Inside the vaccination crisis in ICE detention centres

Gabriel’s life was in jeopardy long before he ever touched the US immigration system, though that certainly didn’t help. An asylum-seeker in the US, Gabriel fled his home country Cameroon after bribing his way out of prison, where he was tortured and threatened with death because of his membership in an Anglophone opposition party.

He made his way to Nigeria, then Colombia, where he met other exiled Cameroonians, and began the long journey through back roads and bus stations north towards America. He trekked by foot through the Panamanian jungle. He dodged a gun battle between rebels and border guards in Honduras.

“It’s a very dangerous place,” said Gabriel, who asked his full name not be used to protect his safety. “You might be robbed, you might be killed by a snake or a dangerous animal. I was scared, but I had no choice.”

It’s a feeling he would grow accustomed to in the US. After waiting for three months for his asylum claim to move forward under Donald Trump’s so-called “Remain in Mexico” policy, which sequestered tens of thousands in camps on the other side of the border, Gabriel finally made it into Immigration Customs Enforcement (ICE) detention in 2019 in Louisiana. That’s where he faced a different kind of threat: the coronavirus pandemic.

“We had so many cases of coronavirus. There’s just no way you can avoid being contaminated. They kept on bringing people from outside, especially at the beginning,” Gabriel said. “You will be sleeping, and the next day, you meet someone new sleeping beside you, and he just tells you he was arrested outside and brought in here. We had to be scared about that.”

Gabriel was detained at the LaSalle detention facility in Jena, Louisiana, a privately run detention centre, for more than a year before being released on medical grounds last month due to the risk at which his hypertension puts him of contracting coronavirus. The state is one of the few places around the country that explicitly mentions migrant detainees in its vaccination plan, but Gabriel said he never heard about it.

“Nobody talked about the vaccine,” he said. “I don’t even think the staff had been vaccinated.”

GEO Group, the company that operates LaSalle, did not respond to a request for comment from The Independent.

The roughly 15,000 ICE detainees across the country are facing a crisis within a crisis: as the broader US public health system struggles mightily under the weight of the coronavirus pandemic, they’re trapped in an often-times adversarial system with a history of subpar medical care stretching back long before the pandemic began, and the vaccine seems nowhere in sight.

“For people in these facilities, who are fighting their case to stay in this county, or are seeking asylum and can’t return, it becomes a choice between facing death at home or death within these facilities,” said Hamid Yazdan Panah, an attorney at Immigrant Defense Advocates, an advocacy group that has pushed regulators in California to vaccinate migrant detainees.

According to public health experts and migrant advocates across the country, authorities at all levels have largely avoided changing this status quo, waiting for one another to make the first move, while migrants sit and wait to see which will reach them first: the vaccine or a positive Covid test.

Nominally at least, immigration officials and the federal government have made migrant detainees a vaccination priority, and a handful of detainees in states like California are already getting the jab.

“It is a moral and public health imperative to ensure that all individuals residing in the United States have access to the vaccine,” the Department of Homeland Security, which oversees ICE, said in February, announcing it wouldn’t carry out immigration enforcement around vaccination sites. “DHS is committed to ensuring that every individual who needs a vaccine can get one, regardless of their immigration status.”

President Joe Biden has also emphasised open access to the vaccine, regardless of immigration status.

“I want to make sure they are able to get vaccinated and so they’re protected from Covid without the ICE or anyone interfering,” the president told Univision during a recent visit to Texas.

But beyond these promises, public officials say there’s no well-developed and executed plan to vaccinate the thousands of migrants in close proximity in detention facilities.

ICE has said it shared the number of required vaccines for its detainees with the Department of Homeland Security (DHS) and Operation Warp Speed, the federal vaccination effort, but it’s unclear whether the Department of Health and Human Services (HHS) has done anything with that information. DHS did not receive a direct allocation of vaccines, and most of the 29 states where there are ICE detention facilities haven’t started distributing the vaccine yet.

An HHS spokesperson told Business Insider in late February that Warp Speed «has given state health departments no direction on prioritisation of detainees within their state plans”.

ICE did not respond to a detailed set of questions about alleged conditions and a lack of Covid precautions inside detention centres, but did supply a statement.

