Releasing Migrants from Detention During the Covid-19 Pandemic
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and Ranit Mishori, MD, MHS, FAAFP2,3
1
Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA; 2Physicians for Human Rights, New York, NY, USA; 3Department of Family Medicine, Georgetown University School of Medicine, Washington, DC, USA.
J Gen Intern Med DOI: 10.1007/s11606-020-05954-4 © Society of General Internal Medicine 2020
am terrified of getting the coronavirus.” “No one can “I social distance.” “The guards have masks, but we don’t.”
This is what migrants in detention are telling their attorneys in the middle of the Covid-19 pandemic. They’re in grave danger, and they are reaching out for help. They live in overcrowded, unsanitary facilities and the desperation they feel has only increased along with the numbers of those testing positive. Many asylum seekers who enter the country are placed in carceral settings while awaiting their immigration hearings. They are not criminals, but because of our government’s harsh policies, they are held in prison-like facilities. In the past, asylum seekers often awaited adjudication while living in the community, and the vast majority—greater than 90% by some counts1—complied with legal requirements as their cases were evaluated. In the last three years, the Trump administration has prioritized detention of asylum seekers and the number of individuals in immigration detention has increased significantly—right now, approximately 30,000 people are currently being held in immigration detention facilities in the USA.2 The confluence of tens of thousands of individuals in detention with a global pandemic is a perfect storm—a situation that could affect the health of detainees and staff, strain local community health systems, and ultimately result in many preventable deaths. Infectious disease outbreaks in detention centers have been poorly managed in the past, causing significant morbidity and mortality, at higher rates than in the community.3 SARS-CoV-2 remains an elusive and poorly understood virus that is ten times more infectious than influenza, has no vaccine, and no preventative therapy. We also do not know if infection with the novel coronavirus confers immunity. The risk of contracting coronavirus is significantly increased in congregate settings—cruise ships, naval carriers, nursing homes, and long-term care facilities—and this risk is compounded in resource-stressed facilities such as prisons, Received May 20, 2020 Accepted May 29, 2020
jails, and detention facilities. These are all places where social distancing—the cornerstone of methods to protect individuals from contracting the infection—is simply not possible. Immigration detention essentially traps hundreds of people in close quarters and in unsanitary conditions, while staff members come and go multiple times a day, each time potentially introducing the virus into the building. As doctors who have spent time in detention centers before the outbreak, we have seen just how little personal space detainees have. Now they tell us of inadvertently brushing the arm of the person at a crow
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