnglish
Pages (from-to)21-24
Number of pages4
JournalPublic Health
Early online date4 Feb 2022
Publication statusPublished - Mar 2022

Bibliographical note

Funding Information: Routine work undertaken by UK Health Security Agency as part of public health response. COG-UK is supported by funding from the Medical Research Council (MRC) part of UK Research & Innovation (UKRI), the National Institute of Health Research (NIHR) and Genome Research Limited, operating as the Wellcome Sanger Institute.

Open Access: Free to read, but no Open Access licence.

Publisher Copyright: Crown Copyright © 2021 Published by Elsevier Ltd on behalf of The Royal Society for Public Health. All Rights Reserved.

Citation: Vusirikala, Amoolya, et al. "Impact of SARS-CoV-2 Alpha variant (B. 1.1. 7) on prisons, England." Public Health 204 (2022): 21-24.



  • COVID-19
  • England
  • Outbreaks
  • Prisons
  • Severe acute respiratory syndrome coronavirus 2
  • Whole-genome sequencing


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