Last week, the CDC announced the end of an emergency public health order that was used over a million times to prevent both children and adult migrants, including asylum seekers, from entering U.S. borders since the start of the COVID-19 pandemic.
The policy, known as “Title 42,” allowed federal health officials expanded leeway to prevent the “introduction, transmission, or spread of suspected communicable diseases” and to prohibit “introduction of persons and property from such countries or places” necessary to “avert such danger.”
While the order was issued under the Trump administration, the Biden administration continued the policy, but is now planning to reverse it in late May.
In a report outlining the agency’s justification for lifting the order, CDC Director Rochelle Walensky, MD, MPH, “determine[d] that the danger of further introduction, transmission, or spread of COVID-19 into the United States from covered noncitizens, as defined in the August Order, has ceased to be a serious danger to the public health.”
Given the tools available to curb the virus — including effective vaccines and therapeutics — and in the context of the current public health environment, the agency determined that the order “suspending the right to introduce migrants into the United States is no longer necessary,” a CDC press release noted.
However, the agency will wait until May 23 to officially lift the order, to give the Department of Homeland Security “time to implement appropriate COVID-19 mitigation protocols,” including expanding COVID-19 vaccination programs for migrants, and to prepare to resume “regular migration under Title 8,” according to the press release.
Public health advocates have long argued that the order should never have been issued, with some groups claiming that the federal government exploited concerns over COVID-19 transmission, using them as a cover for blocking immigrants, including asylum seekers, from entering the U.S.
“Title 42 is a xenophobic policy that uses public health concerns around COVID-19 as an excuse to effectively close the border to asylum seekers. It’s impossible to fully express the devastating impact of 1.7 million expulsions on individual human lives. There has never been any public health justification for Title 42, and its end will come two years too late for too many vulnerable people,” said Carrie Teicher, MD, MPH, director of programs for Doctors Without Borders/Médecins Sans Frontières, in a press release.
Michele Heisler, MD, MPA, medical director for Physicians for Human Rights (PHR) and a professor at the University of Michigan, said that the end of the order is both “wonderful news” and “long overdue.”
There never was any “public health rationale” for Title 42, Heisler told MedPage Today. From her perspective, the decision to implement the order was made purely for reasons of “immigration control.”
“As physicians who have been doing medical-legal assessments, it has been just horrifying” to know that asylum seekers from places like Haiti, Venezuela, and Nicaragua, who left their home countries due to gang violence, political persecution, and domestic abuse, were turned away by the U.S., she added.
“It’s really been a humanitarian catastrophe — subjecting fellow human beings to horrific physical harms and unsafe conditions and creating a great deal of trauma for already deeply traumatized people,” Heisler said.
A 2021 report by PHR researchers, which included interviews with 28 asylum seekers denied entry into the U.S. because of Title 42, noted that many of these individuals were “assaulted, kidnapped, extorted, and subjected to physical and sexual violence in Mexico,” where they lacked protection from Mexican authorities.
Of the 26 participants who were screened for mental health diagnoses, 23 screened positive for PTSD related to their family separation, and 25 of the 26 screened positive for depression.
“Furthermore, all the asylum seekers interviewed described gratuitously cruel and inhumane treatment at the hands of the U.S. government, including physical and verbal abuse by U.S. officials, inhumane detention conditions, active deception about their expulsion and the whereabouts of their family members, and unsafe returns that put people at heightened risk of harm,” the report noted.
While the policy itself was implemented on the basis of public health, the report pointed out that “every aspect of the expulsion process, such as holding people in crowded conditions for days without testing and then transporting them in crowded vehicles, increases the risk of spreading and being exposed to COVID-19.”
When the policy is reversed, Heisler said she anticipates an “upsurge” in immigrants at the border, but the Biden administration, as well as non-governmental and church-based organizations, are all preparing to address that issue. The Biden administration will pilot a new “asylum rule” to help address the backlog of cases, in which asylum officers, along with immigration judges, will be able to hear cases and make decisions on whether a person is eligible for asylum.
PHR will be watching closely to ensure that asylum processes going forward will be “humane, trauma-informed, and equitable,” Heisler added, and to ensure that physicians and legal representation are available to help with the medical and legal assessments whenever possible. “We will want people claiming asylum to have their fair chance to make their claims.”
Looking ahead, Heisler said that as the nation continues to battle misinformation and disinformation, it’s critical “that the CDC be above politics to maintain its legitimacy as a rigorous, evidence-based public health and medicine institution.”
Please enable JavaScript to view the