ICE is guilty of unsafe practices in detention centers causing COVID-19 to spread 

When news of the courageous whistleblower Dawn Wooten broke, I was horrified but sadly not surprised as a physician working in Georgia and evaluating individuals in immigration detention, medical mismanagement, neglect, and abuse seems to be the operating norm at Georgia Detention Facilities. Conditions were abysmal before the pandemic. But as COVID-19 emerged, conditions progressed from awful to unimaginable.  

After conducting several telephonic evaluations and reviewing 20+ medical records of individuals detained, it became clear that poor medical care was being provided without adequate oversight or accountability in these facilities. As exposed by Nurse Wooten, the failure to comply with COVID-19 mandates is the standard of care. Our reviews have corroborated the following: 

• Failure to test individuals with symptoms

• Failure to test individuals who request testing

• Failure to provide accurate information about COVID-19

• Failure to retest individuals with symptoms who test negative

• Failure to isolate individuals with classic signs and symptoms of COVID-19 who test negative

• Failure to release individuals at risk (resulting in the death of more than one individual

• Failure to release individuals at risk due to age and/or comorbidities, despite urging of medical professionals

• Failure to appropriately monitor patients with COVID-19

• Use of solitary confinement for medical isolation, a dangerous practice which research has shown worsens physical and mental health outcomes

• Continuation of interfacility transfers between states and across states despite possible exposure to the virus

• Failure to appropriately and accurately report disease prevalence, conduct contact tracing or report timely and adequate public data 

When medical professionals have advocated for safe release from immigration detention based on public health evidence, ICE has stonewalled, stating that they are appropriately following CDC guidelines. But they are not. ICE continues to ignore the valid and critical suggestions of medical and public health experts in Georgia. 

My first visit to Stewart Detention Center pre-COVID-19 was challenging. I was struck by the impact of the facility on the community. The detention and mass incarceration complex provides much-needed jobs to many individuals in nearby cities, many of which are struggling cities in rural Georgia. The U.S. government has an obligation to provide adequate medical care and conditions for those in its custody. Still, detention facilities have a large impact on their local communities as well. Although I fear for the health of people who are detained, I am also concerned about detention facility staff who may be exposed to the virus while lacking adequate PPE or protections for their job security if they speak out, as well as their moral distress as clinicians who see detainees being treated inhumanely. I am in awe of Dawn Wooten and her courage to speak out. I cannot imagine it was easy. I hope it sparks a chain of further employees to follow suit. Still, most of all, I hope that it results in desperately needed oversight and accountability of ICE’s dangerous detention practices.

Moving forward, we need a permanent solution that doesn’t depend on an agency’s whims. DHS has detained people for decades without legally binding standards on detention conditions and laws that give ICE discretion to detain asylum seekers and other immigrants indefinitely. We must ensure that DHS has legally binding laws from Congress about detention standards and criteria for release from detention. This is critical considering what COVID-19 has done to our populations detained, and the expanding list of unknowns about COVID-19, including the raging mental health crisis looming of those who are detained. Detention alone is an obvious driving factor for new and exacerbation of existing mental health conditions. With increased lockdowns, decreased visits from family, friends, and legal representatives, “medical isolation,” and anxieties about contracting COVID-19 while detained, social isolation is beyond a dangerous level.  

ICE must comply with mandatory CDC rules and guidelines regarding COVID-19, and most of all, release as many people as possible from immigrant detention, including by releasing people already in detention and halting enforcement unless it is connected with an urgent public safety reason. Congress must exercise oversight for these horrendous practices and hold ICE accountable, permanently, by codifying the immigration detention standards as law and by requiring ICE to release detainees. This will help all of our communities be healthier and more secure, whether we’re experiencing an infectious disease outbreak or not. 

With an expanding list of examples of medical mismanagement, abuse, and neglect, I have to wonder what other atrocities are occurring in not only Georgia detention facilities, but detention facilities all over the country. Our first-hand review of cases, and recent allegations, might be just a few examples of what we know. Waiting for more whistleblowers cannot be our only option. The urgency in action and accountability is paramount. 

Amy Zeidan is an assistant professor of Emergency Medicine at Emory University. She works as an ER physician at Grady Memorial Hospital and co-directors The Human Rights Clinic.