Abstract
This cohort study describes the burden of coronavirus disease 2019 among people detained by US Immigration and Customs Enforcement compared with the US population.
Introduction
The US is facing a humanitarian crisis as tens of thousands of people are held in detention centers under Immigration and Customs Enforcement (ICE). Practices undertaken by ICE, such as detainment, deportation, and searches, adversely affect the physical and mental health of those who are undocumented.1 Immigration and Customs Enforcement facilities have been characterized as unsanitary, unsafe, and inhumane by a recent whistleblower.2 Home to moldy, uncleaned bathrooms and limited personal hygiene supplies and medical services, facilities pose health risks to people even beyond the context of a global pandemic.3 Human rights advocates have called for the release of people detained and the suspension of deportation flights.4 Thus far, ongoing deportation flights have led to documented spread of coronavirus disease 2019 (COVID-19) in more than 11 countries.5 Herein, we describe the COVID-19 burden among people detained by ICE compared with the US population.
Methods
Data concerning ICE and COVID-19 for this cohort study were obtained from the COVID Prison Project from May 5 to September 15, 2020, with the ICE mean daily population (MDP) serving as the denominator. General population COVID-19 data were obtained from The New York Times, with denominator data from the American Community Survey (eMethods in the Supplement). We used publicly available data and were exempted from institutional review board approval and informed consent by University of North Carolina at Chapel Hill. We followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guidelines.
We used baseline facility MDP to calculate cumulative case rates per 1000 persons detained by ICE over time and compared this with cumulative case rates in the general population. We also used ICE testing and case data to calculate the percentage tested and test positivity rate (percentage of tests returned with positive results). For county-level comparisons, we used year-to-date MDP from September 12, 2020, to calculate cumulative and current case rates for ICE designated facilities. County cumulative case rates in the general population were also calculated. Risk ratios compared cumulative case rates in facilities and the corresponding county. Analysis was performed using STATA, version 15 (StataCorp LLC) and Excel (Microsoft Corporation).
Results
One hundred sixty-seven facilities housed people detained by ICE, most of which were facilities that primarily housed non-ICE detainees (eg, county jails). Immigration and Customs Enforcement reported at least 1 COVID-19 case in 96 facilities. Using baseline MDP, the overall September 15 cumulative case rate was 214 per 1000 people (5810 cases among 27 189 people); ICE reported 6 deaths. There were 28 designated ICE facilities that exclusively housed people detained by ICE, including 4 family residential centers.
As testing rates reported by ICE increased, case rates increased, and test positivity rates decreased (Figure). However, the increase in case rates among people detained by ICE has outpaced the growth in the US population. The cumulative case rate in the 28 ICE-designated facilities varied from 0 per 1000 to 1050 per 1000 at Webb County Detention Center in Texas (Table). The risk ratio was greater than 1 in 20 of 28 facilities.
Figure. Testing for and Cases of Coronavirus Disease 2019 in Immigration and Customs Enforcement (ICE) Facilities.
Table. COVID-19 Case Rates in Designated ICE Facilities Compared With County Case Rates Per 1000 as of September 15, 2020.
