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At Child Migrant Detention Centers, Biden Is Overseeing a Cruel Public Health Disaster in Waiting

The conditions in child migrant detention facilities aren’t just cruelly overcrowded and holding kids for far longer than is legal or moral — they’re also a perfect storm for a major outbreak in infectious diseases, including COVID-19.

Young unaccompanied migrants sit inside a playpen at the Donna Department of Homeland Security holding facility, the main detention center for unaccompanied children in the Rio Grande Valley, Texas. (Dario Lopez-Mills / AFP via Getty Images)

Confidential data obtained by the Associated Press last month revealed over twenty thousand migrant children currently detained in federal government facilities across the United States. As political instability and climate crises in Central America worsen, Homeland Security secretary Alejandro N. Mayorkas stated the United States is “on pace to encounter more individuals on the southwest border than we have in the last 20 years.” Currently federal government facilities appear to be detaining the largest number of children they have in months, and thousands more than they are equipped to accommodate, dashing the hopes of human rights activists that immigration policy would improve under the Biden administration.

This would be a humanitarian disaster under normal conditions. But gross overcrowding in combination with the reported conditions of these facilities and the amount of time children are spending there could also create a perfect storm for an infectious outbreak in migrant detention facilities.

Around two hundred facilities across the United States each hold about a thousand children or more, with each child staying for days or even weeks at a time. Despite a law limiting the amount of time children can be held to seventy-two hours, reports from mid-2019 noted average stays in these detention centers exceeded seven days. This year, hundreds of children were found to have been detained in these facilities for more than ten days.

There is currently no policy requiring any kind of medical attention be provided to migrant children upon their initial arrest at the border, despite the extremely dangerous conditions most have endured crossing into the United States. Nearly all of these children remain without an annual flu vaccine — and, most alarmingly, without the new COVID-19 vaccine. Despite considerably strong vaccine programs and policies in Mexico and Central America, thousands of migrant children in these facilities likely remain without completion of the World Health Organization’s recommended pediatric vaccination course, including measles, rotavirus, and hepatitis immunization.

A number of these children were forced to flee their home countries before the age of two and before completion of their pediatric vaccination course. And while vaccination coverage over the last two decades has generally held between 80 and 90 percent across Mexico and the Northern Triangle countries of El Salvador and Honduras, this still leaves as many as two out of ten older children vulnerable.

Vaccination trends in Guatemala have been historically similar to those of El Salvador and Honduras, with the exception of a sudden and dramatic drop between 2013 and 2015 when infant immunization coverage fell from over 90 percent to 70 percent and below. These figures have since returned to acceptable rates, though children born during this period of deficient coverage are still of concern. As many as 30 percent of Guatemalan children currently aged six to eight years may not be fully vaccinated.

This immunological vulnerability is especially concerning when we consider the conditions within these facilities.

In a 2019 report, investigators with the Department of Homeland Security examined the conditions of several Customs and Border Protection detention facilities and detailed alarmingly unsanitary conditions and “dangerous overcrowding.” Several facilities were found not to provide children with showers, soap, or clean clothing, and several were found not to provide hot meals or proper nutrition. There is, unfortunately, little evidence that circumstances within these facilities have since improved.

Consequently, at least seven migrant children died in or immediately post Border Protection custody between 2018 and 2019. At least three of these children died of flu-related complications. One child died on the floor of his detention cell after six days of confinement. With record numbers and little change in policy or facility conditions, it should be expected that more children will be lost this year.

It is difficult to imagine more ideal circumstances for infectious disease transmission, and an outbreak is unlikely to remain contained in these facilities. Influenza, measles, and rotavirus are of particular concern. The risk of an infectious epidemic is just one of the many reasons that the United States’ child detention policies are not only grossly inhumane but incredibly senseless.

There remains no evidence that this policy has any practical basis in public safety or public health, much less the safety or welfare of the children detained. As with its predecessor, for the Biden administration, it seems like the basis of this policy may just be cruelty itself.