The European Court of Human Rights (ECtHR) in the case of S.M. v. Italy (judgment of 17 October 2024), assessed whether the detention of a vulnerable detainee during the COVID-19 pandemic constituted inhuman or degrading treatment under Article 3 of the European Convention on Human Rights (ECHR). The applicant, suffering from severe HIV-related health conditions and cognitive impairments, claimed that prison conditions during the pandemic posed excessive health risks, thereby violating his fundamental rights.

Case Overview

The applicant was detained in San Vittore Prison, one of Italy’s most overcrowded detention facilities, during the COVID-19 crisis. Diagnosed with HIV and associated neurological complications, the applicant argued that his condition, combined with the high risk of virus transmission in prison, made his continued detention incompatible with his health needs. Measures implemented by the authorities to counter enhanced health risks, such as medical monitoring, social distancing policies, and attempts to reduce overcrowding, according to the applicant, were insufficient given his compromised immune system.

The applicant sought alternative measures, including house arrest, emphasising that his physical vulnerability increased the likelihood of severe complications in the event of COVID-19 infection. The Italian government argued that by providing regular antiretroviral therapy, implementing protective protocols, and monitoring high-risk, it took adequate efforts to safeguard the prisoner’s health.

Legal Evaluation

The ECtHR judgment focused on the adequacy of health protections provided to the applicant. The Court acknowledged that detainees with chronic health conditions face heightened risks in prison environments, particularly during a global health crisis. However, it noted that no evidence demonstrated that the applicant had contracted COVID-19 or suffered health deterioration directly attributable to the prison conditions.

The Court reviewed the medical records, finding that the applicant received ongoing antiretroviral treatment and medical supervision. Furthermore, the Italian authorities’ broader measures to reduce overcrowding and mitigate risks, though imperfect, were considered sufficient under the exceptional circumstances of the pandemic.

Notably, the Court reiterated that Article 3 ECHR does not impose an automatic obligation to release detainees with medical conditions unless detention results in tangible harm or serious neglect of medical needs.

Conclusion

The ECtHR concluded that the applicant’s detention during the pandemic did not constitute inhuman or degrading treatment under Article 3 ECHR. While acknowledging the general risks posed by COVID-19, the Court found that Italy had acted within its margin of appreciation by ensuring medical care and implementing reasonable measures to reduce exposure to the coronavirus. The applicant’s placement under house arrest or the application of alternative non-custodial measures were not mandatory under the Convention, as his specific health needs were adequately addressed within the detention setting.

It is important to recall that two judges dissented from the majority. They found that Italy failed to prove that not only an adequate protocol was adopted at the national level to prevent the spread of the coronavirus in prison facilities, but that adequate measures to this effect were implemented in Milan San Vittore prison, namely to protect the applicant, suffering from immunodeficiency and other pathologies.

This case underscores the delicate balance between individual rights and public safety during emergencies and that even when States exercise a larger margin of appreciation, the ECtHR can nevertheless check their practice against the ECHR standards applicable to persons in vulnerable situations.