A Tale of Two Crises: The Compounded Effect of COVID-19 and Anti-Immigration Policy in the United States

Abstract

The COVID-19 pandemic is highlighting some important sources of health disparities that assail our society’s most vulnerable people, particularly undocumented immigrants and asylum seekers. The focus of this commentary is on uncovering those sources of health disparities and making a call for action.

Editor’s Note.

This commentary received rapid review due to the time-sensitive nature of the content. It was reviewed by the journal editor.—KKT

The COVID-19 pandemic has affected millions, causing disproportionate health and economic effects (Centers for Disease Control and Prevention [CDC], 2020a; Congressional Research Service, 2020). Reports have uncovered significant disparities in the impact of COVID-19, with undocumented immigrants being an at-risk group often unaccounted for. These immigrants may be at a particularly treacherous crossroad with increased risk compared to the general population, coupled with lower likelihood of access to health care (League of United Latin American Citizens [LULAC], 2020).

Polarized views on undocumented immigration, fears of “invasion,” threats of competition for jobs and resources, harsh rhetoric, inaccurate and misleading information, and a poor understanding of the harmful causes that force people to immigrate are among the factors propelling an anti-immigrant climate in the United States. The COVID-19 pandemic presents as another reason for stigmatizing undocumented immigrants as a public health hazard (Trump, 2020). This pandemic has exposed the irony inherent in these negative attitudes, given that many undocumented immigrants are deemed essential, performing jobs that are keeping the U.S. economy afloat (Labor Council for Latin American Advancement & El Comité Mijente, 2020). Despite their invaluable service, these immigrants are excluded from receiving benefits, including from the Coronavirus Aid, Relief, and Economic Security Act (U.S. Department of the Treasury, 2020).

Since the pandemic outbreak in the United States, there has been an increase in anti-immigrant actions and policies that are placing a large number of undocumented immigrants and asylum seekers at greater risk. For instance, there has been a surge in deportations of anyone detained at border stations without regard to a fair migratory process and in violation of established migratory agreements (Miroff, 2020; Perez, 2020). On March 20, 2020, the Trump administration disseminated a rule and accompanying government order to immediately turn back asylum seekers without affording them a legal process, citing rapid transmission of COVID-19 (CDC, 2020c). This caused a temporary closure of the U.S.-Mexican border and suspension of court hearings for asylum seekers already awaiting hearings. The “Remain in Mexico” policy, which took effect in March 2019 (Liptak & Kanno-Youngs, 2020), has resulted in sending tens of thousands of people seeking refuge to some of the most dangerous parts of Mexico, where they are living in unsafe, unsanitary, and inhumane conditions in open-air encampments and shelters that endanger their health and safety.

Another group of immigrants at risk are those held at Immigration and Customs Enforcement (ICE) detention facilities, where there is also a history of infectious disease outbreaks (Gomez et al., 2020), putting both detainees and staff at risk. Social distancing is difficult to implement because immigrants are held in close proximity. Poor sanitation and hygiene are additional risk factors prevalent in these settings, which are known to be major contributors to transmission (Potter, 2019). Likewise, the scarcity of personal protective equipment can contribute to the rapid spread in detention facilities. In fact, the U.S. and Mexican governments have no crisis or prevention plan for communicable disease in open-air tent encampments, relying instead on international nonprofit organizations with limited resources. Another important factor is that many of these immigrants may have compromised immune systems due to malnourishment, chronic stress from trauma, harsh living conditions, and limited access to health services (LULAC, 2020). Individuals with compromised immune systems have been identified as most at risk, not only for contracting COVID-19 but also for experiencing severe complications from the disease, including death (CDC, 2020b).

In addition to the aforesaid health threats, the consequences of the pandemic on these immigrants’ mental health are also likely to be devastating. Many have a severe history of trauma and high distress associated with the immigration process (Garcini et al., 2017) and detention (von Werthern et al., 2018). The rates of trauma among recently arrived immigrants from Central America is alarming, far exceeding clinical cutoff scores for posttraumatic stress disorder (PTSD; Mercado, Venta, Henderson, & Pimentel, 2019; Venta & Mercado, 2019). Exposure to stress over time can negatively impact the functioning of stress reactivity systems (Chaby, Zhang, & Liberzon, 2017), which in turn increases risk for physical and mental illnesses, including depression and PTSD (Mercado et al., 2019). The compounded stress from a life history of trauma along with stress from the pandemic under hazardous living conditions and with limited access to health services and resources can significantly increase trauma-related distress among these immigrants (Keller & Wagner, 2020). Uncertainty associated with their legal process and the possibility of deportation to the places that they fled from may lead to retraumatization and its associated negative health effects (Green, 2019). Similarly, for immigrants who have been separated from their families as a result of deportation, having to face this pandemic away from their loved ones may have a lasting detrimental impact on their mental health (Miller, Hess, Bybee, & Goodkind, 2018; Rojas-Flores, Clements, Hwang Koo, & London, 2017).

Efforts to protect the health of detainees, deportees, and immigrants living in tent encampments and shelters near the U.S.-Mexican border have fallen short. As the pandemic evolves, the risk for serious health hazards and diminished mental health among these at-risk immigrants increases rapidly; thus, the need for a rapid proactive response aimed at mitigating risk. As part of this response, the National Latinx Psychological Association (NLPA) released an immigration and COVID-19 statement urging the “immediate release of individuals detained in ICE facilities,” while calling upon the U.S. administration to “uphold refugee laws and treaties,” which include “preserving the right to seek asylum and protecting public health through non-discriminatory screening and self-isolation measures that avoid detention” (e.g., reunification with family in the United States; NLPA, 2020). Additional immediate measures needed include the distribution of personal protective equipment, sanitation and implementation of social distancing practices at at-risk sites, distribution of health information that is easy to understand and in Spanish, and access to screening and health services delivered via nontraditional sources of service delivery (e.g., nonprofit organizations). Also, to avoid retraumatization of these immigrants it is important to stop their deportation to the places from which they fled or to places where crime and danger may be rampant.

The COVID-19 pandemic appears at a time of high political debate, an anti-immigrant climate in the United States, and a humanitarian crisis that is pushing thousands of people to flee their home countries in search for safety. The combined stress of having to face this pandemic with limited resources, compounded by hazardous living conditions and a threat to safety, can seriously compromise the physical and mental health of these immigrants. This is a tale of compounded crises with detrimental effects on the health of the most vulnerable. Immediate action to ameliorate harm must be taken so that history remembers this challenging time as a turning point to stand in the defense of human rights. If not, future generations will look upon this time with great regret and embarrassment.