Omicron takes toll on detainees
It’s happening again. COVID is spreading through immigration detention centers across the country like wildfire. This time, however, the coronavirus infection rates are the highest that they’ve ever been, increasing a staggering 848% over the first few weeks of 2022. About 14% of people in U.S. Immigration and Customs Enforcement custody were infected — the worst since the start of the pandemic.
The large number of infections is partially explained by increased transmissibility of the omicron variant. However, ICE has repeatedly demonstrated that it is incapable of handling public health crises. From shirking basic hygiene measures like provision of masks and soap to deliberately under testing for COVID, the agency has flagrantly failed to comply with the most fundamental public health recommendations throughout the pandemic. Even after repeated outbreaks, ICE refuses to release important public health data, such as information on COVID hospitalizations of detainees and infection or vaccination rates among its employees or contractors. When confronted with these failures, ICE lied to courts regarding their COVID response.
Additionally, despite studies demonstrating that the most reliable protection is vaccination, only a third of all individuals who entered ICE detention since the pandemic onset received COVID-19 vaccinations. Unfortunately, even this statistic lacks context and detail: ICE has not shared the percentage of the currently detained population that have been vaccinated since people are constantly rotating through, what types of vaccines are provided and whether individuals received their first or second shot. There is no nationwide plan to offer boosters to all detainees. And there is no plan to overcome the immense distrust of ICE following years of medical neglect, coercion and substandard care, which has led to a third of detainees refusing the vaccine. Only 671 individuals have received a booster vaccine as of January, roughly 2% of ICE’s currently detained population.
ICE lacks a coordinated national vaccination plan or protocol. Each detention facility determines its own protocols for detained people and even staff. While some states, like California, took up the challenge of including detainees in their vaccination roll out plans, many have not. And many ICE detention centers are run by private corporations, which argue that they do not fall under state jurisdiction and operate with even less transparency.
(Notably, these corporations also manage for-profit prisons across the country, where COVID numbers are also surging, but not nearly as severe as what’s happening in ICE detention centers.) At this rate, providing boosters every six months or so will be an impossible task in facilities with such disparate policies and that are so poorly equipped to keep track of a fluctuating population.
The reality is dire for the 21,000 still held in the 200 detention centers, county jails and for-profit prisons. People in overcrowded and poor living environments like detention facilities are three times more likely to die of COVID.
As a human rights lawyer representing vulnerable migrants and an emergency medicine physician conducting physical exams of asylum seekers, I have personally witnessed the decimation of immigrant communities by COVID — and how carceral facilities, like detention centers, are incubators and super spreaders of the disease. One man, who spoke to me under condition of anonymity from Otay Mesa Detention Center in San Diego, described a continued lack of personal protective equipment as well as the resurgence of widespread symptoms such as coughing and fever.
The only thing more pervasive than these ubiquitous symptoms is fear.
Meanwhile, family members of the detained people I support report increasing staff shortages and denials of booster vaccines despite requests.
The American Civil Liberties Union filed a lawsuit seeking booster shots for five immigrants, who were denied their jabs despite having dangerous medical comorbidities that put them at higher risk of death if infected. But immigrants in detention shouldn’t have to go to court to be given access to booster vaccines when their lives are in jeopardy now.
The spread of COVID inside these facilities not only endangers the lives of those in detention, but also in surrounding communities. Coronavirus does not stay trapped within the walls of a detention center; staff enter and exit every day and the detainee population churns regularly. One study demonstrated how the spread of coronavirus from a single jail accounted for close to 16% of all cases in Illinois in 2020. Without a doubt, overcrowded and neglected conditions of carceral settings of all types transform into “epidemic engines” that spread infectious diseases into the broader community. We have seen this spread with influenza, tuberculosis, HIV and now COVID.
While it may be too late for the current omicron surge of the pandemic, the only path forward is clear — decarceration and release of the 75% of detained individuals who hold no criminal records and the thousands more who have only minor misdemeanors. Studies have shown that decarceration is extremely effective at reducing disease burden and transmission. At the same time, groundbreaking settlements hold ICE and its private-prison contractors accountable, paving the way to humane precedents that detention facilities across the country should follow.
If detention centers and other such carceral facilities don’t decarcerate, they will continue to serve as kindling to public health wildfires like COVID.
Theresa Cheng is a UCSF clinical instructor-physician in emergency medicine and a Skadden Fellow/human rights attorney. She is also a Physicians for Human Rights Asylum Network member and is on the board of directors of Border Kindness, a nonprofit providing migrant families with essential needs as well as medical and legal services.