COVID-19 in ICE Facilities Could Overwhelm Local ICUs

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MAY 09, 2020 — Immigration and Customs Enforcement (ICE) reported the first death from COVID-19 among detainees at US facilities this week at a southern California facility. Another 133 detainees and 10 staff at the facility also have confirmed COVID-19. Experts fear local hospitals could soon be overwhelmed.

It may already be too late, according to an April 28 letter from officials at Scripps Health and Sharp HealthCare, both in San Diego, California, to Secretary of Health and Human Services Alex Azar and Acting Secretary of Homeland Security Chad F. Wolf.

High numbers of border crossings, the large outbreak in the ICE facility, and inadequate healthcare conditions just south of the California-Mexico border are all making the situation particularly urgent there, they explain.

Cases in the region are increasing quickly, and the two health systems are together caring for more than 60% of the region’s patients with COVID-19, write Chris D. Van Gorder, FACHE, president and chief executive officer of Scripps Health, and Daniel L. Gross, executive consultant with Sharp HealthCare COVID‐19 Strategic Response.

The Otay Mesa Detention Center, located near the border and not far from the two hospitals, this week reported the death of 57-year-old Carlos Ernesto Escobar Mejia. The facility is considered the virus’ epicenter with respect to immigrant detention, with 139 cases as of May 8, but cases in similar facilities appear to be widespread. Nationwide, ICE facilities have reported 788 confirmed cases among detainees in 41 ICE detention facilities.

In addition, 42 employees working at 15 ICE detention facilities have confirmed COVID-19, as do another 102 ICE employees who are not assigned to detention facilities (as of May 7). Although ICE is not required to report cases among employees of private prison companies working in detention facilities, the Associated Press reported last week that two guards died after contracting COVID-19 while working at an ICE facility in Louisiana.

Van Gorder and Gross are asking the US Centers for Disease Control and Prevention and US Customs and Border Protection to conduct medical checks — including at least body temperature checks — at the border and to quarantine those with suspected COVID-19. They also urge the federal government to pressure Mexico to implement “social-distancing and shelter-in-place policies” similar to those in the United States.


Nearby Hospitals Likely to Be Overwhelmed, Study Shows

Results from a recent modeling study suggest that Van Gorder and Gross are right to be worried. The model predicts that intensive care units (ICUs) in more than half of hospitals within 10 miles of an ICE detention facility would be overwhelmed by day 90 in the event of a COVID-19 outbreak. Expanding that radius to 50 miles lessens the risks, but 8% of hospitals would still be unable to meet the need for ICU beds, the study authors warn.

“As COVID-19 continues to spread in communities, and inevitably into the nation’s detention centers, it is critical that we understand the U.S. healthcare system’s capacity to care for a large influx of patients who require critical care,” write Daniel Coombs, PhD, MSc, of the Department of Mathematics and Institute of Applied Mathematics at the University of British Columbia, Canada, and colleagues. The researchers published the results of their modeling study April 28 in the Journal of Urban Health.

Coombs and colleagues used ICE detainee population data available on the ICE Enforcement and Removal Operations website as of March 2 of this year, to estimate the COVID-19 transmission rate within 111 ICE detention facilities and studied the effects on regional ICU capacity. Their model considered multiple transmission rates (basic reproduction numbers [R0s] of 2.5, 3.5, and 7), outbreak duration (30, 60, and 90 days), and number of detainees in the facility (

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