"I'll Never Get that Time Back": Public Health's Impact on Prolonged Incarceration in Los Angeles County.

The thousands of Americans who died from coronavirus disease 2019 (COVID-19) while incarcerated underscore the heightened vulnerability of people living behind bars. Although the risk of catastrophic outbreaks demands a robust public health response, the measures used to contain disease can also produce profound harms to freedom and justice for people experiencing incarceration. This study draws on an initial survey of 71 individuals formerly incarcerated in Los Angeles County jails, followed by 20 semi-structured interviews with a subset of survey participants, conducted between January 2023 and March 2024. We examine subjective experiences related to pandemic-era infection control measures, including quarantines and lockdowns, as well as their long-term consequences. Participants described pervasive institutional mistrust, including doubts about staff competence to implement infection control protocols, and identified prolonged detention linked to pandemic-era health policies as one of the most damaging outcomes. These findings highlight the need for policymakers to account for the lasting social and economic effects of public health interventions on justice-involved populations, to apply quarantine ethics principles that balance infection control with individual rights, and to pursue strategies that both improve infection control and reduce unjust incarceration within carceral systems. Ethical approval for this study was obtained from the University of California, Los Angeles Institutional Review Board, and informed consent was obtained from all participants.