“They Don’t Care If We Live or Die”: A Qualitative Analysis Examining the US Immigration System’s Treatment of Undocumented Communities during the COVID-19 Pandemic

Abstract

Historically, the US immigration system (ie, institutions, agencies, and laws) has served the goals and principles of white supremacy through its treatment of globally displaced people and this appears to have continued through the COVID pandemic. Yet, the implications for immigrant health are not routinely addressed in mainstream public health discourse, and especially so in regard to public health disasters. This study conducted a series of focus groups with participants from social justice organizations working with immigrants, migrants, undocumented persons, refugees, persons seeking asylum, and persons detained in immigration jails to collect stories on how the immigration system undermined efforts to control the spread of COVID-19 and exacerbated health inequity within immigrant jails and across related community contexts during the pandemic. Focus groups were conducted to explore issues related to immigrants and immigration detention during the COVID-19 pandemic. There was a total of N=14 participants across the 4 focus groups with a dedicated focus group on perspectives of Black immigrants/from Black immigrant organizations only. Each focus group consisted of 3 to 4 participants. Five key themes emerged: 1) dehumanization of immigrants and migrants and devaluation of their lives; 2) inhumane conditions of confinement that propagate risk of disease; 3) denial of resources for COVID-19 prevention and mitigation; 4) expansion of intersecting oppressive systems; and 5) community-based resistance and mobilization against immigration policies and enforcement. Our findings highlight the harms from policing, criminalization, and exclusion that racialized communities face as a result of the (in)actions within the immigration system during a public health disaster including the COVID context.

Introduction

The US immigration system, and the ways it treats those who have been globally displaced—owing to the impacts of neoliberalism (eg, climate or economic crises) and state-sanctioned violence (such as war and sanctions)—serves white supremacist goals and principles.1,2 This system includes not only laws (ie, Title 42) and institutions (ie, Department of Homeland Security) designed to control, restrict, or monitor immigration, but also the many institutions (eg, educational, health care) and community contexts (eg, schools, neighborhoods) that immigrants interface with. Despite the importance of the US immigration system, extant public health literature does not center the voices and experiences of those disproportionately impacted, both directly and indirectly, by the immigration system, particularly in the context of the COVID-19 pandemic.

The mass criminalization of immigrants has persisted throughout US history via the normalization of racism and the marking of immigrants as “illegal.”3 Resultantly, the United States has the largest immigrant detention system in the world, which not only separates families but also detains children with 1 in 3 detained by Border Patrol being minors.4,5 This is despite the fact that the World Health Organization has stated that international law deems detention only acceptable as a last resort, but never for children.6 The criminalization of migration and surge of immigrant jails coincided with the rise in incarceration rates resulting from the War on Drugs in the 1980s and the War on Terror post 9/11. Policies in the United States have continued to expand the immigrant detention systems, most notably following the 1996 Antiterrorism and Effective Death Penalty Act and the Illegal Immigration and Immigrant Responsibility Act, signed into law by President Clinton, that created a daily minimum of detentions and expanded the terms for deportable offenses requiring mandatory detentions that could be enforced retroactively and deprive people of their right to a due process.5

While many have examined the impact of the immigration system, its historical context within a settler-colonial country, and the long-standing resistance to it, the inequitable reality of the intersecting institutions immigrants navigate and the impact they have on immigrants’ health are not routinely addressed within the dominant public health literature.1,2,7–9 As a result, the many ways in which this system is a long-standing public health crisis remains largely understudied. There is, however, growing evidence documenting multiple forms of harm throughout the system, including those specifically occurring within immigrant jails. These include but are not limited to sexual and physical abuse, extended periods of solitary confinement, medical neglect, sleep deprivation, unsanitary conditions, forced sterilization, and overcrowding.4,10–12 Moreover, adverse impacts are not restricted to those directly impacted by detention, and include psychological, social-emotional, and financial consequences reported by their family and community members.5,13–16 Additional challenges that undocumented immigrants face in the community contexts and that are detrimental to health and well-being include avoiding seeking necessary health care and services for fear of being identified and deported, significant police surveillance, and Immigration and Customs Enforcement (ICE) raids that result in family separations.10,17–21

