British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
Department of Mathematics and Institute of Applied Mathematics, University of British Columbia, Vancouver, British Columbia, Canada.
J Urban Health. 2020 Aug;97(4):439-447. doi: 10.1007/s11524-020-00441-x.
U.S. Immigration and Customs Enforcement (ICE) facilities house thousands of undocumented immigrants in environments discordant with the public health recommendations to reduce the transmission of 2019 novel coronavirus (COVID-19). Using ICE detainee population data obtained from the ICE Enforcement and Removal Operations (ERO) website as of March 2, 2020, we implemented a simple stochastic susceptible-exposed-infected-recovered model to estimate the rate of COVID-19 transmission within 111 ICE detention facilities and then examined impacts on regional hospital intensive care unit (ICU) capacity. Models considered three scenarios of transmission (optimistic, moderate, pessimistic) over 30-, 60-, and 90-day time horizons across a range of facility sizes. We found that 72% of individuals are expected to be infected by day 90 under the optimistic scenario (R0 = 2.5), while nearly 100% of individuals are expected to be infected by day 90 under a more pessimistic (R0 = 7) scenario. Although asynchronous outbreaks are more likely, day 90 estimates provide an approximation of total positive cases after all ICE facility outbreaks. We determined that, in the most optimistic scenario, coronavirus outbreaks among a minimum of 65 ICE facilities (59%) would overwhelm ICU beds within a 10-mile radius and outbreaks among a minimum of 8 ICE facilities (7%) would overwhelm local ICU beds within a 50-mile radius over a 90-day period, provided every ICU bed was made available for sick detainees. As policymakers seek to rapidly implement interventions that ensure the continued availability of life-saving medical resources across the USA, they may be overlooking the pressing need to slow the spread of COVID-19 infection in ICE's detention facilities. Preventing the rapid spread necessitates intervention measures such as granting ICE detainees widespread release from an unsafe environment by returning them to the community.
美国移民和海关执法局 (ICE) 的设施中关押着数千名无证移民，这些环境与减少 2019 年新型冠状病毒 (COVID-19) 传播的公共卫生建议不一致。使用截至 2020 年 3 月 2 日从 ICE 执法和遣返行动 (ERO) 网站获得的 ICE 被拘留者人口数据，我们实施了一个简单的随机易感-暴露-感染-恢复模型，以估计 111 个 ICE 拘留设施内 COVID-19 的传播速度，然后检查对区域医院重症监护病房 (ICU) 容量的影响。模型考虑了三种传播情景（乐观、中度、悲观），跨越 30 天、60 天和 90 天的时间范围，涵盖了各种设施规模。我们发现，在乐观情景（R0=2.5）下，预计 90 天内 72%的人将被感染，而在更悲观情景（R0=7）下，预计几乎 100%的人将被感染。尽管异步爆发的可能性更大，但 90 天的估计数提供了 ICE 设施爆发后所有阳性病例的近似值。我们确定，在最乐观的情景下，ICE 设施中至少有 65 个设施（59%）的冠状病毒爆发将在 10 英里半径内使 ICU 床位不堪重负，而 ICE 设施中至少有 8 个设施（7%）的冠状病毒爆发将在 50 英里半径内使当地 ICU 床位不堪重负在 90 天内，如果每一张 ICU 病床都可用于患病的被拘留者。随着政策制定者寻求迅速实施干预措施，以确保全美救生医疗资源的持续供应，他们可能忽略了减缓 ICE 拘留设施中 COVID-19 感染传播的紧迫需求。防止快速传播需要采取干预措施，例如将 ICE 被拘留者从不安全的环境中广泛释放，将他们送回社区。
