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U.S. Immigration and Customs Enforcement (ICE) Endangered Detained Immigrants, Violated Human Rights During Pandemic: Physicians for Human Rights (PHR) Investigation

Interviews with 50 formerly detained people reveal widespread medical neglect, lack of basic supplies, retaliation against immigrants in ICE detention

ICE subjected people detained in its facilities during the COVID-19 pandemic to systemic abuses, lack of adherence to public health measures, and medical neglect, according to a new investigation published today by Physicians for Human Rights in collaboration with faculty and student researchers at Harvard Medical School.

The PHR report finds that ICE’s health and safety practices did not comply with Centers for Disease Control and Prevention (CDC) guidance or with ICE’s own Pandemic Response Requirements, subjecting detained people to unconscionable health risks that violated their constitutional and human rights.

“Praying for Hand Soap and Masks: Health and Human Rights Violations in U.S. Immigration Detention During the COVID-19 Pandemic” documents significant failures in ICE’s handling of the virus within its detention facilities, which created dangerous conditions and left immigrants with no recourse to protect themselves. The report provides evidence of how ICE neglected to practice even the most basic measures necessary for identifying, treating, and mitigating the spread of coronavirus within its detention centers, while failing to provide accurate information about the virus and retaliating against detained people who voiced complaints.

The report represents the most systematic assessment to date of conditions inside ICE facilities during the COVID-19 pandemic, and offers detailed policy and practice recommendations about immigration detention to the Department of Homeland Security, Congress, state governors and local public health authorities, the CDC, and the United Nations Human Rights Committee.

The report was informed by in-depth interviews with 50 people who were detained in 22 different ICE facilities – both public and privately run detention centers – across 12 states and who were released from ICE detention between March 16 and August 12, 2020. The average length of stay in ICE detention among the interviewees was 241 days. The interviews were conducted by student researchers and other members of the Harvard Student Human Rights Collaborative, a Physicians for Human Rights student chapter at Harvard Medical School and took place between July 13 to October 3, 2020.

The researchers caution that the relatively small number of interviewees – 50 people out of more than 16,000 detainees nationwide – may not offer a representative sample. However, the consistency in the interviewees’ accounts of failures across 22 ICE detention facilities renders the findings profoundly alarming, the researchers said.

“Our findings show that ICE has repeatedly violated even its own minimal guidelines and protocols during the COVID-19 pandemic, exposing detained people to grave health threats and violations of their human rights,” said Ranit Mishori, MD, MHS, senior medical advisor at Physicians for Human Rights and professor of family medicine at Georgetown University School of Medicine, and a co-author of the report. “To prevent additional outbreaks of COVID-19 in ICE facilities and their surrounding communities, ICE should immediately release people from immigration detention to safely social distance at home, in line with public health best practices, international human rights, and U.S. constitutional standards.”

The standardized questionnaire used for the interviews with formerly detained people was designed to assess the implementation of ICE’s National Detention Standards (NDS) as well as ICE’s Enforcement and Removal Operations COVID-19 Pandemic Response Requirements (PRR). Using the NDS and PRR as benchmarks, the report analyzes how ICE repeatedly failed to meet its own standards to contain infectious disease outbreaks such as COVID-19.

ICE’s numerous violations of the health, safety, and dignity of detained immigrants included:

  • Detention staff made limited efforts to inform detainees about COVID-19, with some staff downplaying the significance of the pandemic. Some 85 percent of detainees reported they learned about COVID-19 from watching television.
  • “Social distancing” did not exist in ICE detention, with interviewees reporting they slept, on average, fewer than three feet from other detainees. Eighty percent reported never being able to maintain a six-foot distance from others in their eating area.
  • New masks in detention were a luxury. Seventeen percent of interviewees reported they were never given masks. When detained people were given masks, it was often a one-time occurrence, forcing them to make their own replacement masks or reuse the same mask for months.
  • Soap was often not provided, forcing immigrants to wash their hands with water alone or with other bath products. Some 72 percent of interviewees reported not having access to free soap and water or hand sanitizer at some point during detention.
  • Immigrants disinfected detention facilities themselves, often for $1 per day or no pay. Twenty-six percent of participants reported never observing disinfection of frequently touched surfaces in common areas.
  • ICE failed to test or appropriately isolate detained immigrants with viral symptoms. Almost half of the respondents (21 of the 50 PHR interviewed) experienced symptoms of COVID-19 while in detention. Eighteen of these 21 reported their symptoms to ICE, but only three of those people were appropriately isolated from the general population and tested for COVID-19. The remaining 83 percent (15 people) reported their symptoms to facility staff members but did not get tested for COVID-19 and were not isolated.
  • People with comorbidities at heightened risk for severe COVID-19 were not provided with special accommodations. Some56 percent of interviewees (28 people) reported their comorbidities to detention staff, but only four of them were told that they were at high risk of having a serious illness with COVID-19.
  • ICE misused solitary confinement as a form of medical isolation. Several interviewees said they never officially reported their symptoms to facility staff due to fear of being sent to solitary confinement or otherwise punished.
  • ICE retaliated against detained immigrants who complained about issues related to COVID-19, with 56 percent of interviewees reporting acts of intimidation and retaliation after their complaints (ranging from verbal abuse and limiting food to pepper spray and solitary confinement).