The barriers to health of the immigration system affect populations differentially. Black immigrants are subjected to distinct vulnerabilities due to intersecting forms of criminalization and racialization. Black immigrants experience disproportionate targeting by racial profiling and discriminatory policing, as they have a higher likelihood of being detained for criminal convictions than the overall immigrant population, resulting in increased incarceration and deportation.22–24 Policies that conflate immigration with criminal activity, including the “Secure Communities” program, the Criminal Alien Program, and the use of mandatory minimum sentences and harsh criminal penalties, all drive the increased targeting, incarceration, and deportation of Black immigrants.23,25 Thus, over 20% of noncitizens facing deportation on criminal grounds before the Executive Office for Immigration Review are Black.23 The disproportionate targeting of Black immigrants by the criminal justice system, combined with discriminatory immigration policies and practices, mirrors the broader trend of racialized state violence in the United States. These norms and actions are all part of the same web of systems implementing immigration and law enforcement policies and practices targeting Muslims, both immigrant and US-born. One manifestation of structural racism in the post 9/11 era is increased harm vis-à-vis physical violence, violations of rights and autonomy, which exacerbate fear and distrust.26,27

The threats to health that immigrant detention and the policing of immigrants present to immigrants and racialized communities have been compounded during the COVID-19 pandemic.28 Just 1 year prior, in 2019, the population in immigrant jails across the country reached the highest rate in history of 55,000 detained on any given day.10 In 2020, a total of 37,000 people were detained across the United States at the midst of the pandemic.29,30 Moreover, in 2020, moratoriums placed a temporary halt to ICE enforcement and removal activities, while public health experts urged the release of immigrant detainees given their heightened risks of contracting the disease.28 However, the agency continued conducting raids on immigrant communities across the country.31 This is in addition to the increasing detentions and displacements that have occurred over the past few decades, including the approximately 3 million people deported during the Obama administration, marking the highest rate of deportation for any presidency and the resurgence of family detention.32,33

The rapid expansion of these trends over the pandemic merits a historical, intersectional, and race-conscious analysis to investigate how racism and “othering” of immigrant communities operate at every stage of the migration process. Collectively, this othering marginalizes, criminalizes, oppresses, and ultimately dehumanizes groups who challenge neoliberal political agenda founded by white supremacy in the United States.34 Particularly relevant to research exploring root causes of the harms of immigration detention is the published literature describing the origins of this system and how it holds captive communities regardless of whether they are physically detained or not.35 This critical framing and macro-level approach to conceptualizing immigration is key to better understanding the problem and is seminal to the framework of this current study. The goal of this study is to fill a glaring gap in the dominant discourse on COVID-19 by examining the myriad of ways in which the immigration system undermined efforts to control the spread of the virus and exacerbated health inequity within immigrant jails and across related community contexts during the pandemic.

Methods

This study is part of a larger qualitative study entitled “Blinded for Review” that addresses the dearth of academic-community partnerships that uplift community voices regarding social injustices occurring during public health disasters. The project conducted focus groups to collect stories about lived experiences of individuals belonging to socially marginalized communities during the COVID-19 pandemic. It explored issues related to immigration and immigrant detention during the COVID-19 pandemic. All study procedures and the conceptual frameworks (eg, Public Health Critical Race Praxis, decolonizing, and Black feminist epistemologies) are discussed in detail elsewhere; therefore we summarize them briefly below.36,37 “Blinded for Review” Institutional Review Board (IRB) approved all study materials and procedures.

Recruitment and Study Procedures

Task Force members and community partners with knowledge of the immigration system and social justice work referred initial individuals and organizations to the research team. From August to October 2020, using purposive snowball sampling, the research team recruited participants from organizations focusing on social justice, working with immigrants, migrants, undocumented persons, refugees, persons seeking asylum, and persons detained in immigration jails. Interested participants were scheduled for a 15-minute prefocus group session with the moderator to address questions, obtain informed consent, review community norms, and discuss Zoom-related logistics. A demographic questionnaire was conducted to collect information about participants, organizations they represent, and the people they serve.

