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November 04, 2020
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COVID-19 case rates among ICE detainees 13 times higher than US average

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COVID-19 rates at U.S. Immigration and Customs Enforcement detention centers increased each month from April to August and were on average more than 13 times higher than the U.S. average, researchers reported in JAMA.

The increases among detainees could not be fully explained by an increase in testing, the researchers said.

Katherine Peeler infographic

“Further mitigation efforts are needed to prevent COVID-19 spread within ICE detention centers,” Katherine R. Peeler, MD, attending physician in the division of medical critical care at Boston Children's Hospital and instructor of pediatrics at Harvard Medical School, told Healio. “Strategies that have proven effective in other congregate facilities, such as mass asymptomatic testing and changes in dormitory-style housing, should be considered.”

Peeler and colleagues examined COVID-19 test results, confirmed cases and COVID-related deaths between April 1 and Aug. 31 via ICE’s website. They calculated monthly case and test rates per 100,000 persons using average ICE population rates. For comparison, they also calculated corresponding monthly rates for the U.S. population for each month analyzed. Test positivity rates were defined as the number of reported cases divided by reported tests.

In August, ICE’s average daily detained population (21,591) dropped 45% compared with February’s population (39,319), according to Peeler and colleagues. By Aug. 31, ICE reported 5,379 COVID-19 cases, including six deaths, among detainees, with cases occurring in 92 of 135 facilities.

The monthly case rate per 100,000 rose from 1,527 in April to 6,683 in August, with the monthly test rate per 100,000 detainees increasing from 3,224 in April to 46,874 in July. The rate of positive tests dropped between April (47%) and July (11%) but then increased in August (18%).

The researchers also found that case rates on average were more than 13 times greater in ICE facilities than those across the United States — an increase of 1,354% between April and July — and testing rates were 4.6 times higher, with an increase of 247% during the same time period.

“This is incredibly concerning,” Peeler said. “We are failing to protect this vulnerable population.”

Peeler said that the available data “represent an incomplete picture” of ICE facility COVID-19 cases, and that the analysis did not include case or test data for ICE facility staff.

“ICE should collect and report COVID-19 data on all staff working at its detention centers — regardless of employer — as staff may be vectors for COVID-19 spread inside detention facilities,” Peeler said. “In addition, the presented case and test rates are likely underestimates of the true case and test rates, as there is currently limited asymptomatic testing of detainees.”