Just north of the US-Mexico border, Pedro jumped off a train. He doesn’t remember jumping. He doesn’t remember being found unconscious in the Texas desert, or the helicopter evacuation, or the emergency surgeries during his first few days in our pediatric intensive care unit. When he had recovered enough to breathe and speak on his own, we asked the teenager if he’d like for us to arrange a call to his mother.
At first, Pedro wasn’t sure if he should call. Unable to protect her son from violence any longer, Pedro’s mother had sent him north to the US border alone. “My mother told me I’d never see her again,” Pedro said. “She told me to forget her.”
Under an order derived from Title 42—the US code dealing with public health and welfare—the government is using a specious health claim to bar asylum seekers arriving at the border and drive families such as Pedro’s apart. Title 42 gives the Centers for Disease Control and Prevention (CDC) power to close international borders during a pandemic. Despite serious objections from the CDC’s own lead epidemiologists, the Trump administration impelled the CDC to invoke Title 42 in a March 2020 order that disallows entry to persons traveling from Canada or Mexico who would be detained in a congregate setting by border agents. More than a year later, the Biden administration continues to expel migrant families under Title 42.
As physician experts in human rights—and as parents—we abhor the use of false health-related claims to bar migrant families. With family units being summarily turned away, some parents have made the decision to send their children alone across the border. Part of the increase in unaccompanied children such as Pedro being apprehended at our border is an unintended—and decidedly unhealthy—consequence of the Title 42 order. (Most of it, however, is from “push factors” in Central America, including widespread violence, poverty, political instability, and natural disasters.)
The Biden administration is struggling to process asylum seekers after our system was dismantled under Trump. But while deciding whom to admit, they must not rely on the specious link between migrants and disease that Title 42 proffers. In fact, migrants are no more likely to be infected with COVID-19 than US citizens entering the country. The families seeking asylum who were subjected to the Trump administration’s “Remain in Mexico” policy are, according to the last available data in March 2020, entering the country testing positive for COVID-19 at lower rates than the community average in Texas.
Since the early days of this nation, public health claims have often been used to justify discriminatory restrictions on the entry of certain groups of migrants. This practice amplifies the xenophobic perception that immigrants are “dirty” and ridden with diseases.
In fact, global health requires a robust asylum system to prevent genocide and reduce preventable deaths. The international refugee-asylum framework was implemented in the aftermath of World Word II, when the world recognized that people need extraordinary protections when fleeing extraordinary persecution. This framework provides safety to such individuals while their claims of persecution can be validated by the US government. Today, international human rights standards—as well as US federal law—allow for such people to seek asylum in this country.
Under Title 42, hundreds of thousands of people have been denied their due process right to petition for asylum. Instead of being offered the basic protections at the heart of the refugee-asylum framework, they are immediately expelled to Mexico or the countries they are fleeing. Right now, immigrant families who enter the country through Brownsville, Texas, are apprehended, flown to El Paso, and deported to Juarez, Mexico, a city most have never seen. During March, some were inhumanely detained by the Border Patrol under a bridge in Texas’ Rio Grande Valley, sleeping in dirt before being deported.
Our migration system must take evidence-based measures to limit the spread of COVID-19. Public health experts recommend that asylum seekers should be screened for COVID-19 at the border, that they should not be detained in congregate settings, and that our system of border crossings, shelters, and other humanitarian assistance should be supported to enact social distancing and safety measures. We also support widespread access to vaccination for migrants.
Pedro has not forgotten his mother, although they are still separated. Using well-studied health practices will allow us to uphold the human right for families such as Pedro’s to legally seek asylum without putting US communities at risk. The Biden administration should immediately rescind the order barring asylum seeker entry based on COVID-19, and implement rational, evidence-based health policies at the border.
Authors’ Note
Patient’s name was changed to protect his confidentiality. Physicians for Human Rights has taken a policy position regarding the Title 42 order, it is a 501(c)(3) organization that engages in advocacy rather than lobbying.