Focus Groups

Focus groups were video and audio recorded by using Zoom-meeting software and conducted in English. One moderator, and 1 assistant moderator who also served as a technology assistant facilitated the focus groups. Both moderators used a semi-structured focus group guide covering multiple domains related to the COVID-19 pandemic affecting immigrants, migrants, refugees, people seeking asylum, and persons in immigration detention. Specifically, participants were asked to discuss the experiences of those they worked with or served during the COVID-19 pandemic, including concerns regarding COVID-19 information, testing, and mitigation strategies, access to health care and health status during the COVID-19 pandemic, and inequities and challenges prior to COVID-19. Video and audio recordings of the focus groups were encrypted and uploaded to IRB-compliant cloud-based storage. Participants received a $75 Amazon gift card as compensation. The participants reported working with(in) multiple systems and sectors because the communities they serve are immigrants and undocumented persons navigating multiple systems/sectors on a regular basis. To capture conversations across expertise and contexts, our focus groups included participants working across and within the academic (eg, health equity researchers), health (eg, case workers and advocates), and legal (eg, lawyers, organizers, and advocates) sectors. A more detailed account of the methodology, including the interview guide, is presented elsewhere.36

Data Analysis

Focus group audio recordings were professionally transcribed verbatim by a transcription service and reviewed by 2 research team members for accuracy. Transcripts were de-identified and uploaded into Dedoose software for analysis. Thematic analysis was used to develop the codes and identify themes.38 The research team re-read and reviewed each transcript and began the process of code generation. Codes were developed iteratively and refined by the research team. Once consensus was reached on the codes, line-by-line code application was done independently by research team members. The team then identified significant themes, revised, honed, and defined the final themes.

A total of 4 focus groups on the topic of immigrant and immigration detention were conducted with a dedicated focus group on perspectives of Black immigrants/from Black immigrant organizations only. There were a total of 14 participants across 4 focus groups. Each focus group consisted of 3 to 4 participants.

Results

Participant quotes are reported verbatim, except when they have been shortened as indicated by the use of ellipses. Table 1 contains short participant profiles including information on their role within the organization they represent and the community each participant serves. To protect their confidentiality, we use a 5-digit participant ID, indicating the focus group they participated in and their participant number (FG#P#). Please refer to Table 1 for a more descriptive profile of each respondent.

Table 1.

Participant information

Participant ID	Self-reported role	Community
FG1P1	Legal services director	AAPI immigrants
FG1P2	Immigrant rights advocate and independent researcher	People in detention
FG1P3	Health insurance program counselor	Immigrant and undocumented populations
FG2P1	Immigrant rights organizer	Immigrant and undocumented populations
FG2P2	Immigrant rights advocate	People seeking asylum and immigrants
FG2P3	Health clinic case worker	Undocumented and uninsured
FG2P4	Researcher and immigrant rights advocate	People in detention
FG3P1	Immigrant rights advocate	Undocumented immigrants
FG3P2	Immigrant rights activist	People in detention
FG3P3	Researcher and immigrant rights advocate	People in detention, people seeking asylum, and migrants
FG4P1	Academic and immigrant rights advocate	Black asylum seekers and Black immigrants
FG4P2	Religious leader and immigrant rights advocate	Black asylum seekers and Black immigrants
FG4P3	Public health organization leadership	Immigrant and refugees
FG4P4	Public health organization leadership	Immigrant and refugees

AAPI, Asian American and/or Pacific Islander

Overview of Themes

Five themes were identified: 1) dehumanization of immigrants and migrants and devaluation of their lives; 2) inhumane conditions of confinement that propagate risk of disease with the subtheme of climate of neglect; 3) denial of resources for COVID-19 prevention and mitigation; 4) expansion of intersecting oppressive systems with the subtheme of ICE taking advantage of COVID-19 to expand their power and exacerbate harm; and 5) community-based resistance and mobilization against immigration policies and enforcement. We explain what each theme means then summarize how they emerged relative to inside immigrant jails versus community contexts.

Dehumanization of Immigrants and Migrants and Devaluation of Their Lives

A prevailing message across all focus group discussions was the disregard for, and devaluation of, lives of people from racialized backgrounds through the (in)actions within the immigration system of the United States. Although the focus group discussion guides were centered on the experiences and needs during the pandemic, all focus group discussions described how these dehumanizing practices and norms were not new but a continuation of an oppressive and racist history in this country. One example of this was the government’s inactions to protect certain communities from the spread and consequences of the virus:

The government response as far as I’m concerned qualifies for crimes against humanity…a context that has been enveloped by the politics of fear, the politics of deception, the politics of division, the politics of dehumanization of people of color…that reflects the DNA of this country, which is absolutely no value for Black and Brown bodies. (FG4P2)

