support release of people in ICE detention in Briston County
Dear Sheriff Hodgson and Mr. Lyons, We are a group of medical and public health professionals in Massachusetts who serve a diverse group of patients. We believe that the current situation in detention centers poses a significant public health concern and inappropriately endangers detained individuals. We urge that additional detainees be released, especially medically vulnerable individuals, and proper safety measures be immediately implemented. We acknowledge that we are one voice in a growing chorus of people advocating for significant reductions in the number of detained individuals. But we are compelled to share our medical concerns as many of us witness the COVID-19 pandemic unfold in our hospitals. There is a consensus among public health officials that the SARS-CoV-2 pandemic poses an enormous risk to individuals in detention centers, and by extension, to the families and communities of staff. Those who are elderly and have comorbid conditions (including, but not limited to, hypertension, chronic respiratory disease, diabetes, and cardiovascular disease) are especially susceptible. As of April 24, there have been at least 297 detainees, 35 detention facility personnel, and 88 ICE employees, who have tested positive for COVID-19.1 We commend the decision to release 47 detainees in Bristol County but we still remain concerned.2 The novel coronavirus is thought to pass from person to person primarily through respiratory droplets (e.g. coughing or sneezing) and may also survive on inanimate objects for a period of up to 72 hours.3 This allows for the potential spread of the virus through fecal-oral transmission which may result from poor hand washing or living in close quarters with others.4 What makes containment of this virus especially challenging is that people can transmit the virus when asymptomatic, either before they show symptoms or for weeks after their symptoms resolve.5 Medical history has taught us that living in areas of high population density and shared communal space, such as detention centers and nursing homes, are incubators for infectious disease. It is incredibly difficult and nearly impossible to contain person-to-person spread of viral disease when people live in close quarters and share dining halls, bathrooms/showers, and sleeping locations. For example, during the H1N1-strain flu outbreak in 2009 (“swine flu”), jails and prisons experienced a disproportionately high number of cases.6 H1N1 is far less contagious than COVID-19 and at that time a vaccine and antiviral medications existed for the H1N1 virus. Neither exists for COVID-19. On March 22, 2020 John Sanweg, the former acting director of ICE, made a plea to release the thousands of nonviolent, low-flight-risk detainees currently in ICE custody.7 As detention centers begin to see cases of COVID-19, several federal judges have ordered the release of at-risk detainees. On April 23rd, U.S. District Judge Terry Hatter ordered immigration officials to significantly reduce the number of detainees in the Adelanto ICE Processing Center “to such a level that would allow the remaining detainees to maintain a social distance of six feet from each other at all times.” If they are not able to do so, the Court will consider an immediate order of all those detained.8 We acknowledge that maintaining proper protection, sanitation and social distancing measures is incredibly difficult inside detention centers. Many centers have insufficient soap and alcohol-based hand sanitizers to maintain the strict hand washing recommendation necessary to keep staff and detainees safe. There is also a lack of sufficient Personal Protective Equipment, such as gloves, masks, and face shields needed to protect inmates and staff - especially when we are facing a national shortage. Regularly disinfecting communal areas and high-touch surfaces (e.g. door knobs, light switches) also requires increased staff. Furthermore, containment strategies for people who are symptomatic is a challenge given the insufficient number of isolation rooms in detention centers. Existing ICE policies that quarantine cohorts together when there is concern for infection or exposure are not effective as they may spread infection instead of contain them. Given the lack of proper self protection, hygiene, social distancing, the detained population is at extreme risk for viral outbreak. Based on all the available data on detention facilities and the precedents of infectious disease epidemics in correctional facilities, it is our professional judgment that detention facilities are presently under-equipped to prevent an outbreak of disease. Any outbreak within the detention system would also endanger staff members and in turn the public community, which would have disastrous consequences on our already overburdened health care system. Our judicial system is witnessing these predicaments and is starting to take action. But we ask you to take action before the courts. Although the Supreme Judicial Court has ordered reporting of tests for inmates and state and local prisons and jails, we believe this will not be a sufficient strategy of containment and mitigation and that more effective routes exist.9 To reduce the likelihood of an outbreak in detention centers, we ask that you and colleagues use your powers to release detained individuals who can live safely in the community. We ask that you grant clemency to the detained individuals who are medically vulnerable, including but not limited to: those who are pregnant, and those who have respiratory/cardiovascular disease, cancer, HIV/AIDS, diabetes, or other chronic medical conditions. If release is not a possibility for certain individuals, we ask that you grant permission for parole and subsequent release (with any electronic monitoring you deem necessary). In the meantime, as individuals are awaiting release, we urge you to make masks, gloves, soap, and cleaning supplies available to all detainees. We also urge you to create conditions in which at least six-feet distance is maintained in all locations, including in sleeping spaces, dining halls, bathrooms/showers, and other communal areas (except in cases of emergency). To make this possible, several ICE facilities have started utilizing staggered meal and recreation times. During these difficult times, we must unite in our thinking and action to protect populations who are most vulnerable to infectious disease, which especially pertains to individuals in detention. Thank you for taking the time to consider our request. Please contact us if any questions arise. References1. “AILA - ICE Issues Guidance on COVID-19.” American Immigration Lawyers Association, 2020, www.aila.org/infonet/ice-issues-guidance-on-covid-19.2. Dooling, Shannon. “47 ICE Detainees Released From Bristol County; Judge Wants Virus Testing Reports For Those Still Held.” 47 ICE Detainees Released From Bristol County; Judge Wants Virus Testing Reports For Those Still Held | WBUR News, WBUR, 26 Apr. 2020, www.wbur.org/news/2020/04/24/47-ice-detainees-released-from-bristol-county-judge-wants-reports-on-testing-among-those-remaining.3. Doremalen, Neeltje Van, et al. “Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1.” New England Journal of Medicine, vol. 382, no. 16, 2020, pp. 1564–1567., doi:10.1056/nejmc2004973.4. Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H, Evidence for gastrointestinal infection of SARS- CoV-2, Gastroenterology (2020), doi: https://doi.org/10.1053/j.gastro.2020.02.055.5. Riou J, Althaus CL. Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV), December 2019 to January 2020. Eurosurveillance.2020;25(4):20000586. David M. Reutter, Swine Flu Widespread in Prisons and Jails, but Deaths are Few, PrisonLegal News (Feb. 15, 2010), https://www.prisonlegalnews.org/news/2010/feb/15/swine-flu- widespread-in-prisons-and-jails-but-deaths-are-few/.7. I used to Run Ice. We Need to Release the Nonviolent Detainees: It’s the only way to protect detention facilities and the people in them from COVID-19. The Atlantic. March 22, 2020. https://www.theatlantic.com/ideas/archive/2020/03/release-ice-detainees/608536/8. Castillo, Andrea. “Judge Orders ICE to Reduce Number of Immigrant Detainees at California Facility.” Los Angeles Times, Los Angeles Times, 24 Apr. 2020, www.latimes.com/california/story/2020-04-24/judge-orders-ice-reduce-immigrant-detainees-adelanto-facility.9. Betancourt, Sarah. “Judge Seeks COVID-19 Test Data on ICE Detainees.” CommonWealth Magazine, 24 Apr. 2020, commonwealthmagazine.org/immigration/judge-seeks-covid-19-test-data-on-detainees/.
If you would like to add your name to this letter, please email HMS Student Parsa Erfani at parsa_erfani@hms.harvard.edu.