Roosevelt Institute | Cornell University

At the Border: An Urgent Public Health Crisis

By Evin RothschildPublished October 22, 2019

Migrants detained at the US-Mexico border are faced with inhumane conditions and a perfect storm for a future influenza outbreak as cramped conditions, poor conditions, and no access to flu v
Migrants detained at the US-Mexico border are faced with inhumane conditions and a perfect storm for a future influenza outbreak as cramped conditions, poor conditions, and no access to flu vaccines continue to afflict detainees.

         In the past year, the United States Customs and Border Protection (CBP) and Immigration and Customs Enforcement (ICE) have been getting a lot of heat for what many are describing as inhumane conditions at migrant detention camps at the border.  After immigrants cross the border, if they do not have legal permissions to be in the United States and they are caught, the CBP will place them in temporary migrant holding centers.  According to CBP policy, detainees should not be held in these facilities for longer than 72 hours, as they were created for short term stays.  In theory, these centers are just supposed to provide a place for processing before permanent solutions are arranged; however, some facilities are holding detainees for weeks—rather than hours—under inhumane and extremely overcrowded conditions.  Despite Trump issuing an executive order to stop separating families unless the parents pose a risk to the children, the practice of family separation remains.  The conditions have led to the creation of what could quickly become a perfect storm of a public health disaster. 

            As flu season quickly approaches, critics worry about the possibility of a major flu outbreak at the overcrowded detention centers.  Since flu is a respiratory illness, it can easily be spread by droplets from coughing, sneezing, or even just talking. These droplets can then be inhaled into the lungs from the nose or mouth of the potential flu victim. Additionally, people who have not yet shown symptoms are able to transmit the disease a day before symptoms are showing. Due to this feature of the virus, even if those who fell ill with the influenza in migrant camps were immediately isolated, they still have the opportunity to transfer their symptoms to other detainees.  Those with weakened immune systems, specifically children who may be exhausted and stressed from long travels, are more susceptible to the disease and complications associated with it.  This year already, three children have died from the flu and related complications. Compared to the United States flu death rate at about one per 600,000 children, this rate of three deaths in the 200,000 children detained is much higher. This statistic is highly concerning. With overcrowding and lack of hygienic conditions, the number of deaths is bound to increase unless something is done.

            In order to handle the potential catastrophe before it turns into one, there are a variety of steps that should be done both to ameliorate living standards for those in custody as well as prevent against a much larger widespread outbreak.  First and foremost, detainment conditions should be improved. After Congresswoman Alexandria Ocasio-Cortez visited detention camps this summer, she reported officers suggesting that thirsty women drink out of toilets and abusive guards.  Additionally, NBC released a report demonstrating the level of overcrowding: They found a cell meant for 35 people had 155 adults with only one toilet and one sink.  All these practices will increase the likelihood of an outbreak because, aside from the traumatic psychological effects, they are promoting poor hygienic conditions. While Congress members figure out a better long-term solution, the least that can be done for now is ensure that facilities do not become as overcrowded as they are now by moving migrants to alternate locations. Additionally, guards should be better screened and trained to ensure that they are fit to be unbiased and fair in the treatment towards migrants.

            In addition to these improvements, another interventional measure would be providing influenza vaccinations to the most at risk of the population, children and the elderly.  Influenza vaccinations are shown to reduce the risk of flu-associated hospitalization for children, adults, and the elderly.  Although the government may be hesitant to pay the costs to provide the flu vaccine to the most at-risk groups, in the long run, it could actually wind up saving costs associated with potential flu related hospitalizations.  Beyond the economic advantages, it is just the right thing to do that will benefit the health of many children. 

            It is imperative that something is done immediately to improve this public health crisis at the border camps right now. It is my recommendation that first, overcrowding and unhygienic conditions should be dealt with, and then the influenza vaccine should be given to the most at risk immigrant populations.  The sooner that action is taken, the greater the probability that preventable deaths are avoided and an avoidable outbreak is stopped in its tracks.