COVID-19 and the coming epidemic in US immigration detention centres

In the USA, a rapid increase in SARS-CoV-2 infections in every state of the country has resulted in a growing number of hospitalisations, admissions to intensive care units, and deaths in specific age groups and in many people with underlying medical conditions.1 Individuals who are incarcerated, including immigrants in ICE detention, are among the most vulnerable to infection and complicated disease because of existing drivers of inequality.2–3 The incarceration of undocumented immigrants is a relatively new phenomenon in the USA. Inadequate implementation of infection prevention strategies will affect the spread of COVID-19 in the community and burden an already stretched health-care system. Because the transmission of SARS-CoV-2 is predominantly from person to person through droplets, a pillar of infection prevention is social distancing and disinfection, which is antithetical to closed detention settings. The combination of a captive population exposed to a highly infectious disease and substandard care has the potential to increase the incidence of infection and case-fatality rates among detained individuals, put the public at greater risk, and consume substantial medical and financial resources. Because of the existing barriers to adequate mitigation, containment, and provision of medical care in detention facilities, the policy response to this crisis must involve the release of individuals in ICE detention and a halt of ICE enforcement action in the community.