By Tim Stephens
The need for secure borders is a primary governmental function. Further development of barriers at the southern border is the focus of renewed attention in the Trump Administration. A missing element of the wall and detention centers at the border is how to ensure we don’t increase the threat to the United States from disease outbreaks.
History is replete with examples where Mother Nature ignores human borders and political boundaries. Carcasses with fatal diseases have been thrown over castle walls during sieges. The so-called Spanish flu is believed to have originated on a Kansas army base before traveling with the doughboys to the killing fields of France.
Congress has identified the 4.3 million acres of federal lands in Arizona and New Mexico that border Mexico are susceptible to smuggling “nuclear-biological-chemical (NBC)” weapons (emphasis added). Meanwhile, Bill Gates says biological terrorism is not getting “enough attention,” even as conspiracy theorists ascribe to him the “development” of the Zika virus.
Detention centers on the southern border are especially vulnerable, given the large immigrant populations, length of stay, and the number of children that may be carrying, or exposed to, infectious diseases. In May 2016, a measles outbreak started in a detention facility in Arizona. The outbreak was further complicated by a lack of vaccinations of personnel, potentially exposing the entire community. Border Detention Centers are not designed for health delivery, like evaluations, vaccinations, testing, care, treatment and isolation. The lack of border medical quarantine and control capacity in the detention locations unnecessarily exposes our border agents.
In 2014, chikungunya was added to the list of infectious diseases moving across the border, and MERS was transmitted between U.S. citizens. In 2016, it was Zika. In 2009, while public health authority’s focused time, resources and attention on pandemic influenza emerging in Asia, the U.S. southern border became “ground zero.” A novel influenza emerged from Veracruz, Mexico and spread across the globe as a pandemic after being introduced to Imperial and San Diego counties in California.
Medical care needs in the detention centers are under-resourced. Border Patrol staff have to transport the sick and infectious to clinics miles away for simple diagnostics, basic screening and assessment. The additional security personnel for transport needlessly exposes law enforcement agents. The roundtrip and wait times might mean three agents are offsite for one medical case for an entire day. We can and must do better.
To paraphrase Thomas Jefferson, a “country without a bioborder is not a country.” We must add bioprotection and more quarantine capacity in our detention centers. Protection from communicable diseases is essential for the health of border agents, surrounding communities, and ultimately, all residents of the United States.
Tim Stephens is an independent consultant and principal with Prospero Analytics, LLC. He was previously the Director of the National Healthcare Resilience Center and the CEO of the MESH Coalition, the largest healthcare coalition in the nation.