SAHM COVID-19 response: Release Immigrant Youth and their Families from Immigration and Customs Enforcement (ICE) Detention Centers

The World Health Organization 1 (WHO) and Centers for Disease Control and Prevention 2 (CDC) have declared the novel coronavirus (and the disease it produces, COVID-19) public health crisis to be a pandemic, posing serious health threats to the global population and in particular to those living with social and health inequities. Sites of incarceration or detention pose a specific risk for the spread of COVID-19 3. Detention centers are poorly equipped to manage medical conditions in children and youth 4. The inability of detention center staff to adequately triage and provide medical care for children with influenza resulted in several deaths secondary to influenza complications 5. We are now facing a disease that is more deadly and more contagious than influenza, within systems that are not adequately staffed or designed to handle large-scale health crises. 

Immigrant adolescents and young adults face unique dangers due to COVID-19. While early reports suggest that adolescents and young adults are less likely to experience severe illness than adults, they can experience severe morbidity as well as mortality from COVID-19, and this is especially true if they have compromised health status or underlying conditions 6. Youth in detention centers may be at increased risk for severe disease for multiple reasons. They may have underlying medical conditions such as asthma. They may also have compromised immune systems due to undiagnosed or poorly managed medical conditions, malnutrition and the effects of the stress that pushed their families or themselves to migrate, the burden of the migration journey, their lifelong biopsychosocial circumstances, or malnutrition 7

Furthermore, youth in detention centers may be at increased risk due to crowded living conditions 4. Youth have been found to carry high viral loads of COVID-19 even in the absence of severe symptoms, which increases the risk of the rapid spread of disease in detention centers where social distancing cannot be practiced 8

Keeping vulnerable youth in detention centers creates an unacceptable risk to them, their families, and their communities during this unprecedented time. Any increase in severe illness in this population has the potential to overwhelm the local health care systems already experiencing exceedingly high demand. Furthermore, detained youth are less likely to access the appropriate level of health care for any needs. They may not speak English and be unable to communicate symptoms or concerns to detention center staff, particularly when not in the presence of their parents, creating situations where appropriate medical care is delayed or foregone entirely 4. This risk adds to our responsibility to respond to the humanitarian crisis that has led many families to flee their countries of origin and seek refuge in the United States. There is an urgency to this matter, as the United States Immigration and Customs Enforcement (ICE) has confirmed cases among its employees in Arizona and New Jersey detention facilities 9. Reports have emerged from the ICE parent organization that hundreds of Department of Homeland Security staffers have tested positive for the coronavirus, with nearly 1,000 in self-quarantine 10. These federal employees can not only transmit the disease to youth and their families in detention centers but also their own families and communities. If crowded living conditions exacerbate risk for the spread of infectious disease 11, detention centers, like prisons, are the perfect catalysts to exacerbate a pandemic. 

Actions have been taken to address the risks for those incarcerated, across the U.S. and globally. For example, local officials overseeing detention settings have made the decision, in the name of public health and prevention, to release inmates and detainees charged with low-level, non-violent crimes 12. Young migrants in detention, who are merely civilly detained while their asylum applications are being filed, merit at least the same considerations. 
 
The evidence-based concept of youth thriving while living with their families is undergirded by human development, public health and human rights principles and knowledge 13-15. It necessitates that youth be united with their families if separated, and if jointly detained, be released together. Children and families should receive proper testing for coronavirus before their placement with screened sponsors: family members or connections, or civil society groups ready to fill the void when no sponsors were available. Through these placements in the community, they can better practice social distancing, safely self-isolate or quarantine according to their coronavirus test’s results, and access proper health care as needed to control the spread of the infection. Under no circumstances should youth or their families be deported to their country of origin, as they were escaping life-threatening conditions.
 