| Facility name, state abbreviation (population) | County name (population) | ICE designationa | ICE cumulative case rate | County cumulative case rate | RR for cumulative case rates (95% CI) | ICE current case rateb | |||
|---|---|---|---|---|---|---|---|---|---|
| No. of cases | Rate (95% CI) | No. of cases | Rate (95% CI) | No. of cases | Rate (95% CI) | ||||
| Adams County Detention Center, Mississippi (908) | Adams (30 693) | DIGSA | 78 | 86 (68-104) | 877 | 29 (27-30) | 3.01 (2.41-3.75) | 14 | 15 (7-23) |
| Adelanto ICE Processing Center, California (1330) | San Bernardino (2 180 085) | DIGSA | 14 | 11 (5-16) | 50 978 | 23 (23-24) | 0.45 (0.27-0.76) | 1 | 1 (0-2) |
| Berks County Family Shelter, Pennsylvania (37) | Berks (421 164) | FRC | 0 | 0 | 6641 | 16 (15-16) | 0 | 0 | 0 |
| Buffalo (Batavia) Service Processing Center, New York (374) | Genesee (57 280) | SPC | 49 | 131 (97-165) | 307 | 5 (5-6) | 24.44 (18.40-32.47) | 0 | 0 |
| Caroline Detention Facility, Virginia (230) | Caroline (30 725) | DIGSA | 7 | 30 (8-53) | 299 | 10 (9-11) | 3.13 (1.49-6.54) | 2 | 9 (0-21) |
| El Paso Service Processing Center, Texas (534) | El Paso (839 238) | SPC | 190 | 356 (315-396) | 21 826 | 26 (26-26) | 13.68 (12.20-15.35) | 5 | 9 (1-18) |
| Elroy Federal Contract Facility, Arizona (1036) | Pinal (462 789) | DIGSA | 250 | 241 (215-267) | 10 198 | 22 (22-22) | 10.95 (9.81-12.22) | 1 | 1 (0-3) |
| Florence Service Processing Center, Arizona (274)c | Pinal (462 789) | SPC | 0 | 0 | 10 198 | 22 (22-22) | 0 | 0 | 0 |
| Folkston IPC (Main), Georgia (202)d | Charlton (13 392) | DIGSA | 67 | 332 (267-397) | 599 | 45 (41-48) | 7.42 (6.01-9.16) | 18 | 89 (50-128) |
| Immigration Centers of American Farmville, Virginia (507) | Prince Edward (22 802) | DIGSA | 339 | 669 (628-710) | 541 | 24 (22-26) | 28.18 (25.41-31.25) | 0 | 0 |
| Jackson Parish Correctional Center, Louisiana (623) | Jackson (15 744) | DIGSA | 73 | 117 (92-142) | 586 | 37 (34-40) | 3.15 (2.50-3.96) | 67 | 108 (83-132) |
| Karnes County Residential Center, Texas (218) | Karnes (15 601) | FRC | 79 | 362 (299-426) | 753 | 48 (45-52) | 7.51 (6.21-9.07) | 0 | 0 |
| Krome North Service Processing Center, Florida (542) | Miami-Dade (2 716 940) | SPC | 182 | 336 (296-376) | 164 687 | 61 (60-61) | 5.54 (4.92-6.24) | 2 | 4 (0-9) |
| La Palma Correctional Center, Arizona (1004) | Pinal (462 789) | DIGSA | 366 | 365 (335-394) | 10 198 | 22 (22-22) | 16.54 (15.21-17.99) | 11 | 11 (5-17) |
| Laredo Processing Center, Texas (202) | Webb (276 652) | DIGSA | 6 | 30 (6-53) | 12 733 | 46 (45-47) | 0.65 (0.29-1.42) | 5 | 25 (3-46) |
| LaSalle ICE Processing Center–Jenna, Louisiana (977) | LaSalle (7520) | DIGSA | 29 | 30 (19-40) | 415 | 55 (50-60) | 0.54 (0.37-0.78) | 2 | 2 (0-5) |
| Otero County Processing Center, New Mexico (646) | Dona Ana (218 195) | DIGSA | 152 | 235 (203-268) | 3049 | 14 (13-14) | 16.84 (14.59-19.44) | 2 | 3 (0-7) |
| Pine Prairie ICE Detention Facility, Louisiana (523) | Evangeline (33 395) | DIGSA | 65 | 124 (96-153) | 1270 | 38 (36-40) | 3.27 (2.59-4.13) | 0 | 0 |
| Port Isabel, Texas (708) | Cameron (423 163) | SPC | 145 | 205 (175-235) | 22 222 | 53 (52-53) | 3.90 (3.37-4.51) | 3 | 4 (0-9) |
| Prairieland Detention Facility, Texas (493) | Johnson (175 817) | DIGSA | 88 | 178 (145-212) | 2699 | 15 (15-16) | 11.63 (9.59-14.10) | 16 | 32 (17-48) |
| Richwood Correctional Center, Louisiana (507) | Ouachita (153 279) | DIGSA | 110 | 217 (181-253) | 5896 | 38 (38-39) | 5.64 (4.77-6.67) | 37 | 73 (50-96) |
