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As COVID-19 Surges, ICE Detainees Face Disease, Vaccine Inequity, and Neglect

Separation of families. Denial of medication and medical care. Nonconsensual medical procedures. For decades, health and rights advocates have documented abuses against people held in U.S. Immigration and Customs (ICE) detention. However, as COVID-19 began to rage across the United States, pandemic-related inadequacies worsened conditions for detainees and exacerbated the existing threats to their health and safety.

As part of Physicians for Human Rights’ (PHR) webinar series on COVID-19, on June 28, 2021, expert panelists discussed the health and human rights implications of COVID-19 inside ICE detention centers. The conversation included how the public health crisis has been handled throughout the pandemic, how vaccination has been managed for detained populations, and what needs to be done to ensure that the right to health is protected for people in detention.

As COVID-19 began to rage across the United States, pandemic-related inadequacies worsened conditions for detainees and exacerbated the existing threats to their health and safety.

The discussion was moderated by Lee Gelernt, a civil rights lawyer at the American Civil Liberties Union (ACLU) and deputy director of the ACLU’s Immigrant Rights Project. Panelists included: Nilson Barahona-Marriaga, a former ICE detainee at the Irwin County Detention Center in Georgia; Eunice Cho, JD, a senior staff attorney at the ACLU National Prison Project; Josiah Rich, MD, MPH, a professor of medicine and epidemiology at the Warren Alpert Medical School of Brown University, practicing infectious disease and addiction specialist at The Miriam Hospital and the Rhode Island Department of Corrections, and director and co-founder of The Center for Prisoner Health and Human Rights; and Sophie Terp, MD, MPH, an associate professor of clinical emergency medicine at the Keck School of Medicine at the University of Southern California.

Dire Conditions in ICE Detention Exacerbate Risk

People held in ICE detention are awaiting adjudication from immigration authorities; they range from recently arrived asylum seekers fleeing persecution and violence to undocumented people who have long resided inside the United States. On average, 26,000 people per day are detained in more than 200 ICE detention facilities nationwide. Detention can last from a few months to years.

When COVID-19 started to spread in the United States, it wasn’t long before ICE facilities and other carceral systems – where crowding makes protection against the pandemic difficult – were hit hard. Despite widespread calls for the release of ICE detainees – the vast majority of whom are facing civil, not criminal charges – in order to protect their health, these mitigation measures were ignored; instead, detainees endured what quickly became a public health and human rights crisis.

As of June 24, 2021, according to the COVID Prison Project, 831 people in ICE detention were being monitored or under isolation after testing positive for COVID-19. Due to a lack of transparency around conditions in ICE detention facilities, however, the number of positive cases is likely significantly higher. As reported by PHR, these numbers can be attributed to ICE’s failure to follow Centers for Disease Control and Prevention (CDC) guidelines to protect those in its custody when COVID-19 first emerged. Not only did ICE not enforce social distancing among detainees, it did not provide adequate personal protective equipment such as masks, hand soap, or hand sanitizer for those detained.

One of these was Nilson Barahona-Marriaga. As someone formerly detained by ICE, Barahona-Marriaga experienced abuse and neglect by ICE officials firsthand. “We didn’t receive any kind of information about what was happening with COVID-19,” he said. “Everything we knew about it was because of the media. We watched numbers go up and began to hear about health conditions that can put you at a higher risk.”

Along with other detainees, Barahona-Marriaga participated in a desperate appeal by way of a hunger strike. They demanded that ICE follow public health guidelines, provide detainees with protective equipment such as masks and cleaning supplies, and release medically vulnerable people from detention. Their efforts were in vain. In retaliation, Barahona-Marriaga said, ICE officials turned off running water. “These are the kinds of things that made me want to come and tell my story, because people are suffering in detention,” Barahona-Marriaga said.

These and other instances of abuse against hunger strikers in ICE detention were also extensively documented by PHR and the ACLU in the recent investigation, Behind Closed Doors: Abuse and Retaliation Against Hunger Strikers in US Immigration Detention.”    

U.S. Mass Incarceration Fuels Pandemic Vulnerabilities

Panelists addressed how the pandemic has highlighted the severe vulnerability of the United States to a virus like coronavirus due to the high rates of incarceration in the country. “We are incarceration-crazy,” said Dr. Rich. “We lock up a higher proportion of our citizenry and immigrants than any other civilization in the history of mankind.” While a short-term solution to the extraordinary risk of COVID-19 spreading in congregate settings is to follow recommended public health precautions – such as mask-wearing, testing, quarantining, offering vaccines, and releasing detainees – “Ultimately, the fundamental problem is there are too many people [in detention],” said Dr. Rich.

Dr. Sophie Terp further underscored the challenge of implementing recommended public health precautions in often-crowded detention environments. According to Dr. Terp, people in ICE detention facilities should be given precedence for vaccinations. “Study findings really highlight how immunizations for COVID-19 need to be prioritized – particularly for detained individuals whose age or comorbid conditions place them at increased risk for mortality,” she said.

“Our country will ultimately be judged in this period by not only how we tackled COVID generally, but how we dealt with the most vulnerable people.”

By Lee Gelernt, a civil rights lawyer at the American Civil Liberties Union (ACLU) and deputy director of the ACLU’s Immigrant Rights Project

Today, infection rates in these facilities remain high. According to a recent New York Times study, the infection rate in ICE detention was five times that in prisons and 20 times that in the general public. Frequent transfers of detainees and regular shift changes of ICE officials have also caused the infection rate to surge. Compounded by the Delta variant, slow vaccine rollout, and a lack of personal protective equipment and supplies, the threats to the health of detained people only grow.

ICE’s failure to prioritize the health and well-being of detained people amid an international public health emergency is further proof that change is desperately needed. In addition to calls to improve conditions in detention, including wider access to vaccines, PHR is calling on President Biden to end the U.S. reliance on mass immigration detention and invest in community-based social services as alternatives.

“Our country will ultimately be judged in this period by not only how we tackled COVID generally, but how we dealt with the most vulnerable people,” concluded moderator Lee Gelernt. “Among these is certainly those who have been locked away in ICE detention facilities.”