Coronavirus Disease 2019 Burden Among Unaccompanied Minors in US Custody.

Abstract

BackgroundPrior to the COVID-19 pandemic, crowded and unsanitary living conditions lacking medical expertise made U.S. detention centers hotbeds for infectious disease outbreaks. There have been 30,000 COVID-19 cases, positivity rates exceeding 50%, and nine deaths in Immigration and Customs Enforcement (ICE) custody, but the extent of disease among children under the care of the Office of Refugee Resettlement (ORR) has not been well-documented. We sought to evaluate the burden of COVID-19 among unaccompanied minors under the ORR’s responsibility.MethodsWe analyzed SARS-CoV-2 testing results of refugees and asylum seekers in facilities associated with the ORR from 02/01/2020 to 11/18/2020, courtesy of a Freedom of Information Act request.ResultsORR facilities performed 7,132 SARS-CoV-2 tests from 3/13/2020 to 11/18/2020. Overall, the SARS-CoV-2 positivity rate was 13.4%. Factors associated with higher positivity rates were age group (16 to 17 years old); identifying as male; undergoing testing in April, August, or September; staying in a for-profit versus a non-profit facility, and detention in certain facilities. The mean detention time with a positive test was 14.8 ± 3.2 days. Greater than 10 percent of positive tests were in long-term detainees.ConclusionsThe high SARS-CoV-2 test positivity rate raises concerns about an inability to limit the spread of SARS-CoV-2 within detention facilities housing unaccompanied migrant children, particularly those run by for-profit companies. Mandated measures for social distancing and vaccination among detainees and detention facility employees are needed to limit the spread of the virus.