For three days last week, physicians from around the country led demonstrations and a vigil outside of Customs Patrol and Border Protection (CBP) facilities in the San Diego area. After receiving no response to their repeated offers to the departments of Health and Human Services and Homeland Security to provide free flu vaccinations to immigrants in custody, the physicians (and a few NPs) had come to the border with donated influenza vaccine to press for a pilot vaccination program. CBP officials finally said they would pass the request up their chain of command.
Preventable deaths, plus a matter of the larger public health.
Three migrant children died in CBP detention centers during last year’s flu season. The last hours of 16-year-old Carlos Gregorio Hernandez Vasquez, who died in May of influenza, were documented on a grim surveillance camera video that recently circulated widely on the Internet. But the issue of influenza vaccination for migrants is not “merely” one of such preventable deaths; it is a public health issue. This year’s flu season has ramped up in recent weeks, and a “window of opportunity” for vaccinating this vulnerable population is closing.
The CDC recommends that everyone six months of age and older receive influenza vaccination each year. Vaccines for flu and other communicable diseases are available at longer-term detention facilities run by Immigration and Customs Enforcement, but not at short-term border detention centers. There, children are supposed to spend less than 72 hours in the facilities before transferring to an ICF facility, and that is one reason given by CPB for not vaccinating. But conditions at the short-term detention centers are ideal for the spread of infection, and influenza virus can be contracted after very brief exposures.
Physicians from the American Academy of Pediatrics have visited detention centers near the border, and their reports describe cold rooms, lights kept on 24 hours a day, floor mats inside metal cages for sleeping, and the pervading smell of urine, feces, and perspiration. News stories from other sources have described suboptimal nutrition. The stress of living under these conditions, often separated from family, can suppress immunity and make infection more likely.
The public health problem, of course, is that influenza virus, once introduced, doesn’t limit itself to those in the immediate environment. Influenza can be transmitted for about 24 hours before symptom onset, so staff at the facility can’t protect themselves by avoiding kids who look sick. Infected staff will then take the virus home to their own household and communities.
Lessons of the 1918 influenza pandemic.
It’s interesting to note that the 1918 influenza pandemic appears to have begun in the barracks at Camp Funston in Fort Riley, Kansas, when more than 100 soldiers developed flu-like illness in March of 1918. Crowded conditions in one shared airspace ensured the rapid transmission of the virus.
Even if this year doesn’t present us with a new, mutated virus that will spread around the globe, crowded and dirty conditions at any location will help to ensure the spread of influenza. Public health authorities stress the particular need for vaccinating people who live in group housing of any kind, including dormitories, nursing homes, military barracks, and prisons. Shouldn’t we also, for everyone’s sake, ensure that vulnerable migrants being held in federal detention centers be protected as well?
The key issue here is the inhumane treatment of not only legal asylum seekers, but the brutal, emotionally and physically damaging policy of separation of children from their parents in addition to the unhealthy conditions. For whatever reasons these people are here, there is no excuse to force parents and children to live in unsafe and unhealthy accommodations and deny them basic healthcare such as vaccines.
By order of the Administration in Washington, children in the immigration process at the Homestead, Florida detention center, were deprived of the already-provided recreational equipment, educational classes and legal advisers. Literally basketballs, soccer balls, and anything recreational or educational was discontinued and the the Miami-Dade contracted teachers were barred from the premises. Children were expected to sit in their cells and have no stimulation, including being disciplined for any physical contact with another child such as a hug. That is cruel and unusual punishment for a child. These services were being provided as the children moved through the facility and months of processing. When protests including members of Congress brought the press, the children were transferred out to places unknown. Shame on all of us, especially nurses, for allowing this to continue.
https://thehill.com/opinion/immigration/449970-cuts-to-recreation-violate-detained-immigrant-childrens-human-rights