Co-Authors:
Lorena Del Pilar Bonilla, MD, Franklyn Rocha-Cabrero, MD, Claudia Alejandra Alvarez, DO and Lily Ostrer, MD

As physicians, we are advocating for patients suffering from COVID-19 in Florida. Since the initial detection of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) in Wuhan, China back in December 2019, it has turned into a global pandemic. The US Secretary of Health and Human Services (HHS) declared it a public health emergency on January 31, 2020. With over 13 million infected globally and a case fatality rate greater than 4% in the US, it is critical to slow the viral spread. 

Healthcare experts agree that behavioral changes are vital to slow the spread of the virus, decrease mortality and prevent overwhelming the healthcare system. These measures include: physical distancing, frequent hand-washing and self-isolation if symptomatic. Local and state governments have issued stay at home orders, prohibited major gatherings and closed non-essential businesses to the general public. However, ICE detainees and  employees remain at high risk of infection, due to lack of compliance with CDC recommendations. 

The CDC Interim Report for COVID19 in detention facilities acknowledges the barriers to disease prevention, including an inability to physically distance, frequent entrances and exits of staff, limited medical isolation areas and limited protective equipment, among others. There is evidence suggesting that mitigation strategies are not being implemented by ICE, including in South Florida (contains ~2000 individuals detained). An outbreak would risk the lives of the people in detention, employees, families and other citizens outside the detention facility. 

As a collective voice of physicians in the frontline of more than 20,000 members within the national Committee of Interns and Residents (CIR-SEIU), and Doctors for Camp Closure, we call for the release of all people in detention. In response to the current pandemic, we call for the following measures: 1) Desist new intakes of immigrants, 2) Provide enough protective equipment, 3) Provide enough sanitary products, 4) Educate staff and people in detention about COVID19 symptoms, reporting and social distancing guidelines in their respective language, 5) Allow volunteer healthcare workers to provide medical checkups in-house or telemedicine, 6) Establish a system that encourages self-reporting of COVID 19 symptoms without punishment, 7) Halt enforcement, courthouse and other non-essential administrative proceedings. 

Healthcare professionals have a duty to educate, inform and propose evidenced-based policies for the general public and government agencies, including ICE, to help reduce the transmission of this virus and protect vulnerable communities. Current efforts include a letter from medical professionals sent to ICE officials. As guardians of community health, we urge our government officials to enforce explicit directives to control COVID19 in detention facilities.

Affiliations
Dr. Lorena Del Pilar Bonilla – Internal Medicine, Hospitalist, Baptist Medical Group; Co-founder of Doctors for Camp Closure-Florida Chapter
Dr. Franklyn Rocha-Cabrero – PGY3 Neurology, Jackson Memorial Hospital/University of Miami; CIR Delegate for Florida Chapter
Dr. Claudia Alejandra Alvarez – Clinical Associate Professor and Associate Program Director of Family Medicine, Borinquen Medical Center, Family Medicine, Hospitalist, Florida Acute Care Specialists, Jackson Memorial Hospital; Co-founder of Doctors for Camp Closure-Florida Chapter
Dr. Lily Ostrer – PGY2 Internal Medicine-Pediatrics, Jackson Memorial Hospital/University of Miami; CIR Delegate for Florida Chapter

Updated July 14, 2020