The sentiment of being neglected and lives being devalued was also expressed by persons experiencing detention during the pandemic:

We got a lot of letters that were telling us like, ‘We are disposable to this government’… ‘The government doesn’t care about us. We’re not part of this country’…They’re coming from folks who have lived their entire lives in the US and are feeling a complete sense of abandonment and the sense of ‘they don’t care if we live or die…the government doesn’t see our value as humans. They don’t recognize our common humanity… And they’ll let us die in here without our families and without seeing our families, without even letting our families know where we are. And they don’t care.’ And I think the cruelty and the dehumanizing that happens or that people are sensing—their humanity is being taken from them… (FG2P4)

The fear that the lives of those detained in immigrant jails as disposable to the government was also expressed by family members:

Families outside were in disbelief they felt, ‘Well, doesn’t the government have a responsibility to take care of them?’ And, in fact, they do, and they couldn’t understand why that wasn’t happening…their family members in detention were just an afterthought, not where they’ve been protected and totally disposable. (FG1P2)

The government’s failure to protect peoples’ health and prevent transmission of COVID continued within the community context (ie, not within immigrant jails), including the systematic exclusion of undocumented persons in a range of governmental relief programs and proposed mitigation strategies—“…I’ve seen more frustration with the fact that they [undocumented individuals] feel they’re being left out…more frustration in that they’re not receiving any kind of help from the government.” (FG1P3) Another example of this was the 2020 stimulus checks, which aimed to help people deal with financial challenges during the pandemic, but systematically excluded most undocumented individuals and mixed-status families from benefits39,40:

Lack of resources for undocumented community members… the pandemic has just highlighted how bad it is…. the stimulus money didn’t go to families that have mixed-status homes. It makes sense that mom wouldn’t get the stimulus, but why wouldn’t dad get it? Or the children get it? (FG1P1)

Moreover, the government’s (in) actions that compromised the health and safety among racialized communities had international implications:

So, we [the United States] deport COVID. Every 2 weeks, those planes are going to Haiti. As soon as the one group are taken out of the hotel, the next flight—and I’ve got it documented. I know which days the flights have been going. So, every 2 weeks, we’re deporting COVID as well as the people. (FG2P2)

Participants discussed how the devaluation of lives was facilitated by the criminalization of persons because of their legal statuses. They described how the COVID context exposed how the criminalization of one’s legal status intersects with multiple systems of oppression that ultimately result in reinforcing the notion that the lives of persons belonging to these communities are devalued. “It’s almost a trifecta, if you will, of being stigmatized, and being criminalized, and being marginalized, but most importantly, of being dehumanized, you see, in terms of that.” (FG4P2)

Inhumane Conditions of Confinement That Propagate Risk of Disease

This theme connotes that detained people were disproportionately and distinctly vulnerable to a myriad of adverse health outcomes, including COVID-related risks, given that they were not afforded the same COVID protections as the broader public, and that prepandemic conditions in immigration jails were described as detrimental to health and inhumane. As one participant who works with persons in immigrant jails described, in the jails, things are getting worse:

… we already know that place does not provide medical care. The fact that you’re detained, you’re already stressed. You’re forced to live with strangers. You have lights on 24/7. There, the air you’re breathing is just recycled. The food is horrible…you don’t get the nutrients that you need. Add all of that to the fact that now, we have COVID-19. (FG3P2)

This participant further shared what detained individuals have shared with them including, “When I came here, I wasn’t sick, and I developed all these problems by being here.” (FG3P2)

According to participants in all of the focus groups, neither masks nor possibilities of social distancing were provided within the immigration jails. Furthermore, the facilities engaged in harmful practices including excessive use of chemicals and pesticides for cleaning purposes. One participant explained how people in immigrant jails noticed an increase in nosebleeds as a result of the chemicals being used and how, “…they’re gassing up people with pesticides…you cannot imagine how bad things are.” (FG3P2) However, as another participant explained, despite the inadequate infrastructure, blame was placed on the detainees for the spread of cases:

…You have 50 people to a dorm, social distancing is impossible… then they might ask people to sign a waiver saying that they promise to practice social distancing…so that ICE could demonstrate like, ‘Well, see you promised you would do social distancing.’ So that if they weren’t able to, it’s their fault and not the facility’s fault for setting up an impossible situation. (FG1P2)

