The harmful effects of isolation in the context of COVID-19 and other infectious diseases Isolation experienced by (suspected) violent extremist prisoners has been exacerbated by state responses to the COVID-19 pandemic. States have introduced many new measures in places of deprivation of liberty to prevent or respond to COVID-19 outbreaks, which has resulted in different types of “lockdowns”, “quarantines” or “isolation” for people in 267 detention. This may lead to solitary confinement or even prolonged solitary confinement. Temporary quarantine or medical isolation for those (suspected to be) infected may, 268 indeed, be a necessary precaution to stop the spread of COVID-19 in prisons. But the conditions, even if the person is placed in cells or areas that are used for solitary confinement, should not resemble solitary confinement, and detainees must have access 269 to meaningful human contact every day. Even if people in prison are not placed in isolation or quarantine, prisons across the region have suspended visits from family, friends and lawyers, as well as social, professional and religious activities, and this has greatly reduced detainees’ interaction with the outside world and time spent out of the cell. This leads to experiences of isolation that can have a harmful effect on the psychological health and well-being of prisoners, 270 including (suspected) violent extremist prisoners. Isolation can have particularly serious consequences for people in situations of vulnerability, such as people with mental health 271 conditions, children, women or those with psychosocial disabilities. Contact with the outside world is a key safeguard against torture and provides opportunities for reporting 272 ill-treatment and, therefore, any limitations on contact with the outside world must be 273 compensated for using alternative methods of communication. Where possible and in line with the “do no harm” principle, detention monitors are advised 267 PRI, “Preventing Harm and Human Rights Violations in Criminal Justice Systems”, PRI Briefing Note, 2020, pp. 14-19. 268 Consider UN Nelson Mandela Rule, 24.2: “Health-care services should be organized in close relationship to the general public health administration and in a way that ensures continuity of treatment and care, including for HIV, tuberculosis and other infectious diseases, as well as for drug dependence.” See also section 2.2, “Healthcare provisions.” 269 For a detailed analysis of the difference between medical isolation and solitary confinement, see: AMEND, “The Ethical Use of Medical Isolation – Not Solitary Confinement – to Reduce COVID-19 Transmission in Correctional Settings,” 9 April 2020; ODIHR and APT, Guidance on Monitoring Places of Detention through the COVID-19 Pandemic, (Warsaw: ODIHR & APT, 2020), p. 26-27; CPT, “Statement of Principles relating to the treatment of persons deprived of their liberty”, 20 March 2020, Principle 8; SPT, “Advice of the Subcommittee on Prevention of Torture to States Parties and National Preventive Mechanisms relating to the Coronavirus Pandemic”, 25 March 2020, para. 14. 270 UN Special Rapporteur on the Right of Everyone to the Highest Attainable Standard of Physical and Mental Health, A/HRC/38/36, 2018, para. 91; ODIHR, OSCE Human Dimension Commitments and State Responses to the Covid-19 Pandemic, (Warsaw: ODIHR, 2020), pp. 102-103. 271 See: Global Initiative on Justice with Children and others (PRI), “Operational Guidelines for Professionals on Children in Conflict with the Law During COVID-19”; Olivia Rope (PRI), “Coronavirus and Women in Detention: A Gender-Specific Approach Missing”. 272 ODIHR & PRI, Guidance Document on the Nelson Mandela Rules, op. cit., note 10, Chapter 5, para. 13-15. 273 CPT, “Statement of Principles Relating to the Treatment of Persons Deprived of Their Liberty”, op. cit., note 269, Principle 7; SPT, “Advice of the Subcommittee on Prevention of Torture to States Parties and National Preventive Mechanisms relating to the Coronavirus Pandemic”, op. cit., note 269, para. 11. 60