While ICE is reported to undercount and misrepresent the extent of COVID-19 spread in its facilities, and access to testing has been limited, the agency’s handling of COVID-19 has resulted in reported infections of at least 558 people currently held at these facilities and eight deaths in custody as of January 4, 2021.

Indeed, a study by the same researchers published in the Journal of the American Medical Association (JAMA) in October found that the number of people per month who tested positive for SARS-CoV-2 (the virus that causes COVID-19) in ICE detention between April and August 2020 was 5.7 to 21.8 times higher than the case rate of the U.S. general population during that same time.

“What came across most consistently in our interviews was the sense of fear: fear of the unknown about the virus, fear about contracting it, fear of dying, and fear of never seeing their families again. There was no actionable manner to deal with this fear because complaining about ICE’s handling of COVID-19 precautions and medical care led to severe retaliation in the form of solitary confinement, pepper spray, and loss of privileges – even limiting access to soap during a pandemic,” said report co-author Katherine Peeler, MD, medical expert at PHR and a faculty member in the Department of Global Health and Social Medicine at Harvard Medical School.

“ICE and the U.S. government have both legal and ethical obligations to provide humane and evidence-based medical care for those in their custody,” said Peeler, who is also medical director of the asylum clinic of the Harvard Student Human Rights Collaborative at Harvard Medical School, a chapter of the PHR asylum program. “Our findings suggest that, on this front, ICE failed. While our study interviewed only 50 former detainees, ICE very clearly violated those obligations as described by these 50 individuals. We suspect that this is simply the tip of the iceberg.”

Based on these findings – and to prevent further outbreaks of COVID-19 – the report authors call for the safe release of people from immigration detention, in accordance with recommendations by public health experts, international human rights, and U.S. constitutional standards. PHR is leading an advocacy campaign to mobilize health professionals and the public to call on Congress to implement alternatives to immigration detention and to fulfill U.S. obligations for the humane care for all those currently detained.

“While conditions in some ICE detention facilities have improved slightly since the onset of the pandemic, these changes have only come after litigation was initiated and detained immigrants shared their harrowing stories with lawyers, advocacy organizations, and the press,” said Kathryn Hampton, senior asylum program officer at PHR, and a co-author of the report. “Among nations, America is exceptional in its widespread use of punitive, dangerous, and unethical immigration detention during the pandemic. International law requires governments to limit their use of immigration detention only with due process protections and as a last resort, and the U.S. Constitution prohibits punitive measures in civil detention, requiring the government to ensure safe and healthy conditions.”

“Time and time again, ICE has proven incapable or unwilling to ensure basic health and safety standards for the thousands of people in their custody,” said Hampton.

Health experts, as well as domestic and international organizations, have highlighted the deadly risks of immigration detention amid infectious disease outbreaks and have long called for releases on public health and humanitarian grounds during the COVID-19 pandemic. The World Health Organization, the UN High Commissioner for Human Rights, and the UN High Commission for Refugees stated in March 2020 that, given the risk of severe illness and death from COVID-19, people in immigration detention should be released “without delay.” U.S. federal courts have variously ordered ICE to locate and release people at high risk of severe illness or death due to the coronavirus, to give masks and sanitizer to detainees, to ensure availability of testing, and to take a range of precautionary measures, such as isolating people who test positive, temporarily halting intake, enforcing social distancing and mask wearing, and providing appropriate sanitary and hygiene supplies.

DHS did not respond to a request for comment on the findings of the report.

Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.

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