In at least two countries, Guatemala and Honduras, US deportees have tested positive for COVID-19. Deportations pose health risks to the receiving countries and the deportation staff. Despite early efforts by these countries, such as closing their borders, continued deportations undermine those policies.
The US Immigration and Customs Enforcement (ICE) is not taking sufficient measures to prevent the spread of COVID-19 by deportees. ICE’s current pre-deportation health screenings do not account for asymptomatic carriers. Further, the conditions inside detention centers are ideal for the virus to spread, increasing the risk of deporting someone who is COVID-19 positive.
To slow the spread of COVID-19, the US should pause deportations until testing shows the deportee is negative for COVID-19. It should also improve conditions in detention centers to reduce the likelihood of the virus spreading. To improve conditions, ICE should release non-criminal detainees to enable social distancing at detention centers. If the US doesn’t pause deportations, an influx of COVID-19 may contribute to a humanitarian crisis in countries that are poorly equipped to handle a health crisis. We document those risks and propose alternatives to both detention and deportation policy.
US deportations spread COVID-19 to Guatemala
To limit domestic damage from the global coronavirus pandemic, the Guatemalan government stopped all incoming flights and closed borders to travelers on March 13. Only Guatemalan nationals are allowed to enter the country through land borders, and they are required to spend 14 days in self-quarantine after entering. As of May 5, only 730 cases of COVID-19 have been confirmed in Guatemala.
Despite these measures, deportees from the US continue to arrive. Between March 21 and April 20, over 1,400 deportees were sent to Guatemala. As of April 24, at least 85 of those deportees had tested positive for COVID-19. Many are directly linked to spreading the virus to others. Guatemala’s health minister confirmed that 75 percent of the deportees on a March flight had tested positive for COVID-19 upon arrival in Guatemala. These coronavirus cases in Guatemala are directly attributable to US deportation policy and are undermining Guatemala’s efforts to stop the spread.
On March 17, Guatemala asked the US to temporarily stop all deportations until the pandemic was over. This made Guatemala the first country in Central America ever to defy US deportations. By stopping deportations, Guatemala hoped to halt the spread of the disease throughout the country. However, this lasted only two days before the Guatemalan government backed down and allowed deportation flights to resume.
On April 6, Guatemala announced a second, temporary prohibition of flights with deported people landing in the country during Holy Week, a major holiday in the country. This temporary suspension took place from April 5 to 11. During this week, Guatemalan officials also prohibited the movement of people between different areas of the country.
Guatemala also asked the United States to send fewer deportees per flight. A more crowded flight means there is a larger possibility for the virus to spread in transit. It also means that Guatemala would have to treat and quarantine more people at a time, which the country’s healthcare system lacks the capacity to do. Guatemala lacks funds to purchase sufficient test kits and relies on donations from other countries or organizations — like the Panamerican Health Organization — for tests.
It is unclear how many COVID-19 tests Guatemala holds. As of April 17, the country had received 38,548 tests from donations. The country’s population is about 17.25 million. Reporting suggests that Guatemala is only performing 200 to 220 COVID-19 tests a day. Further reports claim that there are fewer than one test for every 100,000 people, likely making Guatemala the country with the fewest tests in Central America.
Testing the deportees who arrive each day would overwhelm Guatemala’s testing capacity. Deportation flights happen at least once a day and carry an average of 150 people. For example, on April 13, two flights brought in a total of 182 deportees. Testing all 150 arrivals would leave only about 50–70 tests for the general public in Guatemala. On top of the country’s limited testing supply, Guatemala is running out of space to quarantine people and rooms in hospitals to treat patients.
So far, US policymakers have not sympathized with the plight of developing countries concerned about the importation of COVID-19 cases through deportation. On April 10, President Trump issued a memorandum threatening to enact visa sanctions on countries that do not accept deportees. The memorandum states that the US will sanction all countries that deny or delay the reception of its deported citizens. As a result, on May 5, Guatemala announced that it had agreed to work with the US on deportations on the condition that ICE test all deportees before they board flights to Guatemala.
Guatemala is in a bind: it cannot afford to deny deportees, and it cannot accept them. The best solution for the country’s public health would be to pause deportations until testing capabilities improve, but this action would incur the wrath of the hemisphere’s biggest economy and military power. A single deportee can have an outsized effect, as the case documented below shows.
Patient 36
29-year-old Patient 36 showed no symptoms on his March 26 deportation flight to Guatemala. While he was required to spend time in isolated quarantine in his hometown of Momostenango upon his return, this was impossible as he shared a small house with several family members. One day after his return home, he began showing symptoms of COVID-19. On March 29, Patient 36 was transferred to a hospital and tested positive for the virus. Six of his family members also tested positive, including a nine-month-old baby. Since then, the town of Momostenango has seen several cases of people with fevers. However, no tests are available to verify if the cases are related to coronavirus.
