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In Texas’s ICE facilities, immigrants remain in close quarters and sanitizer is running short. Advocates worry a COVID-19 outbreak could be severe.

In the days since the president declared the coronavirus pandemic a national emergency, the coronavirus has effectively turned Texas on its head. Schools have closed, bars and restaurants have been limited to takeout service, and gatherings of more than ten people are prohibited. But inside the walls of the South Texas Detention Complex in Pearsall, it’s as if the virus doesn’t exist. 

At the privately run Immigration and Customs Enforcement processing center, female detainees have learned of the coronavirus by watching the news. They live in close quarters, sleeping in bunk beds that line the barracks. So far, the only change within the facility is a new wall sign suggesting that the women cough into their elbows and wash their hands for twenty seconds. Throughout the facility, the detainees are anxious, said Cristian Sanchez, a RAICES attorney who works with clients at Pearsall. “It’s as if the coronavirus hasn’t happened in the outside world,” he said. “There’s been absolutely no change in procedure, and no one has talked to my clients about preventative measures. There’s no gloves, no hand sanitizer, no masks, no anything.”

Kat Russell, another attorney at RAICES working with detainees at the Pearsall detention center, said her clients reported that they ran out of soap in the female dorms on Sunday and were told to use shampoo to wash their hands. 

Several of Sanchez’s clients are sick, reporting coughing, fever, aches, and chills, but so far none of them have been separated from the other detainees or had their temperatures taken. When he goes to visit them, Sanchez brings his own supply of pens, sanitizer, and antibacterial wipes to disinfect the contact visitation rooms where they meet. 

ICE suspended family visits March 13 due to coronavirus concerns, and lawyers say legal visitors have been asked to fill out a questionnaire as well as have their temperature taken before visiting facilities. On March 18, ICE announced that it would be delaying the bulk of its deportation efforts amid the national emergency to focus on people who are deemed a threat to public safety, and that the agency would be taking steps to mitigate the spread of COVID-19 in their facilities. “Detainees who meet CDC criteria for epidemiologic risk of exposure to COVID-19 are housed separately from the general population. ICE places detainees with fever and/or respiratory symptoms in a single medical housing room, or in a medical airborne infection isolation room specifically designed to contain biological agents, such as COVID-19,” the agency’s statement reads. The agency also plans to transport those with moderate to severe symptoms to “appropriate hospitals with expertise in high risk care.” 

Legal and medical experts familiar with these detention centers have previously referred to them as “tinderboxes for infectious-disease outbreaks.” Now, as the number of coronavirus cases in the U.S. continues to grow each day, these same experts are sounding alarms that the country’s entire immigration system is vulnerable. Without a vaccine to prevent the coronavirus, the Centers for Disease Control and Prevention has recommended that people avoid exposure by maintaining social distancing, washing hands often, and disinfecting frequently touched surfaces. Within the confines of a detention facility, these recommendations are nearly impossible to follow. Detainees are often housed in close quarters, making distancing infeasible, and causing viruses like influenza and the new coronavirus that are transmitted through respiratory droplets to spread easily in detention centers. “If the virus was to come in, I don’t think there’s any way that it wouldn’t spread very, very rapidly,” said Russell. 

Already, a medical worker at an ICE detention center in New Jersey has tested positive for coronavirus. The agency told The Marshall Project that there are currently no detainees in their custody with confirmed cases of COVID-19. But lawyers with RAICES say they don’t know of any migrants at Pearsall who have been tested. 

ICE officials did not respond to requests for comment. 

As facilities wait for the virus to hit, attorneys who have visited the facilities say that they haven’t done enough to prepare. With nearly 40,000 people in ICE custody alone, legal experts and immigrant advocacy groups have called for the release of migrants from detention to reduce the risk of an outbreak. RAICES wrote a letter to Daniel Bible, ICE Enforcement and Removal Operations field office director, urging him to release immigrants in detention who they believe are at risk. “We are working with at least six children with symptoms of cold, cough and flu with several families complaining of inadequate testing and/or treatment. We are currently aware of 4 pregnant women and 14 babies under two years old detained there. Let’s make this clear: Their lives are in danger.” 

Some medical experts are skeptical of the agency’s ability to provide adequate health care and slow the spread of the virus. The majority of ICE detainees are housed in remote rural facilities, and hospitals in these areas often operate with fewer beds, smaller emergency room staff, and limited ventilators, which have proved crucial to treating severe cases of COVID-19. Poor diet, anxiety, and exhaustion are also factors that can contribute to a compromised immune system and make individuals more susceptible to infection. Alan Shapiro, a pediatrician and cofounder of Terra Firma, a New York-based group that facilitates access to medical care for immigrant children, has visited a number of these facilities across the country, including the South Texas Family Residential Center in Dilley and the Central Processing Center in McAllen. “Border processing stations really aren’t equipped to deal with a pandemic,” he said. “They’re trained to do inspections of basic infectious diseases like chickenpox or lice, but they just don’t have the medical infrastructure to deal with a major outbreak.” 

Shapiro argues that testing, quarantining, and contact tracing (identifying those that an infected person may have come into contact with) for detainees and employees are all essential to tamping down the spread of disease. Without taking these precautions, “anyone coming in or out, including new migrants or staff, can become vectors of the disease,” said Shapiro.  

Advocates are also concerned with the recent track record of the Department of Homeland Security, which oversees ICE,  when it comes to migrants’ health. Last May, a flu outbreak and the death of a sixteen-year-old Guatemalan child prompted the temporary shutdown of the country’s largest Border Patrol detention center, located in McAllen. Officials at the processing center identified 32 migrants with high fevers who were later quarantined. Later that summer, ICE quarantined 5,200 adults after mumps and chickenpox outbreaks in 39 detention centers nationwide, according to CNN. At least seven children have died from infectious diseases while in the custody of the U.S. Customs and Border Protection (CBP). 

In December 2019, CBP officials refused recommendations from the CDC to provide flu vaccinations at points of entry for migrants ages six months or older, drawing the ire of medical professionals across the country. The number of infectious disease outbreaks over the past year, coupled with reports of deaths from vaccine-preventable illnesses, has troubled medical experts like Mark Travassos, a pediatric infectious disease specialist at the University of Maryland School of Medicine. 

“It’s very difficult to figure out how the situation in these detention centers is changing,” Travassos said. “Over the past year, it’s come to light that there were these infectious disease outbreaks and that thousands of people were quarantined because of easily preventable illnesses like influenza and mumps, but there’s little to no standardized reporting on it from CBP or [the Department of Homeland Security].” 

Warren Binford, a law professor at Willamette University, said what she witnessed when she visited detention facilities to interview migrant children held there appeared to be “intentional medical neglect,” with children who described arriving in good health later coming down with severe illnesses within days due to unsanitary conditions. Binford is one of many calling for the release of children and their family members from custody. “The vast majority of these children have family or loved ones in the U.S., according to DHS figures,” she said. “All of these facilities are operating at different levels of risk, but nothing they do will be as safe as having these children at home with their families.”