COVID-19 deaths in ICE detention demand medical action now

This May, we witnessed the death of two immigrants in ICE detention who passed away from COVID-19 complications. These deaths have attracted national attention as several reports have outlined the inadequate COVID-19 protections provided to immigrants within ICE detention facilities. 

As physicians and physicians-in-training at the Harvard Medical School’s Asylum Clinic, we have received urgent requests to speak on behalf of the needs of detainees living in circumstances promoting the rapid spread of COVID-19, such as crowded dormitory-style housing where detainees lack basic access to soap or masks. We cannot ignore these warnings any longer and need immediate action to release additional detainees and improve public health conditions inside detention centers.

On March 22, John Sanweg, the former acting director of ICE, made a plea to current officials to release the thousands of nonviolent, low-flight-risk detainees currently in ICE custody. Although the detained population has declined significantly by around 30 percent over the last two months, the inadequate current conditions mean that COVID-19 will continue to be disastrous for the over 26,000 individuals still in detention. For example, detainees are often transferred between centers without testing, promoting viral spread within facilities. 

Many individuals still face an uphill battle to release. Reports from the first death in ICE detention reveal that Carlos Ernesto Escobar Mejia was prevented from being released by the judicial system despite multiple medical vulnerabilities. In his April bond hearing, Escobar Mejia was denied release due to convictions from the 1990s and because he was classified as a “flight risk”, despite being an amputee who could not drive and who had attended all of his hearings in the last eight years. 

Escobar Mejia was held in Otay Mesa Detention Center, which is run by the for-profit company CoreCivic. He experienced delayed access to medical care despite his progressively worsening symptoms. Instead of being immediately tested for COVID-19 and taken to the hospital, he was “cohorted,” moved into a pod with a group of people suspected of having COVID-19. CDC guidelines state that proper cohorting entails “isolating multiple laboratory-confirmed COVID-19 cases together as a group” and should only occur “if there are no other available options.” 

Grouping individuals together with suspected, rather than confirmed, COVID-19 dramatically increases the risk of transmitting COVID-19 to previously uninfected individuals. However, this dangerous and incorrect cohorting method is routinely practiced inside detention facilities. Since transportation and security costs for off-site care is paid for by the facilities, this financially disincentivizes organizations from providing prompt transfers to hospital care. We need an immediate independent review to ensure that detention facilities are providing prompt medical care and COVID-19 testing to individuals, especially those with medical comorbidities and severe symptoms. 

The tragedy of Escobar Mejia’s death underscores the need for the release of more individuals from detention. Even though further release would drastically mitigate the spread of COVID-19 and protect detainees’ lives, officials have attempted to engender opposition to this process. On May 6, ICE added a Judicial Releases section to their Coronavirus response website listing the criminal charges or convictions of the detainees released by judicial orders. 

Similar initiatives have been made by local-level officials, such as in Bristol County, Mass., where the Sheriff’s Office sought to engender fear among the greater community through a Prisoner Release Alert System that publicly shared the charges and/or convictions of released detainees. In its first alert, the Sheriff’s Office included charges for which detainees were never tried, thereby presuming guilt without due process.

These actions by government agencies reinforce the false messaging that most ICE detainees have dangerous criminal records, despite the fact that more than six out of ten immigrants in detention have never been convicted of a crime. This tactic is not about public safety: it provides no recommendation on public protection. Instead, it is fear-mongering cloaked under the guise of garnering public trust and support. It serves only to feed the existing xenophobia of immigrants in our communities.

To avoid the further spread of COVID-19 and deaths of individuals held in detention facilities, we are calling for immediate safety measures, mass COVID-19 testing, and prompt access to medical care for sick detainees. Reports of poor conditions inside detention facilities emphasize that further release is still necessary for public health and safety. Additionally, once individuals are released, government agencies should not publicize charges that reinforce the criminalization of immigrants. These changes cannot wait. Otherwise, these deaths only mark the beginning of a disaster unfolding inside U.S. detention centers. 

Caroline Lee, Nishant Uppal, and Parsa Erfani are evaluators at the Harvard Asylum Clinic and medical students at Harvard Medical School. Dr. Katherine Peeler is the Medical Director of the Harvard Medical School Asylum Clinic and Medical Expert with Physicians for Human Rights.