The CDC must rescind a misguided policy tying asylum seekers to COVID

This week, advocates across the U.S. are joining together in the “Title 42 Week of Action,” marking the one year anniversary of the Centers for Disease Control and Prevention invoking Title 42 of the Public Health Service Act to authorize the Department of Homeland Security to shut down U.S. land borders to newly arriving asylum seekers. This was done, ostensibly, to reduce the threat of COVID-19 spread. But it was a pretext. Behind the scenes, the act was ordered by the Trump administration to use the growing pandemic to advance its anti-immigrant agenda. 

The consequences of this border policy have been severe — more than 500,000 asylum seekers have been denied entry this year without any chance to state their claims to asylum. The border shutdown is causing extensive suffering, health harms and human rights violations, ironically, in the name of public health.

Three months into the Biden administration and with a new CDC director at the fore, the specious public health border directive is still largely in place.

The premise of the CDC order — namely that asylum seekers represent a heightened COVID-19 threat — is severely flawed and based on politically motivated assumptions put forth  by the Trump administration. There is no evidence to suggest that migrants are at increased risk of contracting COVID-19 than truckers, commuters, U.S. citizens, or others currently allowed entry from Mexico and Canada. For instance, test positivity for migrants from one high volume port of entry was significantly less than for the population at large. 

The other premise behind the order, that processing asylum seekers would increase overcrowding and thus transmission of COVID-19 in Customs and Border Patrol processing centers and Immigration and Customs Enforcement detention is also based on a fallacy. Most people in detention are awaiting administrative hearings or transfer; they don’t need to be detained. The backlogs, prolonged detention and unsanitary conditions we saw under Trump were products of the administration’s own punitive policies. 

Even Dr. Robert Redfield, the former CDC director, recognized the unfounded nature of these public health claims and initially resisted issuing the border directive. Redfield eventually relented under pressure from Trump administration officials who wanted to capitalize on the opportunity to find new ways to close our borders.

Tragically, the “invisible border wall” mounted by Title 42 expulsions has accelerated public health harms and led to the systematic violation of international laws and treaties mandating that countries honor the right to seek asylum. Over the past year, new migrants arriving at the border, including pregnant women, unaccompanied children and other vulnerable individuals have been expelled point-blank without processing, oftentimes forced to return to the dangerous conditions from which they fled. Those who settle along the Mexican side of the border live in crowded shelters or makeshift camps without adequate sanitation, and face high rates of kidnapping, extortion and violent assault. The mental health impacts of these conditions, among a population already at risk of post-traumatic stress disorder, are particularly striking. 

These violations of human rights at the border are an affront to purported U.S. values and undermine our credibility on the international stage. The Biden administration promised to rapidly shift away from harsh, xenophobic policies, but with the misuse of Title 42, we are seeing a continuation of the same. Although unaccompanied children are now, thankfully, being allowed entry and processing following a revision of the CDC order last month, single adults and families are still being categorically excluded. 

It doesn’t have to be this way. Arriving migrants can be COVID-19 screened and tested, processed and either released to stay with family members and close friends in the U.S. (more than 90 percent of the population have these connections), or sent to quarantine in vacant hotels or shelters for the recommended two weeks, as has been done for residents in many U.S. cities. Overall, the processing of families and single adults can happen in an even more streamlined way than for unaccompanied children, since adults do not require a guardian and families traveling together can be kept united. Releasing migrants into the community doesn’t circumvent their legal cases — over 97 percent of asylum seekers reliably follow up for their hearings.

The Biden administration has asked for more time as they work to investigate and undo harmful Trump era policies, reinstate asylum infrastructure and address the backlog of children and asylum seekers waiting for relief, all within the context of an ongoing global pandemic. 

Getting a proper immigration system in place is no small feat, even when there’s no pandemic. But ceasing reliance on false excuses costs nothing and can start immediately. Being honest about the true challenges and the immediate need to reinstate safe processing of all migrants arriving at our land borders could spark a more rapid response, creative solutions and leveraging of government resources and community partnerships.

The CDC border directive is unscientific, harmful and an affront to true public health policy. We can no longer allow this smokescreen to enable the Biden administration to expel migrants under false claims. CDC Director Rochelle Walenksy must rescind this order immediately. Doing so would not only reaffirm her commitment to evidence-based policy, but could expedite the necessary task of the Biden administration to restore asylum  and implement immigration policies that protect  human rights, health, and dignity for all migrants at the border. 

Juliana E. Morris, MD, EdM is a primary care doctor in Chelsea, Massachusetts and a member of the Physicians for Human Rights’ Asylum Network. Dona Kim Murphey MD, PhD, is a physician scientist and director of Medical Initiatives with Project Lifeline. Ranit Mishori, MD, MHS, FAAFP is senior medical advisor at Physicians for Human Rights and professor of Family Medicine at Georgetown University School of Medicine.