“Immigration and Customs Enforcement (ICE) is firmly committed to the health and welfare of all those in its custody. Covid-19 vaccines for ICE detainees are being allocated by local and state health departments, and were incorporated into the total Covid-19 vaccine amount distributed by the federal government to each state,” Paige Hughes, an ICE spokesperson, told The Independent. “At this time, a limited number of ICE detainees have begun to receive the Covid-19 vaccine based on availability and priorities for vaccinating individuals in the state where they are currently detained.”

The nebulous state of vaccinating the nation’s migrant detainees has left public health experts begging for answers.

“Many of us in the public health and advocacy world would like to know, and at the moment it is unknowable,” says Dr. Ranit Mishori, senior medical advisor to Physicians for Human Rights (PHR) and a Georgetown University professor of family medicine. “It is a subject of intense debate and intense queries because we don’t know. It’s also unclear whose responsibility it is. Some people say it’s the state’s, it’s the federal government’s, it’s the private contractor’s. The bottom line is it seems there is no plan.”

HHS did not respond to a request for comment. The White House directed The Independent to address its questions to DHS, which also did not respond to a request for comment.

The reason for public health experts’ urgency is simple: ICE detention centres have been ground zero for Covid outbreaks in the US. One study estimated that detainees had a monthly case rate 13.4 times higher than the general population. A PHR survey of detainees across the country found that nearly all were unable to social distance, and 27 different people reported that when new detainees entered their detention centre, they were not quarantined.

“They would all say the same thing: we are safer in detention then out in the world with our families,” Charles Joseph, a recently released migrant, who helped lead a hunger strike over the state of pandemic precautions at the Mesa Verde Detention Center outside Bakersfield, California, told me.

Things are even worse at local jails contracted to house immigrants alongside inmates, according to Hannah Lichtsinn, a professor at the University of Minnesota medical school and co-founder of the Minnesota Immigrant Health Alliance. She said the many-layered arrangement – a federal contract, at a local jailhouse, regulated by county health officials, if at all – has led to a “substantial failure” to protect migrant health.

“Jails don’t exist in a bubble. People come into jail and people leave jail,” she said. “People who are held in detention have no ability to take steps to protect themselves. If you have no agency over your daily life it’s impossible to do that.”

“There’s no oversight of the quality of the care in these facilities as a result,” she added.

The Minnesota governor’s office, Minnesota public health department, and Kandiyohi County Sheriff’s Department did not respond to a request for comment.

“We have not heard of ICE providing the vaccine to families in detention or to anyone in detention. The most that ICE is doing is testing families for Covid at least once. They’re not even giving families the result of those Covid tests in facilities,” said Andrea Meza, director of family detention services at RAICES, which provides free legal services to migrants. “I don’t expect that ICE or our local government or state government will have a plan to vaccinate folks in ICE detention any time soon.”

Chris Van Deusen, a spokesperson for the Texas Department of State Health Services, did not respond to a detailed set of questions from The Independent, but said vaccination was up to ICE.

“Generally speaking, law enforcement agencies is responsible for providing care for people in their custody (sic),” he said. “There are some ICE facilities that are enrolling as Covid-19 vaccine providers.”

Georgia, home to a number of detention centres, was a similar story.

“We have heard about a small number of individuals in detention receiving a dose, but not much else,” Kevin T Caron, from Georgia Detention Watch, said in an email.

The governor’s office and public health department of Georgia did not respond to a request for comment.

In Minnesota, despite an advisory panel once considering incarcerated people for vaccination, the state has stuck to prioritising distribution by age, and Ms Lichtsinn, from the Immigrant Health Alliance, said she is sceptical that older migrants in detention are getting the vaccine.

“I seriously doubt that that is happening,” she told The Independent. “I have not heard of it happening at all, and I know from my work with a county jail that does not do any ICE detention that they’re close to hopefully being able to get the vaccines, but haven’t been able to get that yet, and that’s with a lot of advocacy in one of our main urban jails, which is very different from where most of our ICE detainees are being held.”

Even in liberal California, whose population is nearly a quarter immigrants, advocates said the state took months to respond their requests for more information about a plan for vaccinating migrants in ICE facilities. The state finally made formal plans to do so on 12 March, about a year into the pandemic. The nation’s first Covid casualty in ICE custody was last May, when Carlos Escobar-Mejia, a 57-year-old Salvadoran man, died in the Otay Mesa Detention Center, near San Diego.