Climate of Neglect

All focus group participants expressed that COVID-related needs, including providing tests or treatment if someone was either symptomatic and/or had a positive result, were not being met in immigrant jails. Participants explicitly described this as ongoing forms of neglect. One participant elaborated on conversations with persons in immigrant jails:

I had a conversation with a couple of asylum seekers…They were contracted with the virus. And I was told by their friends, while they were in isolation alone, they were experiencing extreme medical negligence. So, they are not getting the medical support. They’re not getting enough food. They have been discriminated because of, again, their blackness, because of their immigration status. (FG4P1)

If people reported symptoms or a positive test result within the immigrant jails, they were told to “sleep it off” and, at most, provided ibuprofen. This was largely described as a form of neglect, and one that is routine within immigrant jails that evoked a lot of fear. “They’re afraid of dying in detention because they’re not going to get the medical attention they require.” (FG3P2)

The negligence was described as manifesting in several other forms. For example, information was not being provided to people experiencing detention, regarding their COVID status, nor was information being provided to the community members who were inquiring about the health of a detained individual:

It’s not transparent at all and it’s very patchy for us to get information on those individuals…we know for sure that cases are being underreported, and we’re convinced that more people have probably died as a result, and it hasn’t been reported by ICE. (FG1P2)

Ultimately, the fear that was heightened as a result of the neglect they were experiencing resulted in a preference for being deported:

A lot of people are telling us, ‘I just want to get deported. Even if I die in Guatemala or wherever. I’d rather leave than staying here. I’d rather leave now deported than getting back to my family in a box from here’…Detention is meant to break you, and give up and take the deportation, and we try to keep them [those experiencing detention] in good spirits. How do you do that when they say, ‘You say that I’m going to die because of COVID-19. I’m going to die because of the pesticides. Which one is the one, or just medical neglect because I have all these illnesses and I’m not being provided what I need’ (FG3P2)

Denial of Resources for COVID-19 Prevention and Mitigation

This theme refers to multiple structural barriers that impeded certain communities from accessing COVID-related protections either due to being inaccessible because of how protections were being administered or provided, or due to fear of legal repercussions and/or punishment if protections were sought out. The participants shared that both within immigrant jails and community contexts, people generally want to get tested for COVID-19, but that there was reluctance to do so because of punitive implications of testing positive. For example, detained individuals with symptoms and/or testing positive were put in solitary confinement and then restricted from any services and/or programs:

They want to know but they don’t want to be punished for it. But if it means that they might be able to sort of get out, even if it means being deported, they might welcome a test. And solitary confinement cells, I mean, the UN says 15 days in solitary confinement is torture. So being put in there 14—some people actually stayed longer, like 18 days. (FG1P2)

For undocumented individuals in community contexts, there was preference for being tested but testing is largely deemed not accessible as based on location, and/or not affordable when free tests were not available. Moreover, testing sites were primarily located in affluent areas and required drive-ins that are not universally feasible:

While we are grateful for those sites, we were disappointed that even those sites lacked the sensitivity to facilitate access to immigrants in general, especially Black immigrants. Why? Because we use public transportation for the most. And most of these sites or both those sites were only for drivers…I was very disturbed by that. (FG4P2)

Among undocumented individuals in community contexts, there was fear to test because of the potential that had for the legal process. As an immigrant rights advocate explained, this fear of surveillance led to undocumented individuals refusing support/resources, albeit limited: “fear of documentation like people taking their information down and it being in the system, being like, ‘Oh, well, now they have my info and they can find me.’” (FG3P1) Moreover, there was widespread concern that a positive test finding could potentially result in ineligibility for services and/or delay their legal process. There was also fear that a positive test result would lead to their personal and health information being stored and shared, and the worry that health-related information was being collected, stored, and shared was contextualized within the broader experience of undocumented individuals being excessively monitored and surveilled, “Because being undocumented is a constant looking over your shoulder.” (FG3P2)

Expansion of Intersecting Oppressive Systems

There was consensus across the focus groups that the pandemic created opportunities for multiple institutions and agencies within the immigration system to expand their abuse of power, both within immigrant jails and throughout community contexts, to exacerbate harm and undermine health.

