Leading Public Health Experts Gravely Concerned About New Proposal to Deny Asylum

Experts including epidemiologists and infectious disease specialists find that Trump administration’s rationale for proposed rule denying refugees protection is a misuse of science and public health practice

WASHINGTON – In a letter to the U.S. Attorney General William Bar and the acting Secretary of Homeland Security Chad Wolf, 170 public health and medical experts at leading public health schools, including the Columbia Mailman School of Public Health and the Johns Hopkins Center for Humanitarian Health, medical schools, hospitals, and other U.S. institutions, expressed concern about a sweeping rule proposed by the Trump administration last month that would deny people refugee and torture protection on the pretext of addressing diseases. The 30-day period for public comment on the rule ends on August 10.

The letter reads in part:

The rule ignores and misuses the science and core principles of public health. It would grant the Department of Homeland Security (DHS) and the Department of Justice (DOJ)—agencies that lack public health expertise—authority to label asylum seekers as a national security threat, scapegoating them as vectors for a potentially vast array of diseases and denying them protection. These sweeping new bans would direct immigration authorities to deport people seeking refuge and torture protection to life-threatening dangers in violation of U.S. law and treaty obligations. Like the March 20, 2020 order from the Centers for Disease Control and Prevention (CDC) that DHS has been using to evade humanitarian protections at the border under the pretext of COVID-19, the proposed regulation is based on specious justifications and would be detrimental.

Rather than banning and denying protection to refugees, public health experts have recommended  U.S. authorities adopt evidence-based public health measures to mitigate risk of the spread of COVID-19 and reiterated that such measures can both safeguard public health and the lives of children, families and adults seeking U.S. protection. In May, dozens of leading public health experts sent a letter to the Department of Health and Human Services and CDC criticizing the CDC’s March 20 order, which DHS continues to use to expel children and people seeking asylum at the southern border under the pretext of preventing the introduction of COVID-19, as revealed in recent media reports.

“The signatories of this letter all clearly understand the paramount importance of public health measures during this pandemic, and strongly support evidence-based decision-making to keep the American public safe and secure,” said Dr. Paul Spiegel, Co-Chair, Lancet Migration. “However, public health must not be exploited to further political agendas and must respect international law, in this case, the United States’ international legal obligations towards asylum seekers and refugees. And the signatories are proposing a way forward to do this.”

This unprecedented mandatory bar to refugee protection on purported public health grounds would, if codified into regulations, make permanent and expand the administration’s use of public health as a pretext to block asylum seekers from U.S. protection. The rule would give the DHS and DOJ expansive authority to declare a potentially vast array of other treatable diseases (gonorrhea, syphilis, tuberculosis, and Hansen’s disease [leprosy], among others) as national security threats in order to deny asylum to refugees even after the coronavirus threat abates. In addition to blocking asylum seekers during preliminary screening interviews, the rule would prohibit immigration judges from granting U.S. protection to asylum seekers in the United States merely for having recently transited through a country where COVID-19 is prevalent, and/or exhibiting symptoms possibly linked to COVID-19, like a cough or fever, including in U.S. immigration detention centers that medical experts have noted create conditions for contagion.

The letter sent today by public health experts, including dozens from border-state universities, hospitals and other institutions in Texas, New Mexico, Arizona and California, outlines how the proposed rule is not based on sound public health principles, noting that the rule is disproportionate and not designed to halt disease transmission, mandatorily barring refugees who have even “come into contact” with a communicable disease covered by the rule. With high numbers of COVID-19 cases in the United States, the proposed rule would bar many asylum seekers who have been exposed to COVID-19 on U.S. soil.

The authors of the letter note:

Asylum seekers infected with a covered disease while in the United States would be barred from protection—potentially even years after arriving in the United States—and subject to deportation, including asylum-seeking doctors, nurses, or other essential personnel engaged in vital work to address the disease. Perversely, the rule punishes asylum seekers, including those in U.S. immigration detention, for the failure of U.S. authorities to prevent and mitigate communicable disease outbreaks.

In proposing the rule, the Trump administration cites the spread of COVID-19 (and the potential for other communicable diseases) as justification to block and deny protection to asylum seekers, but there is no public health rationale for applying public health measures differently based on immigration status. In 2010, the CDC lifted an immigration ban on individuals living with HIV—first adopted in the 1980s when there were more known cases of HIV/AIDS in the United States than anywhere else in the world—acknowledging that the restrictions were not an effective or necessary public health measure. The letter’s authors urge the United States to “not repeat past mistakes by adopting another discriminatory and ineffective ban on the pretext of public health.”

“When public health is subverted to serve political agendas; or to exclude, control or discriminate against certain subgroups of our society, we should all be concerned,” said Monette Zard, Director of Columbia University Mailman School of Public Health’s Program on Forced Migration and Health. “The July proposed rule and similar policies do not protect us; they are the antithesis of public health and undermine the very goals they claim to serve.”

The experts conclude:

This proposed rule, like the March 20 CDC order, is xenophobia masquerading as a public health measure, and both must be rescinded. These policies undermine the credibility of public health practice and expertise in the United States, with devastating results for the safety and well-being of both asylum seekers and the American public.

The full text of the letter, issued under the auspices of the Columbia University Mailman School of Public Health and Johns Hopkins Center for Humanitarian Health, with the full list of signers, can be found here.