The California governor’s office and public health department did not respond to a request for comment.

“They are in federal custody,” Mr Panah, the California migrant attorney, said. “Since the start of the pandemic, ICE has done everything it can to essentially remove itself from responsibility or liability in the context of Covid-19.”

The irony of the vaccine challenge inside ICE facilities is that it is of the US’s own making.

Immigration detention is ostensibly non-penal, and most of those being detained are not criminals deemed to be dangerous to society, but rather those awaiting administrative immigration proceedings and asylum cases. ICE has already released more than 3,600 people from detention, many on medical grounds like Gabriel, on court orders since last March, and health experts suggest the easiest way to avoid an outbreak inside detention centres would be to simply empty them out for the duration of the pandemic.

The Biden administration has responded in a different way, keeping the detention centres open, and trying to keep almost all new unauthorised migrants out. They’ve left in place the Trump era “Title 42” order, which allows authorities to deport nearly everyone crossing the border without documents out of public health consideration during coronavirus.

“The border is not open,” White House press secretary Jen Psaki said on Friday at a press briefing. “The vast majority of individuals apprehended or encountered at the border continue to be denied entry and are returned.”

Those who are allowed in right now are usually children, who are arriving in such large numbers right now that federal authorities say they have had to house them in Border Patrol facilities longer than the three days allowed by law, as they struggle to find adequate space and resettlement services.

Barring a mass exodus from ICE facilities around the country, migrant advocates say the federal government should take charge of health at its detention facilities, regardless of whether they’re operated by private contractors, providing clear information in multiple languages and medical help from a trusted third party.

“I wouldn’t trust ICE, with all due respect to America, but I wouldn’t trust ICE, not one bit,” Giovannie Morrison, a Jamaican man being held at the Golden State ICE facility in California, told me. “You never know what they will do.”

He said that Covid precautions inside have been scarce, social distancing and mask-wearing is impossible, and multiple staff members have told him they wouldn’t take the coronavirus vaccine even if it was offered to them.

“They’re not giving us any info about this virus, or the vaccine, what’s in it, what causes it, the effects of it, the side effects of it,” Mr Morrison, who goes by Gio, said. “No one is giving us that. In my personal opinion, that’s a no, I ain’t taking that.”

GEO Group, which also manages the Golden State facility, did respond to a request for comment from The Independent about its Covid protocols.

Overcoming the lack of trust will be crucial, according to health experts, but even before the pandemic, ICE had a shoddy track-record on providing quality medical care.

“There have been scores of reports, whistleblower testimony, GAO Government Accountability Office reports, OIG Office of the Inspector General reports, that documented really poor conditions, lack of access, neglect, and subpar conditions,” said Dr Mishori, from PHR. “This is not new to any of us, and it’s been going on for years. What’s new is that in the past, the world wasn’t dealing with such a huge public health crisis.”

States have taken analogous measure to prioritise other high-risk, often non-white populations in high-risk settings, such as some California counties vaccinating farm workers or Massachusetts giving inmates early access. But vaccinating non-citizen detainees has proved exceedingly controversial so far.

A plan to vaccinate the inmates at Guantanamo Bay was met with instant outrage and was paused earlier this year. And Republicans have blasted Mr Biden’s commitments to vaccinate migrants, even if they are largely symbolic at this point.

“President Biden’s plan to vaccinate illegal immigrants ahead of Americans who are currently being denied the Covid-19 vaccine is a slap in the face to millions of hard-working families who have been waiting months for the vaccine,» House Republican Whip Steve Scalise said in a statement in February.

For now, it’s hardly even a plan though, and more of a statement of priorities without any obvious followthrough. Instead, the daily fate of migrants like Gio and Gabriel comes down to the scattered decision making of a collection of local health officials and detention authorities. Some, like Gabriel, will see their release. He’s staying with a friend in Oklahoma while he continues appealing his asylum case.

And some, like Gio, will wait it out on the inside.

“I had a rough life, a stressful life, a traumatised life,” Mr Giovannie told me before we finished our call. “I’d like to spend my 40th birthday free without looking over my shoulder, spend it with my loved ones, and not in any jeopardy.”

But in an opaque system, under muddled directives, among a high-risk population, during a global pandemic, escaping jeopardy is all but impossible.

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