Participants in all of the focus groups described how various intersecting institutions and entities (eg, ICE, immigrant jails) abused and expanded their power to detain and deport people and deny services and care. Resultantly, this inflicted further harm to these communities during the pandemic. Participants explained that the neglect and harms communities experienced were all intentional, or in adherence to how the multiple systems they interact with were designed to function:

It’s very clear that the pandemic was a good excuse to give to those that are in power even more, and for those that are not in power to have even less. And in our conversations, we can see families getting really angry at the fact that this is so purposely done. The reaction of this federal government is not any coincidence… It’s purposely done. (FG3P2)

An example of this was the enforcement of policies (eg, Title 42) that shut down legal services to people seeking asylum and created new legal barriers and forms of criminalization in the immigration process:

Everybody’s still crossing…. But that excuse that they’re closing the border is closing the border to asylees or people seeking asylum. …It’s an expedited deportation process. So, they’re not getting any due process…it’s kind of a different way to look at criminalization. So, they’re just not even giving them a chance…They’ve deported citizens. So, they’ve lost all due process just because they look Brown. They may not speak English. (FG2P2)

During these conversations, participants discussed how inevitable and unsurprising it was that the pandemic would be used to inflict further harm inside immigrant jails and to undocumented families and individuals within the community contexts. “These are the people, I mean, who are not only imprisoning our communities but also killing them inside the centers.” (FG4P1)

A fundamental piece of the discussions on how the immigration system, in particular, was expanding power and control over racialized communities was a historical perspective and how these practices were a continuation of strategies to maintain the white supremacist dominance:

What we’re seeing now with these executive orders…from the Department of Justice related to immigration—is that they’re using laws that are some of the initial laws that were first crafted in terms of immigration in this country long ago, going back to the late 1700s, that from the beginning, were always about keeping others out, keeping certain people out…Basically non-Whites out…that’s always been what immigration law is about…These laws still exist to do what they’ve always meant to do, which is to keep this nation White. (FG1P2)

The need to develop a historical perspective was discussed as it lays bare the long-standing connections and parallels across racialized communities:

…It is no secret that the criminalization of Black immigrants is directly connected to the US framework of the dehumanization and the marginalization…I have found that as a Black immigrant, having learned their story, and having learned the story of African Americans, it has helped me to put perspective around what the heck I’m dealing with in this yet-to-be United States of America. I have found—and I think this is very important—that without getting to know and understand the story of the First Nations of this land and the story of African Americans as immigrants in so many cases, that we have a lot of blind spots in really seeing how all of this is connected. (FG4P2)

Another manifestation of long-standing oppressive systems being amplified during the COVID-19 was discussed within the context of anti-Black racism. Participants working with Black immigrant communities underscored that the unique and disproportionate oppression Black immigrants and refugees face have been heightened during the COVID pandemic:

When White America has a cold, African Americans have the flu, and Black immigrants has pneumonia. You see? And that is across all sectors. Human services, criminal justice, the legal field, policy. All of that. And I dare say, including other immigrants. (FG4P2)

Moreover, participants discussed that the distinct experiences and needs of Black immigrants and refugees are less understood and discussed, in general, as well as within the dominant narrative during the pandemic:

Black people, Black immigrants. Yes, we have the highest deportation and incarceration rate. Forget about the criminal justice system. I’m talking about within the immigration system, so the immigration movement. (FG4P1)

ICE Took Advantage of COVID-19 to Expand Their Power and Exacerbate Harm

The expansion of ICE’s role, budget, and harmful practices (within immigrant jails and community contexts) were widely discussed:

I think we also need to talk about the expansion of immigration enforcement like ICE. They increased their budget by more than 100%. They increased the law enforcement agencies around the border, CBP. And they put them in detention for an indefinite period of time now. (FG4P1)

Within the immigrant jails, ICE was denying medical services, for both physical and mental reasons, as well as opportunities to prevent the spread of COVID. There was grave concern that the neglect within these settings was resulting in a rise in deaths within ICE facilities. “We have more deaths right now in ICE custody than last year alone. This is the highest number of people that have died in a single year alone up there all this year.” (FG3P2)

Concern and outrage regarding ICE’s practices were not confined to immigrant jails but also widespread within community contexts. During the pandemic, ICE was not only increasing raids but also expanding who was being detained, which impacts entire households and families. Moreover, during these raids, there was explicit disregard for behaviors that could prevent the transmission of COVID:

