In late June, a federal judge ruled that migrant children held at three federal detention centers must be released due to health risks from the coronavirus pandemic. Judge Dolly Gee wrote that keeping them in these facilities would be “like leaving them in a burning house.” She rebuked U.S. Immigration and Customs Enforcement (ICE) for failing to enforce the CDC guidelines to control the spread of COVID-19 in detention facilities.
As physicians and infectious disease specialists, we agree with her reasoning and feel strongly that we must release all detained refugees and asylum seekers in federal facilities, not just children.
Detained refugees and asylum seekers — both children and adults — face hazardous and unsafe conditions. COVID-19 has swept through federal detention centers. Across 67 ICE facilities nationwide, more than 2,700 detainees have tested positive for the coronavirus.
We are among many in the medical community who are alarmed by ICE’s failure to adhere to CDC guidelines for the prevention and evaluation of COVID-19, despite making public claims to do so. Repeatedly, the Department of Homeland Security (DHS) has declined to support migrant detainee health and safety — for example, refusing to provide CDC-recommended influenza vaccinations to U.S. Customs and Border Protection detainees.
We recently wrote in Clinical Infectious Diseases about how the reality of ICE practices falls far short of its stated goals. Detainees are not given sufficient space for social distancing and have limited access to masks and basic sanitation measures like sinks and toilets.
ICE policies for COVID-19 evaluation are particularly concerning. Detainees with coronavirus symptoms can be quarantined with detainees experiencing any respiratory symptoms, allowing the virus to spread among the ill. In contrast, under CDC guidelines, detainees who are COVID-19 positive should be isolated individually, with separate bathrooms.
Moreover, COVID-19 testing is inadequate at ICE facilities: more than half of ICE detainees tested were positive for COVID-19, an extreme positivity rate that indicates the need for more widespread testing of detainees.
Judge Gee’s alarm and sense of urgency are clear. She writes that ICE’s family detention centers are “on fire and there is no time for half measures.” She points to evidence of COVID-19 in facilities and proof that viral infections have previously spread between detained children. The ruling compels the release of detained children. For the remaining detainees, it calls for improved monitoring for infection, and enforcement of social distancing, mask use, and enhanced testing.
We applaud Judge Gee’s ruling, but more must be done. The fire of COVID-19 contagion is rapidly spreading across detainment centers. It is not just restricted to ICE facilities but also includes facilities that DHS’s Office of Refugee Resettlement (ORR) manages. In one Chicago facility where ORR places unaccompanied migrant minors, 42 children already have tested positive for COVID-19. We urgently need plans in place to release these children from these dangerous detainment centers.
Plans for release must also extend to detained adults. Adults are at the highest risk for COVID-19 complications; two adult detainees infected with COVID-19 have already died. Refugee and asylum-seeking adults deserve the same protections as children. We cannot stand by as they face the possibility of dying from an infection contracted while in the care of the federal government.
Judge Gee’s ruling is an important first step towards protecting refugees and asylum seekers. But it must be expanded before more detainees die. Only by acting with urgency can we hope to mitigate the disastrous effects of a global pandemic on one of the most vulnerable populations.
Mark A. Travassos, MD, Carlo Foppiano Palacios, MD, and John J. Openshaw, MD, are infectious disease specialists in Maryland, Connecticut, and California, respectively.
Last Updated July 24, 2020