| River Correctional Center, Louisiana (294) | Concordia (19 259) | DIGSA | 22 | 75 (45-105) | 497 | 26 (24-28) | 2.90 (1.92-4.37) | 9 | 31 (11-50) |
| South Louisiana Detention Center, Louisiana (433) | Iberville (32 511) | DIGSA | 3 | 7 (0-15) | 1391 | 43 (41-45) | 0.16 (0.05-0.50) | 0 | 0 |
| South Texas Family Residential Center, Texas (770) | Frio (20 306) | FRC | 4 | 5 (0-10) | 666 | 33 (30-35) | 0.16 (0.06-0.42) | 0 | 0 |
| Stewart Detention Center, Georgia (1381) | Stewart (6621) | DIGSA | 338 | 245 (222-267) | 414 | 63 (57-68) | 3.91 (3.43-4.46) | 26 | 19 (12-26) |
| T. Don Hutto Residential Center, Texas (293) | Williamson (590 551) | FRC | 0 | 0 | 8446 | 14 (14-15) | 0.00 (0.00-0.00) | 0 | 0 |
| Webb County Detention Center, Texas (80) | Webb (276 652) | DIGSA | 84 | 1050 (1028-1072) | 12 733 | 46 (45-47) | 22.81 (22.43-23.20) | 0 | 0 |
| Winn Correctional Center, Louisiana (1040) | Winn (13 904) | DIGSA | 202 | 194 (170-218) | 598 | 43 (40-46) | 4.52 (3.90-5.23) | 36 | 35 (24-46) |
Abbreviations: DIGSA, Dedicated Intergovernmental Service Agreement; FRC, Family Residential Center; ICE, Immigration and Customs Enforcement; RR, risk ratio; SPC, Service Processing Center.
DIGSA is a publicly owned facility operated by state/local government(s) or private contractors in which ICE contracts to use all bed space or facilities that house only ICE detainees. FRC is a facility that accommodates and cares for family units who remain together while awaiting their proceedings, and SPC is a facility owned by the government.
Current Cases: COVID-19 positive cases currently in custody under isolation or monitoring.
This facility is separate from Florence Correctional Center. The Florence Correctional Complex serves a number of government agencies. There are reported COVID-19 cases among ICE detainees at this facility.
There is a separate annex facility at this location, which is excluded from the population denominator.
Discussion
Cumulative case rates among people detained by ICE are higher than those of the US population and dwarf those of surrounding communities. However, this study has limitations. This analysis depends on ICE reporting; thus, cases may actually be higher.6 With a mean stay of 38 days, it is difficult to assess mortality and testing rates given high population churn. We report crude rates because age data for ICE detainees are not available. It is likely that the age structure is younger than that of the general population. Facility staff were excluded. There are potential differences in facility responses to COVID-19 (https://www.freedomforimmigrants.org/map). Ultimately, it is imperative that expeditious action is taken to protect people housed in ICE detention facilities from COVID-19 by reducing the number of people detained and terminating raids, transfers, and deportation flights.
eMethods. Data Description and Sources
References
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- 5.International Rescue Committee COVID-19 escalating in ICE detention centers as states hit highest daily records—and ICE deportation flights into Northern Triangle continue. August 3, 2020. Accessed September 3, 2020. https://www.rescue.org/press-release/covid-19-escalating-ice-detention-centers-states-hit-highest-daily-records-and-ice
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
eMethods. Data Description and Sources