During the COVID-19 pandemic, despite travel restrictions at our borders and a suspension of many asylum proceedings, the United States continues deportations. With infection rates much higher than in most other countries, U.S. deportation practices risk exporting the novel coronavirus (SARS-CoV-2) from the United States to receiving countries, many of which have little to no capacity to safely quarantine deportees, compounded by weak healthcare systems that could collapse under the strain of large outbreaks of the disease.
Coronavirus testing (viral testing for an acute infection) and antibody testing (that tests for past exposure) have been proposed as ways to make deportation flights safe during the pandemic. However, testing inaccuracies and implementation limitations render these approaches woefully inadequate to ensure that the United States is not endangering people’s lives and spreading the coronavirus to other countries.
First, testing for the novel coronavirus is not sufficient to make deportations safe. Immigration and Customs Enforcement (ICE) is authorized to use rapid tests for a small sample of detainees prior to their flights. However, after a study by New York University (NYU) researchers reporting a false-negative rate of almost 50 percent, the Food and Drug Administration warned the public that these rapid tests may yield inaccurate results. Even if ICE began using the more reliable non-rapid RT-PCR tests among detainees, considered to be the “gold standard” in testing, false negatives could still occur (up to 30 percent), due to inappropriate timing of testing after exposure to the virus, or issues with specimen collection.
Second, coronavirus testing may be futile in the context of ICE transfers between detention facilities. With congregate living arrangements making social distancing impracticable and frequent transfers between detention facilities increasing risk of infection, it would be impossible to ensure that detainees with negative test results did not become infected between the time of their tests and their deportation flights.
Like viral testing, widespread antibody testing would not ensure safe deportations. Antibody tests are intended to detect people who have been infected with the virus, but antibody tests have multiple issues rendering them ineffective for clinical or population-based management, which is critical to control the COVID-19 pandemic.
Depending on the test kits used, multiple antibody test kits have been shown to have very low levels of accuracy, even in people who are confirmed to have had COVID-19. This poor accuracy is especially pronounced in light of the low base rate of infection in many parts of the United States, which greatly reduces the predictive value of antibody tests. When prevalence of infection is low, even extremely accurate antibody tests are likely to yield false-positive results and thus would provide a false sense of safety in the context of deportations.
Additionally, antibody tests can yield negative results in patients whose infections are more recent (within the first week of infection) and who have not yet started producing antibodies. These tests also miss infections among immunocompromised people whose immune system does not produce antibodies effectively.
Most importantly, using antibody testing as a green light to board deportation flights assumes that past infection confers immunity or prevents reinfection. While this may be true based on experience with other viral infections, we do not yet have the evidence to show that having been infected with SARS-Cov-2 makes the person immune, or even if it does, for what length of time.
In addition to the limitations of testing, deportation cannot be safe if reception in the deportee’s native country is not safe. Possible lock-downs in receiving countries make it difficult for deportees to travel to their homes to shelter in place with family and friends or make other arrangements. Forced quarantines in inadequate facilities can lead to mixing of infected and non-infected people. Deportees often are coming from challenging circumstances where they likely lack the resources to find other solutions.
For these critical, public health reasons and based on the science and evidence, Physicians for Human Rights urges the United States government to stop all deportations immediately and to reject claims that testing could make deportations safe during this pandemic.