After finding out about Patient 36, the Guatemalan government looked for the other 41 deportees who shared a flight with him. Once the government was able to locate them, they were put in quarantine. However, by then, many had already gone home and interacted with their families. If any of the deportees had been carrying the virus, people in their hometowns were also exposed to it.
The risks of the virus spreading are significantly worse for Guatemala than in developed countries. Patient 36 illustrates the risks and is not a unique case. Opportunities for social distancing within a household are small or non-existent. Many Guatemalans share rooms with family members or housing with other families. Data from the United Nations shows that 39 percent of Guatemalans live in multi-generational households, compared to only 16 percent in the US. In addition, the average Guatemalan household size is 4.8, compared to 2.5 in the US. This suggests that a single infection in a Guatemalan household could spread to more people and faster than in a US household. Furthermore, many of the towns to which deportees are returning are remote areas with limited access to healthcare and suffer from chronic malnutrition and poverty. Of the 8,594 people who were deported from January to February this year, only 453 stayed in Guatemala City.
The US should require negative COVID-19 tests before deportations
The lessons from Guatemala’s experience also apply to similar countries in Central America. For example, on March 30, Honduras confirmed three cases of COVID-19-positive deportees sent from the United States.
ICE guidelines during the pandemic specify that flight medical providers screen deportees for symptoms before returning them to their home countries. The US government certifies that deportees to Guatemala do not have the virus and have been in quarantine for 15 days before their flight back to Guatemala.
Yet the guidelines are not preventing ICE from deporting COVID-19 carriers. ICE’s current pre-deportation screening only tests for fever, not for the virus. Given the number of asymptomatic cases, carriers are going unrecognized.
In addition to the risk of asymptomatic cases of COVID-19, news reports suggest that ICE has deported some individuals with high fevers. On March 30, Guatemalan officials found three children with high fevers from a flight of 120 deportees that was screened after landing. On April 6, the US deported 85 Guatemalans from El Paso, Texas. Two had high fevers when tested upon landing.
ICE needs to update its testing protocols to account for asymptomatic cases. Instead of only a temperature check, ICE should confirm that individuals are COVID-19-negative before deporting them. Requiring a negative COVID-19 test result is necessary to account for the asymptomatic nature of many COVID-19 infections.
ICE detention centers must improve conditions to lower COVID-19 risks
Sanitary conditions and space for social distancing are key to preventing the spread of respiratory illnesses like COVID-19. However, ICE detention centers are overcrowded and often have unsanitary conditions. The Washington Post, the Los Angeles Times, and Politico have each reported on the poor conditions within ICE detention centers. Immigrants who are waiting in ICE detention centers have claimed that the centers are not following the Center for Disease Control’s protocols to prevent the spread of the virus. These range from not providing face masks or gloves, not separating the healthy and the sick, or not providing enough soap so that migrants can wash their hands or shower. A related lawsuit was filed on April 13.
During an interview about a detention center in Louisiana, a detainee claimed that the facility is not regularly cleaned, that there is no access to hand sanitizer or masks, and that there is no way to practice social distancing. Separately, another man made similar claims about a detention center in Virginia.
Sanitary conditions were a problem in detention centers before the outbreak of COVID-19. There are few independent analyses of ICE detention center conditions. However, reporting, ongoing lawsuits, and ICE’s past record of containing similar illnesses suggest serious public health concerns in ICE facilities. For example, in August of 2019, four groups sued ICE alleging that conditions in the facility did not meet health standards set by the Department of Justice, such as having adequate healthcare workers on site. As of April 2020, this case is ongoing in federal court.
ICE has also struggled to contain disease outbreaks in the past, partly due to these conditions. Between September 2018 and August 2019, there were 898 cases of mumps among 57 different detention centers. When published, the CDC’s report noted that there were still ongoing mumps outbreaks in 15 facilities across seven states. Investigative reporting by ProPublica documented several other smaller cases of spreading illnesses, though none as widespread as the mumps.
As doctors with the CDC concluded in a review of the mumps outbreak, new outbreaks “continue to occur.” Mumps spreads easily in close-contact settings, much like COVID-19. A potential key difference is that a vaccine for mumps exists, and vaccinations featured prominently in the CDC’s suggested response.
Part of the reason for the spread of previous illnesses is the dramatic increase in the number of detainees. As Figure 1 shows, the average daily number of detainees has grown from less than 7,000 to an estimated 47,000.
According to a former ICE director, facilities require that inmates “remain in close contact with one another.” The increasing numbers of detainees over time lead to crowding. In 2019, for example, the Department of Homeland Security’s Inspector General found that a detention center in El Paso was holding between 750 and 900 detainees in a space a fire marshal had only authorized for 125.