They’ve also got new policies about collateral arrest. So, when they would go in, they don’t just take the person who they’re targeting; they take everybody in the household if they get the door open….it just puts so many more people at risk for detention. And so that’s an impact, that’s a COVID impact because they’re just gathering up everybody. And even leaving citizen children abandoned and no care…the ICE guys didn’t have masks and they were going up close… then going over and handling all of the undocumented [individuals] and not having any protection. And so, it was just a giant cesspool of COVID spreading…They’re transmitting COVID. (FG2P2)

Community-Based Resistance and Mobilization against Immigration Policies and Enforcement

The pandemic presented distinct and unprecedented challenges to health and safety. However, similarly to prior contexts in which governmental systems (including the immigration system and others) operated to undermine the well-being of systematically marginalized persons and communities, the oppressive and dehumanizing experiences and conditions during COVID-19 were responded to with resistance by and mobilization of advocates, activists, and community members. Specifically, both within the immigrant jails and community contexts, there was a strong sense of resistance towards the multiple forms of oppression by those impacted by the criminalization of legal status. The shared experience of detention and multiple forms of oppression created a sense of solidarity and support within the immigrant jails:

…a lot of the people in detention… are really great organizers, they come from prisons, so they already survived the criminal justice system. They already survived prison. And so, they end up supporting others that have never been in detention. They have never been in a cage. (FG3P2)

Moreover, the mobilizing has also resulted in mobilizing across groups. “…All the organizations that I work with really has a goal of bridging Black and Brown, but also Black and Black in terms of African Americans and Black immigrants around that.” (FG4P2)

One of the shared goals among those mobilizing within the immigrant jails was resisting the long-standing dehumanization of those experiencing detention as a manifestation of white supremacy. One participant emphasized international solidarity, particularly relating to anti-Black racism:

We as Black immigrants, we ought to organize to humanize because folk can only do what they think they have a right to do to you when you allow them to dehumanize you. The longer I reclaim my humanity had to do that in South Africa because apartheid was a white supremacist strategy of dehumanization of black folk. So when we humanized ourselves, we could say apartheid is a heresy, right? (FG4P2)

Throughout the discussions, all participants explicated that joining the abolition movement is imperative. “We had to really rethink what our priorities were in that moment. And we decided…to participate in the free-them-all groups… we figured this is no more beating around the bush. Abolition is the only option here as an end goal.” (FG2P4)

Discussion

This study is one component of a larger study aiming to uplift the accounts of organizers, activists, and advocates working directly with racialized communities during the pandemic, which have historically been ignored within the dominant public health discourse, and especially in the context of public health disasters. This study explores what professionals and health equity advocates have observed during the 2020 COVID pandemic impacting refugees, undocumented individuals, and other persons residing in immigrant jails. Our findings reveal a myriad of ways the US immigration system has made the COVID-19 pandemic worse for these populations. Instead of approaching the containment and management of COVID-19 as an imperative for all populations vis-à-vis coordinated and systematic efforts on a population and community level, the communities represented in this study were by and large regarded as an afterthought or even worse—disregarded and punished. Participants in all of the focus groups described that these lives are fundamentally devalued by the state. The findings made evident the critical need for a historical perspective as participants highlighted the impact of policies and attitudes that predated the pandemic, and coupled with the pandemic response, served to deepen inequities.

Overall, study participants indicated that the government failed to protect the communities they work in. This resulted from inaction and/or perpetuating long-standing exploitative and harmful practices. For example, beginning in 2020, governments provided some forms of assistance to both curb the spread of the pandemic and assuage collateral consequences of reduced pay and job loss.41 However, many programs (including but not limited to relief checks) explicitly excluded undocumented people despite fear-mongering claims by some politicians that undocumented people would receive these relief checks.42 Exclusion of undocumented individuals from governmental assistance programs is not new; immigration reform implemented in the 1990s barred them from receiving government aid from several social programs and this persisted through the pandemic.43 Moreover, restrictions and/or barriers to obtaining a driver’s license potentially limited people’s ability to access free COVID testing when only provided in a “drive thru” setting, that requires access to both a license and a vehicle.44,45

The findings corroborate other reports of the government continuing to target undocumented immigrants with overtly hostile acts during the first 2 years of the pandemic. During COVID surges, ICE conducted immigration raids around the country, resulting in increase in migrants in detention facilities, deportations, and limited ability for undocumented migrants to shelter in place, and reducing trust in the government.46 All of these consequences amplified the health and non-health impacts of the pandemic both domestically and abroad. For example, deporting people to countries with higher case fatality rates than the United States—and fewer health care resources to deal with severe cases—can spread the disease and send people into a setting that increases their mortality risk.47

