Close the Camps in the Time of COVID-19

There are over 200 ICE detention facilities across the United States, where detainees often spend months to years awaiting their decisions on immigration cases. As the COVID-19 pandemic spreads across the United States, health professionals have warned that the disease could prove deadly in these facilities, where conditions are subpar in the best of circumstances. Recent reports show that in both adult and pediatric facilities, migrants in detention are routinely denied care and treated like criminals. Routine chronic health maintenance is neglected, medications are scarce, and acute concerns are brushed aside. Many facilities operate without in-house physician staff, relying instead on under-trained and overworked nurses whose duties extend far beyond triage. In a pandemic, these already existent weaknesses will be amplified, leaving detained migrants vulnerable to significant risk of contracting COVID-19 under conditions in which quality care is all but impossible.

ICE has come under scrutiny repeatedly for the poor quality of their migrant detention centers. Their centers are defined by cramped quarters and overcrowding, lack of basic hygiene and medical supplies, and inhumane treatment of migrants. Because of the dismal sanitation conditions in these centers, they have already seen widespread outbreaks of infectious diseases like mumps, measles, influenza, and chickenpox. Such diseases can be reliably prevented with adequate vaccination and screening regimens. However, given the poor treatment of and resources allotted to migrants, it is questionable whether detention centers can effectively contain the spread of preventable infectious diseases.

This is complicated by COVID-19, for which we currently do not have an effective vaccine, treatment regimen, or screening protocol. COVID-19 spreads through respiratory droplets, and scientists have already advocated for frequent hand washing, social distancing, and isolation as ways to mitigate disease spread and severity. Given the crowded conditions and inaccessibility to adequate hygiene in migrant detention, it would be impossible for its inhabitants to partake in these practices.

Detainees have already protested these conditions with fears of spread of the virus. Many are participating in hunger strikes, and at least one has committed suicide. Even though ICE has increased its supply of N95 respirator masks to limit transmission of the disease, it is unclear how efficacious this will be given the poor baseline condition of centers. Additionally, given the shortage of personal protective equipment (PPE) throughout hospitals in America, these valuable resources would be best allocated for healthcare workers directly helping afflicted patients who need them the most.

Migrants are imprisoned for reasons drastically different to those incarcerated for committing crimes. However, cited conditions - including overcrowding and poor sanitation - are common between jails, prisons, and migrant detention centers. Prisoners cannot adequately practice “social distancing,” and fears of outbreaks of COVID-19 in jails and prisons have stimulated policy makers to order the release of hundreds of low-risk prisoners in order to combat overcrowding, create more quarantine spaces, and mitigate disease spread. Such a model should be extended to ICE detention centers, in which most detainees are also non-violent and solely being held for immigration purposes. By March 27, US District Judge Analisa Torres had already ordered the release of individuals in ICE custody with underlying medical conditions that predispose them to infection, and we must consider widespread releases as the epidemic continues to ravage communities throughout the U.S.

In light of COVID-19, we must re-evaluate what these detention centers mean for our communities as the virus spreads and question how we value human life. The inhumane and under equipped conditions of detention centers pose not only a public health threat, but a major violation to foundational human rights. This crisis highlights the deep inequities faced by migrants and asylum seekers worldwide. As medical students who serve asylum clinics in Philadelphia, New York, and Boston; as advocates on the Physicians for Human Rights Student Advisory Board; and as ourselves children of immigrants, we have witnessed how systems currently in place reinforce the structural violence that keeps the powerless disempowered. As the COVID-19 pandemic continues, it is imperative that we value the lives of those who lack voice and agency. How our nation chooses to respond reflects the importance we place on securing the health and human rights of even the most vulnerable.

Healthcare and public health professionals, immigrant advocates, and community members will join the national call-in to representatives, senators, and local ICE directors on Tuesday, March 31 as part of the National #FreeThemAll Week of Action. Open letters and petitions are already circulating in order to halt immigration enforcement and detention that places thousands of lives at risk. We are undoubtedly in a crisis, but that is all the more reason that we must stand up for the rights, care, and dignity of migrants in our country, for the betterment of all of our patients and communities.

Michael Dorritie, Michelle Munyikwa, PhD, Shefali Sood, and Samantha Truong are medical students at Touro College of Osteopathic Medicine, University of Pennsylvania Perelman School of Medicine, New York University Grossman School of Medicine, and Harvard Medical School. They form the Physicians for Human Rights National Student Advisory Board’s Advocacy Committee.