An Outbreak Of Coronavirus Along The Border Could Be Deadly And Devastating

The disease would "spread like wildfire" among the tens of thousands of immigrants stuck in tent camps and shelters along the border, one doctor said.

The U.S. government has advised Americans to wash their hands obsessively, avoid close contact with others and stay home as much as possible to prevent the spread of COVID-19, the disease caused by the novel coronavirus, which has infected more than 1,000 people in the country. But thousands of migrants seeking asylum in the United States can’t follow these instructions since the Trump administration has forced them to wait for their court dates in overcrowded and unsanitary camps and shelters near the border. 

Without the government’s help, volunteer doctors in Mexican border towns told HuffPost they are scrambling to take preventative measures to stave off a coronavirus outbreak. But if the disease enters these congested environments, it could “spread like wildfire” and lead to deaths, said Helen Perry, the executive director of the nonprofit Global Response Management who has been coordinating medical efforts in Matamoros. 

“The potential for a devastating outbreak in those circumstances is really great,” said Dr. Ranit Mishori, a senior medical advisor at Physicians for Human Rights, adding that these migrants face a perfect storm of factors. “They’re marginalized, they have no access to care and they’re so vulnerable. People can absolutely die.”

Elias, 2, a Honduran asylum-seeking child, plays near the tent where he lives after being relocated from the plaza near the G
Elias, 2, a Honduran asylum-seeking child, plays near the tent where he lives after being relocated from the plaza near the Gateway International Bridge in Matamoros, Mexico, on Dec. 7, 2019.

Since January 2019, the Trump administration has turned back almost 60,000 asylum-seekers under a program known as “Remain in Mexico.” On Wednesday, the Supreme Court overrode a lower court’s decision to block the program, which has forced tens of thousands of people to live for months in dangerous Mexican border towns where crime is rife and medical resources are scarce. 

The shelters and tent camps in border cities such as Matamoros, Tijuana and Ciudad Juárez are playgrounds for viral illnesses like COVID-19. In Matamoros, roughly 2,000 people live in tents packed together along the Rio Grande. They are constantly in groups, eating together and waiting to use portable showers and toilets. Their only access to water is from big containers brought in by volunteers. 

“You can’t just tell someone, ‘Hey, just don’t come out of your tent for a couple days,’” Perry said. “The thought that there’s going to be any kind of quarantine is pretty limited.”

They’re marginalized, they have no access to care and they’re so vulnerable. People can absolutely die. Dr. Ranit Mishori, professor of family medicine at Georgetown University

There are currently only seven known cases of the coronavirus in Mexico, and the biggest threat of infection comes from American volunteers, physicians told HuffPost. 

But as more doctors and nurses cancel their trips across the border to aid the asylum-seekers, immigrants are being cut off from their only access to health care. Dr. Hannah Janeway, who helps run the Refugee Health Alliance, said so many volunteers have canceled trips to Tijuana that there are three weeks between March and April when the Refugee Health Alliance won’t have enough U.S. doctors and nurses to staff the medical clinic. On Tuesday, Perry said seven volunteers had canceled ― the equivalent of a full medical team that cycles through the camp on a weekly basis.

In the event of a coronavirus outbreak, which medical experts told HuffPost is a real possibility, these tent camps and shelters don’t have the infrastructure or the staffing to treat thousands of people, especially those with underlying health conditions who may require critical care.

“A lot of these shelters are kind of on the outskirts of the city. It’s not a quick ride to any hospitals,” said Janeway, who is volunteering in Tijuana. “Any potential [health] complication could be deadly.” 

In Tijuana and Ciudad Juárez, thousands of immigrants are crowded into shelters run mostly by religious organizations, some of which are simply large open spaces where people sleep in tents. Since hundreds of people are forced to share a single bathroom in some cases, they aren’t able to wash their hands often and there is no privacy, Janeway said.

While the majority of these immigrants aren’t elderly people, the group most likely to die from the coronavirus, many struggle with malnourishment and serious health issues that put them at a higher risk than the general population. 

Volunteer doctors and nurses are doing what they can to prevent and prepare for a coronavirus outbreak given the difficult circumstances.

Perry’s team in Matamoros is in the process of trying to move kids and adults with general infections or health conditions such as asthma to the far edges of the camp, where they can have separate bathrooms and volunteers who can bring them food and water every day. They are also setting up makeshift sinks for hand-washing and trying to stock up on vitamin D supplements to help boost people’s immune systems.

Another important aspect of preventing an outbreak is education. Immigrants who have just fled life-threatening situations are not laser-focused on the disease, so volunteers in both Tijuana and Matamoros have been putting up posters and passing out fliers reminding people to wash their hands and minimize touching. Perry is setting up a hotline that immigrants can call if they have questions or feel sick. 

Migrants, most of them asylum-seekers sent back to Mexico from the U.S. under the Trump administration's "Remain in Mexico" p
Migrants, most of them asylum-seekers sent back to Mexico from the U.S. under the Trump administration's "Remain in Mexico" program, occupy a makeshift encampment in Matamoros, Mexico, on Oct. 28, 2019.

If an outbreak happens, Perry said they will try to isolate people with the coronavirus and make sure those in critical care have access to emergency services. U.S. volunteers have been trying to work with the Mexican government and other local aid organizations, but they said the medical systems in these border cities are already overwhelmed.

Meanwhile, the U.S. government has not given doctors or nurses any resources or guidance about a potential outbreak. A Customs and Border Patrol spokesperson told HuffPost that agents are referring anyone with coronavirus-like symptoms to the Centers for Disease Control and Prevention, but did not answer questions about what CBP is doing to protect immigrants forced to wait along the U.S.-Mexico border.

Given the Trump administration’s track record of putting immigrants in life-threatening situations, volunteers aren’t hopeful they will get any government assistance. In U.S. border patrol stations, immigrants are often crammed together and forced to sleep on the floor, with little or no access to soap, toothbrushes or showers. Last year, six immigrant children died in U.S. custody, many from treatable illnesses such as the flu or respiratory issues. And in December, immigration officials blocked doctors from giving flu vaccines to detained kids.

Ideally, no asylum-seeker with health issues should be stuck in Mexico, especially given a potential coronavirus outbreak, Janeway said. But she doesn’t think the government will allow them to cross the border. While “Remain in Mexico” is supposed to make an exception for severe health concerns, lawyers said clients with heart conditions and parasitic infections have been repeatedly turned away. 

“I think that there is a callousness in a lot of these policies that basically devalues life,” Perry said. “We’re saying there’s such an incredible risk that we need to advise Americans not to take cruises and travel internationally. But what does that say about the sanctity of life for individuals who are not Americans?”