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Close immigration detention centers or see a coronavirus catastrophe | COMMENTARY

Protesters around the country are calling for officials to release people from jails, prisons, and immigration detention centers in response to the coronavirus.
Protesters around the country are calling for officials to release people from jails, prisons, and immigration detention centers in response to the coronavirus. (Matt Rourke/AP)

With the recent diagnoses of COVID-19 cases in immigration detention centers — including ill children — we are on the cusp of a catastrophe.

The surge in migrants and asylum seekers that began in 2018 has proven the United States Customs and Border Protection ill-equipped to handle infections in its detention centers. This has had disastrous consequences for detainees. At least three children have died from influenza-associated causes while under the care of CBP since 2018; none had died in the decade prior.

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Felipe Alonso Gomez, the most prominent such case, contracted the flu in a detention center in New Mexico. An unaccompanied minor with influenza in Texas did not receive mandated hourly checks overnight and was found dead the next morning. In 2019 alone, thousands of detainees were quarantined for mumps, influenza, and chicken pox outbreaks. These findings have raised significant concerns about delays in getting detained children needed medical care, and brought to the fore evidence of inadequate medical expertise and training among border patrol staff.

The arrival of the coronavirus pandemic portends disaster in immigration detention centers. Refugees and asylum seekers are kept in crowded conditions with little sanitation, sometimes without soap or proper bedding. Such conditions are prime for the rapid spread of COVID-19 in these facilities. Given the border patrol’s slow response to medical crises thus far, it is likely that such an outbreak will not be detected until it has infected a significant number of detainees and staff, further abetting the pathogen’s spread — potentially even to the surrounding community.

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The federal government has responded to this looming threat by working to close the southern border to refugees and asylum seekers, believing that migrants are potential disease vectors and so must be stopped from entering crowded detention centers. This is a familiar refrain. When Felipe Alonso Gomez died, President Donald Trump tweeted that Felipe was “very sick” when first detained, actually contradicting a statement by border patrol.

But what is extraordinary about the federal government’s approach is the implicit acknowledgment that detention centers are tinderboxes for infectious disease outbreaks, combined with an unwillingness to actually improve these conditions. In focusing on border traffic, the government has failed to address the elephant in the room — the desperate need for significant reforms in the detention centers themselves. This is not a surprise; last year, the Department of Health and Human Services declined to make potentially life-saving influenza vaccines available to border patrol detainees, citing logistical challenges.

The solution to this crisis is clear: immigration detention centers need to be shut down in the face of the looming pandemic. Safe, humane housing needs to be found for detainees, allowing them the ability to achieve social distancing. Medical support must be made readily available for unwell detainees, including COVID-19 testing and isolation and treatment of detainees if they are found to be positive. Ill detainees requiring medical intervention should be transported to hospitals in a timely manner.

At the same time, border patrol medical staff evaluating detainees should be provided sufficient personal protective equipment so that that they are not at risk for contracting COVID-19 themselves. And these employees should stay at home if they are feeling unwell. Already, several Department of Homeland Security detention center employees have tested positive for COVID-19, suggesting the possibility that employees may themselves introduce the virus into a facility.

Pandemics require extraordinary public health measures. At this time, schools and restaurants have closed; millions of Americans currently shelter in place. It should not be extraordinary to have the federal government treat refugees and asylum seekers humanely and to look out for their health and well-being, as well as that of detention center staff. And yet it would be, based on the administration’s track record thus far. But that is what the situation demands, and a sense of humanity compels.

Dr. Mark A. Travassos (marktravassos@gmail.com) is a pediatric infectious disease specialist in Maryland.

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