ABSTRACT
Introduction: COVID-19 disproportionately affects racial and ethnic minority groups as well as people in jails and immigration detention centers in the United States. Between April and August of 2020, the mean monthly COVID-19 case ratio for ICE detainees was 13.4 times that of the general US population. This study aims to understand the experiences of detained asylum seekers during the pandemic and to provide insight into COVID-19’s impact on this population. Methods: This qualitative study employed first-person, in-depth narratives gathered via semi-structured interviews with 12 asylum seekers, all of whom were detained in immigration detention centers during part of the COVID-19 pandemic and who had subsequently been released. Interview transcripts were analyzed using a consensual qualitative research approach. Results: The analysis yielded seven domains and 22 categories. The first domain focused on participants’ health before detention, including reports of good physical health, previous experiences of psychological distress, and pre-existing conditions. The next domain contained descriptions of detention conditions and reflected interviewees’ experiences of poor conditions, lack of food and/or poor quality of food, limited freedom of movement, isolation, and disrupted sleep. The third domain represented themes of COVID-related detention conditions, such as lack of access to masks, inability to social distance, poor facility hygiene, and insufficient or extended isolation/quarantine. The fourth domain encompassed asylum seekers’ reports of the prevalence of COVID-like symptoms in detention settings. They indicated that they knew someone who had symptoms or experienced COVID-like symptoms themselves. The fifth domain included participants’ health care experiences in detention. They noted a poor response to COVID-19 in the facility, obstacles to receiving care, and dissatisfaction with management of their symptoms while detained. The sixth domain included the impact of detention conditions on the health of interviewees;they reported a deterioration of their physical health and mental health. The final domain consisted of the interviewees’ perceptions of their current health. Some stated their experiences in detention continue to impact their health;others reported improvement in their physical health and mental health after their release. Discussion: Detained asylum seekers are a vulnerable population who face inadequate medical care, an inability to social distance, poor hygiene, restricted movement, and a lack of infection control which exacerbate their risk of contracting and spreading COVID-19. Advocating for improved disease prevention, screening, prompt access to health care and treatment, cohorting of cases, and community alternatives to detention to decrease population size are crucial to halt the communicability of the virus.