Our findings also highlight why it may be difficult to limit harms from the forms of policing and stigmatization that occur in response to a public health disaster. Because global control of the pandemic requires identifying and isolating positive cases through contact tracing, testing, and other surveillance, it requires monitoring people and their movement—all of which increase the vulnerability of undocumented individuals and their social networks for being criminalized and/or deported. Further, in communities that are marginalized and criminalized as a default, seemingly benign recommendations—like social isolation because of a pandemic—may serve to separate undocumented people from limited resources that are available to them via their social connections.

As these findings illustrate, public health agencies may reinforce efforts to control certain populations for the “greater good” of the public’s health.48 This requires making decisions that classify some lives as less valuable and worthy of life. These decisions are made within racialized societies in which the White, cisgender, heterosexual individual is deemed worthy of protection, with socially marginalized and racialized groups of people seen as “threats.” The process of turning people into “threats” involves groups of people whose identities are reduced to race- or class-based stereotypes, as often seen in response to emerging and infectious diseases.49–53 Through this process, the racialized “other” becomes the threat to public health.49–51 One example of this logic during the COVID-19 pandemic was the decision to invoke section 265 of Title 42, which grants the US government the ability to deny immigration when “there is serious danger of the introduction of [a communicable] disease into the United States.”54 Over 1.8 million expulsions were carried out under Title 42 between March and April 2022, despite calls from public health experts to revoke Title 42.55 Rather than focusing efforts on mitigating the spread of COVID-19, Title 42 shifts blame onto the “other,” or the immigrant, and advances political agendas of immigration control.56

Limitations

This study sample was composed of individuals working in, or with, organizations serving individuals and/or families directly impacted by the immigration system, and particularly those in immigrant jails, but not the persons who had been detained in immigrant jails during the pandemic themselves. In addition, the study did not capture the stories, experiences, and perspectives of non–English-speaking populations, and it is possible that some potential participants were not able to join given other demands of their time and/or their precarious conditions during the pandemic, but it did include the perspectives of those who work directly with them. While the results do not encompass all issues related to immigration and detention during the pandemic, the focus groups did allow for questions and topics to be raised by the participants that they prioritized. Although the findings are not generalizable, the Zoom format allowed for the recruitment and participation of people who work closely with populations we would not have otherwise reached, especially during a pandemic, across the country. Additionally, owing to University constraints, only a $75 Amazon gift card was made available to participants as remuneration for their participation. Some potential participants declined the invitation given Amazon is linked to ICE and deportations.57,58

Conclusion

To imagine, and fight for, a more just world for persons targeted by the immigration system and those globally displaced, the actions of government actors such as the police and ICE during a pandemic should be understood as historical continuations of inequitable intersecting systems (including the immigration system and other contexts throughout communities) and processes in need of dismantling.

In the context of the US immigration system, the injustices associated with immigration and forced migration are a continuation of a history during which those migrating are criminalized for a myriad of reasons. They are criminalized for having migrated (versus blaming the structural factors that resulted in their migration), and in the context of this pandemic they have been criminalized for being a reservoir of disease (versus the global conditions facilitating the emergence of novel infectious diseases) or marked as not needing protecting from infection or worthy of care.50,59 The continuation of this behavior, which has been seen in other pandemics, indicates that not much has been truly transformed during this latest one.

Racialization and dehumanization are facilitated by and reinforced through the political contexts out of which decisions for disease prevention and mitigation are managed. We are repeatedly seeing these processes at play during pandemics, where undocumented persons are viewed as expendable in the course of the pandemic, and are outright treated as culpable for spreading the virus. In all, a pandemic response that would have treated all people, irrespective of immigration status, as worthy of humanity and protection, would have produced not only a more humane pandemic response, but also a more effective one—because, fundamentally, a global pandemic will not be curbed when we marginalize or ignore the needs of some. The essential and vital interests of public health have historically been used to dehumanize, stigmatize, criminalize, and racialize groups of people; and COVID-19 has proven to continue this legacy, both domestically and on the international level. Thus, we ask of our colleagues as we continue to build in the movement for health equity, did the COVID-19 pandemic derail the agenda of white supremacy or create opportunities to advance it?