If these allegations are true, then COVID-19 has only worsened those health conditions. Placing detainees in close, overcrowded conditions means that there is no way to practice social distancing and stop the spread of contagious diseases. Early research suggests that detention centers will be hotbeds for the spread of COVID-19 without prompt action. A study simulating the outbreak at 111 ICE detention facilities found that 72 percent of detainees are likely to be infected within 90 days of the virus’s introduction to facilities. The study goes on to suggest that infections at this scale “would overwhelm ICU beds within a 10-mile radius.”
The number of immigrants infected with the virus in ICE detention centers is already on the rise. On April 12, 61 detainees had tested positive for COVID-19. Ten days later, on April 22, 287 detainees had been confirmed COVID-19-positive in addition to 35 detention center staff members and 88 ICE employees working outside of detention centers. To prevent further spread of COVID-19 to detainees, ICE must immediately improve health conditions inside of detention centers.
ICE detention centers should release detainees
One way to improve conditions inside detention centers is to release detainees. States are taking a similar approach with prisoners in jails. New York, New Jersey, Colorado, California, and Ohio, among other states, are releasing groups of prisoners to reduce the risk of spreading COVID-19. Releasing low-risk prisoners provides space for distancing those still in custody. Similarly, detention centers could release detained immigrants to free up space in immigration detention centers without much risk. Most detained immigrants are lower risk than the criminal offenders in jails and prisons across the US.
The release of some ICE’s immigrant detainees is happening, but at a small scale and in some cases because of judicial rulings. For example, the American Civil Liberties Union won the release of four detainees who were in greater danger because of preexisting conditions. And a California judge ordered that at least 100 immigrants be released from an ICE facility by April 27. Detainees have already been released in states like Colorado and New Jersey, but only in small numbers.
March 2020 data on detainees shows that more than 60 percent have no criminal record. A report from Syracuse University’s immigration database, TRAC, concluded that “more than six out of ten [detainees] had no conviction, not even for a minor petty offense.” Fewer than 6,000 detainees nationwide — less than 20 percent — have serious criminal convictions on record as of July 2019. The majority of these detainees are held for immigration-related or civil offenses.
The proportion of detainees with criminal records differs from one facility to the next. Some facilities have much larger concentrations of criminal immigrants. TRAC data shows that even detention centers with relatively more criminal immigrants can still release substantial numbers of low-risk detainees to create space for social distancing.
Low-risk detainees will include some immigrants with criminal convictions, just as prisons are releasing people convicted of low-level crimes. TRAC data shows that only 10.7 percent of detainees have what ICE defines as a serious offense, such as robbery or sexual assault. That means even those with lower-level convictions can be released into alternative programs.
ICE already uses alternatives to detention. These programs include GPS ankle monitors, weekly check-ins, and unscheduled phone calls or in-person visits. Many of the programs are cheaper than detention and do not appear to be ineffective or abused by the participants. Because these programs allow social distancing, they should be scaled up to prevent COVID-19’s spread.
To decide which immigrants to release into alternative programs, ICE and the Department of Homeland Security’s Inspector General (IG) should develop criteria and require that detention centers apply it to their detainees. Sole reliance on ICE officials would be dubious considering that the agency is currently party to multiple lawsuits concerning health standards in detention facilities. The DHS and IG have the legal authority and technical expertise to evaluate candidates for release.
The criteria should include criminal history, options for housing or support outside of ICE’s detention center, and the level of crowding in the detention center. Releasing immigrants with serious convictions poses public safety risks. That still leaves almost 90 percent of detainees as candidates for release. Many detainees have relatives or friends who can take them in or support them outside of detention centers. Nonprofit organizations already work with ICE on alternatives to detention and can take in released detainees. Releasing detained immigrants without a place to go may put detainees in danger. Finally, some detention centers may not need to release detainees because they are not crowded, while others may need substantial reductions to comply with social distancing recommendations.
The release of detainees into alternative programs should happen within 90 days. Otherwise, COVID-19 will spread quickly among detainees and affect local communities.
Action is needed to prevent the international spread of COVID-19
We are currently in crucial times as the world struggles to end the pandemic. The best way to fight COVID-19 is for countries to cooperate by minimizing exposures to the virus. The US should work with the countries receiving deportees instead of penalizing them.
Continuing with deportations amongst the crisis threatens to overwhelm developing countries. Guatemala, for example, is finding deportees that are COVID-19 positive almost every day. Yet, the country lacks the healthcare capacity to administer testing both to deportees and the public. Furthermore, living arrangements increase the risk of spread among Guatemalan families. Pausing deportations will reduce the international spread of COVID-19.
Similarly, new COVID-19 cases are being reported at detention centers almost every day. ICE should release low-risk detainees to slow the spread within immigrant detention centers. Releasing deportees can also prevent the spread of the virus among ICE employees.
Both a pause on deportations and a release of low-risk ICE detainees are necessary to prevent the further spread of the virus. Both actions will save lives.