We at the Society for Adolescent Health and Medicine (SAHM), along with thousands of medical and public health experts, recommend the immediate release of detained youth and their families into the custody of appropriately screened sponsors in the U.S. This measure is the safest strategy to protect this population living with social and health inequities as well as federal employees working at the centers and their communities. It is an essential strategy to prevent overwhelming of health systems in the broader society. We call on ICE, state and federal officials to act now to protect the health and human rights of immigrant youth and families in detention. There is still time to do the right thing. There is still time to save lives. But we must act now, as the window of opportunity is closing rapidly.

SAHM Diversity Committee

 

References:
  1. World Health Organization. (2020). Coronavirus disease 2019 (COVID-19) Situation Report - 51. Accessed 4/3/2020.  https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf?sfvrsn=1ba62e57_10
  2. Centers for Disease Control and Prevention. (2020). Coronavirus Disease 2019 (COVID-19).  Accessed 4/3/2020.  https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html
  3. Akiyama, Matthew J., Anne C. Spaulding, and Josiah D. Rich. Flattening the Curve for Incarcerated Populations—Covid-19 in Jails and Prisons. New England Journal of Medicine (2020).
  4. Linton, J., Griffin, M., & Shapiro, A. (2017). Detention of Immigrant Children. Pediatrics, 139(5), E20170483-0483v1.
  5. Foppiano, Palacios C., John J. Openshaw, and Mark A. Travassos. "Influenza in US Detention Centers-The Desperate Need for Immunization." The New England journal of medicine 382.9 (2020): 789.
  6. COVID, CDC, and Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19)—United States, February 12–March 16, 2020. MMWR Morb Mortal Wkly Rep 69.12 (2020): 343-346. Accessed 4/15/2020. http://www.ecie.com.ar/images/paginas/COVID-19/4MMWR-Severe_Outcomes_Among_Patients_with_Coronavirus_Disease_2019_COVID-19-United_States_February_12-March_16_2020.pdf
  7. Linton, J., Choi, R., & Mendoza, F. (2016). Caring for Children in Immigrant Families. The Pediatric Clinics of North America, 63(1), 115-130.
  8. Rasmussen SA, Thompson LA. Coronavirus Disease 2019 and Children: What Pediatric Health Care Clinicians Need to Know. JAMA Pediatr. Published online April 03, 2020. doi:10.1001/jamapediatrics.2020.1224
  9. Mansoor,S:  “About 700 New Jersey Police Officers Tested Positive for Coronavirus, State Police Head Says,” Time (Mar. 29, 2020). Available at https://time.com/5812113/newjersey-police-coronavirus/. Accessed April 21, 2020.
  10. United States Immigration and Customs Enforcement. (2020). ICE Guidance on COVID-19. Available at https://www.ice.gov/coronavirus. Accessed April 21, 2020.
  11. Wang, Yixuan, et al. "Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID‐19) implicate special control measures." Journal of medical virology (2020)
  12. Prison Policy Initiative. (n.d.). Responses to the COVID-19 pandemic. Retrieved April 3, 2020, from https://www.prisonpolicy.org/virus/virusresponse.html
  13. Office of the United Nations High Commissioner for Human Rights. (1948). Universal Declaration of Human Rights, Article 16.
  14. Office of the United Nations High Commissioner for Human Rights. (1989). Convention on the Rights of the Child, Article 9.
  15. Zolkoski, S. M., & Bullock, L. M. (2012). Resilience in children and youth: A review. Children and youth services review, 34(12), 2295-2303.
Resources:
 
https://www.vera.org/publications/coronavirus-guidance-for-criminal-and-immigration-legal-systems
 
https://www.prisonpolicy.org/virus/virusresponse.html
 
http://www.euro.who.int/en/health-topics/health-determinants/prisons-and-health/publications/2020/preparedness,-prevention-and-control-of-covid-19-in-prisons-and-other-places-of-detention-2020
 
https://www.ncchc.org/COVID-Resources
 
https://www.cdc.gov/coronavirus/2019-ncov/community/correction-detention/index.html

 

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