Dr. Erin Gustafson, MD, MPH
Acting Public Health Officer, County of San Bernardino
351 N. Mountain View Avenue
San Bernardino, CA 92415
May 13, 2020
Dear Dr. Erin Gustafson,
We are writing to you as health workers, public health practitioners, researchers, advocates, students, scholars, and organizers — with support from local community organizations — from across San Bernardino County to express our concern about the urgent need to address the COVID-19 pandemic at the Adelanto Immigration and Customs Enforcement (ICE) Processing Center.
While the state has taken decisive action to protect Californians against this highly contagious virus, we fear public health protections are falling short for people within prisons and jails, including those detained at the Adelanto ICE Processing Center. Individuals inside carceral facilities are fundamentally unable to physically distance or take other preventive measures to curb transmission. Heightened exposure to infectious diseases exists for incarcerated people inside carceral facilities where there is overcrowding, poor ventilation, poor nutrition, and poor health care, contributing to a higher likelihood of delayed diagnosis and limited infection control.
Further, correctional officers and other workers are potential vectors for COVID-19 from the general population to incarcerated populations, increasing the likelihood of an outbreak inside the facility. Additionally, due to shared hygiene facilities and non-uniform availability of free alcohol-based disinfectants (i.e., those certified by the EPA) and soap, we are leaving many members of our community inside our jails, prisons, and detention centers defenseless to this deadly virus.
Attempts at isolating individuals in inherently punitive settings — like prisons, jails, and detention centers — are akin to solitary confinement and not preventive care. Public health and medical scholars have declared isolation of a person of any age in carceral settings as torturous, yet it is still regularly used as a tool for punishment. Individuals sent to solitary confinement are more likely to die (of any cause) in the first year after release, and mental illness is likely to worsen under these conditions.3 Solitary confinement and other isolation strategies for symptomatic or exposed individuals — especially when not coupled with adequate testing, medical care, or transparent communication — harm health instead of protecting it.
ICE and GEO Group have a long history of complicity in medical neglect and deaths at Adelanto ICE Processing Center. It is clear they lack the necessary resources and political will to address an outbreak. If there is an outbreak there, epidemiology suggests widespread outbreaks among San Bernardino area residents would follow. Another way is possible — decarceration supports decreased disease transmission both within the carceral facility and in the community more broadly. Indeed, one study found that decreasing incarceration rates from just 3% to 2% of the general population reduces TB infections in prison by 44% and by 21% in the general population. While TB has a higher rate of infection, we can reasonably conclude that we would see the same effect for COVID-19. Keeping individuals incarcerated and detained without proper preventive measures will likely lead to unnecessary death among those confined to these facilities, workers at carceral facilities, and the general population.
This is a critical health equity issue, given that people inside the Adelanto ICE Processing Center are by definition structurally marginalized by their immigration status. Releasing people from the Adelanto Detention Facility represents an equity-centered public health approach and will ensure we are also ‘flattening the curve’ for the most vulnerable communities. We are seeing data already from across the country on the disproportionate harm COVID-19 is having on communities of color. This is compounded by the reality that undocumented immigrants and their families are structurally excluded from critical protections, such as state unemployment benefits and the federal stimulus packages, while also being disproportionately represented in the essential workforce. These inequitable dynamics leave them unduly vulnerable to exposure and infection.
We stand with community leaders in the Inland Coalition for Immigrant Justice (IC4IJ) in demanding that the San Bernardino County Department of Public Health exercise its statutory authority by:
1. Conducting routine inspections and reporting all potential cases of COVID-19 in the Adelanto ICE Processing Center to the public
2. Providing clear guidelines and education materials to all facility employees and detained people
3. Sending a letter to ICE recommending that the ICE facility release high risk populations, including people over 50 years of age and people with conditions identified by the CDC to increase the risk of serious illness from COVID-19
4. Opposing the expansion of Adelanto ICE Processing Center
Keeping people inside the Adelanto ICE Processing Center will undermine efforts of San Bernardino public health officials and may lead to an escalating death toll in the area. Given the body of evidence that supports reducing the population inside state prisons, county jails, and detention centers to curb COVID-19 transmission, we request that you, Dr. Gustafson, use your authority to ensure California can further mitigate the impact of this pandemic for those confined to the Adelanto ICE Processing Center and serve as a model health department by including the population detained there within the scope of the population you are duty-bound to protect.
The fact that incarceration is harmful to the health of everyone in jails, prisons, or detention centers did not begin nor will it end with the novel coronavirus. The health of each of us is dependent on the health of all of us. We cannot stress enough the urgency of decisive action at this time. Our public health values necessitate that we operate in alignment with the science, take guidance from and work alongside community-led coalitions, and ensure the public health community is always on the side of protecting the health and well-being of all people in our community.
Sincerely,
Ann Cheney, PhD (researcher)
Annie Le, MD, MPH (doctor)
Daniel J Klooster (professor)
Frances Tao, MPH (student doctor)
John Dover (medical student)
Josue Reynaga, MA (medical student)
Jurupa Valley (medical student)
Kathy Gomez (medical student)
Lisa Bell, RRT, CWS (respiratory therapist and certified wound specialist)
Madeline Saavedra, MD (doctor)
Mia Montoya (medical student)
Nelly Chuqui
Rebecca Adkisson (nurse)
Reyna Gonzalez (health NGO worker)
Sang Nguyen (medical student)
Sharon Rushing (public health professional)
With emphatic support from the following local organizations:
Asian Pacific American Labor Alliance (APALA) IE Chapter
California Partnership
Center for Community Action and Environmental Justice (CCAEJ)
Chicano Latino Caucus of San Bernardino County
CLUE-Clergy and Laity United for Economic Justice
Coachella Valley Immigrant Dignity Coalition
Coalition for Humane Immigrant Rights (CHIRLA)
Freedom for Immigrants
Health Equity and Structural Competency Collective
IE COVID-19 Student Taskforce
Immigrant Defenders Law Center
Immigration Center of San Bernardino, Inc
Inland Empire Coalition for Immigrant Justice
Inland Empire Harm Reduction
Legal Aid at Work
Mi Familia Vota
Pre-Health Dreamers
Root & Rebound
San Bernardino Community Service Center
Sister Warrior Freedom Coalition
Starting Over, Inc
Time for Change Foundation
TruEvolution Inc
Undocumented Advocates Collective
Unity Fellowship Social Justice Center