Dear Dr. Walensky,
I am writing in support of a recent letter you received from Physicians for Human Rights (PHR), a global advocacy organization that has worked at the intersection of science, medicine, law, and human rights for more than 30 years.
As a health professional, I echo PHR’s grave concern that the Centers for Disease Control and Prevention (CDC) has issued a new order on August 2, 2021 to continue blocking and expelling families and adults seeking asylum at southern and northern U.S. land borders. These expulsions have been justified by the Biden administration as necessary to protect public health from the Delta variant of the virus that causes COVID-19, yet findings from PHR’s recent investigation indicate that the Title 42 expulsions order, although ostensibly a public health policy, is systematically putting people’s health and lives in danger. At the same time, the order violates U.S. international and federal legal prohibitions against returning people to countries where they face severe harm and persecution.
PHR recently published the investigation, “Neither Safety nor Health: How Title 42 Expulsions Harm Health and Violate Rights,” (
https://phr.org/our-work/resources/neither-safety-nor-health/) which exposes the severe health and human rights harms of the Title 42 border expulsion order, under which the U.S. government has expelled children and adults seeking refuge nearly one million times since March 2020.
This report found that, as a result of the Title 42 expulsion order:
1) Families arriving at the U.S.-Mexico border seeking asylum were cruelly and forcibly separated by U.S. Customs and Border Protection agents from a spouse or biological child during expulsion, and from minors for whom they were the primary caregiver.
2) Family separations due to Title 42 expulsions caused severe psychological harm to children, resulting in developmental setbacks, disturbed sleep, and excessive crying.
3) Migrants and asylum seekers were subjected to cruel and inhumane treatment at the hands of the U.S. government, including physical and verbal abuse and active deception about their expulsion and the whereabouts of their family members.
4) Asylum seekers were held in crowded conditions for days without testing for COVID-19 and then transported in crowded vehicles or airplanes to be expelled to Mexico.
5) The expulsions and treatment by U.S. border agents exacerbated mental health conditions of asylum-seeking children and adults; almost all of those interviewed screened positive for PTSD, anxiety, and depression.
6) After being expelled by the U.S. government, asylum seekers reported they had been assaulted, kidnapped, extorted, and subjected to physical and sexual violence in Mexico.
As public health experts have long objected, the Title 42 order lacks epidemiological evidence to justify banning the entrance of only migrants and asylum seekers at U.S. borders, while keeping those borders largely open to other travelers. Former CDC officials have themselves indicated that they never supported the use of Title 42 to deny people the opportunity to seek asylum. It is extremely disappointing to see this Trump-era policy embraced and extended under your watch. Public health law should be guided by public health expertise, and not politics. In addition to undermining the well-being and legal rights of asylum seekers, the CDC’s own name and reputation as a trusted scientific institution are also being eroded by the perpetuation of a public health order that has no basis in public health best practice.
I stand with PHR’s recommendation that the U.S. government exercise effective and evidence-based public health measures for processing asylum seekers at the border, rather than expelling children, adults, and families into potentially dangerous settings. Although the Delta variant is a significant development in the pandemic, the same public health principles that led CDC officials to oppose the border expulsion policy from the outset continue to hold true: families and adults can be admitted to the United States while observing recommended mitigation measures such as testing and quarantining that keep them and the general public safe.
I appreciate your prompt attention to this matter.