Despite worldwide efforts to contain the COVID-19 pandemic, the virus continues to spread. Particularly vulnerable populations that are often overlooked include immigrants living in the US. Immigrant populations overlap with all special populations, including pediatric patients, immunosuppressed persons, racial and ethnic minorities, pregnant women, the elderly, and many more. Additional challenges to be addressed are accessibility to health care and the ability to adhere to precautions. The following information is based on current evidence and evolving information and legislation.
By Caroline Schulman, MD; and Aisha T. Terry, MD, MPH, FACEP
Immigrant populations include all noncitizens, those both lawfully present and undocumented, which constitute over 22 million people. Both groups are less likely to have access to health care than citizens.1 This section primarily focuses on undocumented immigrants because they are less likely to have access to public services for housing, food, education, and health care. Many have overcrowded households without the ability to self-isolate if they become symptomatic or are concerned about having been exposed and possibly infected with COVID-19. In Washington, DC, during the COVID-19 pandemic, it is common to have households of four or more people living in studio apartments. Many do not have primary care physicians and rely heavily on emergency departments.1 An especially vulnerable subset of this population is immigrants in US Immigration and Customs Enforcement (ICE) detention facilities. These facilities often have inadequate social services, including services related to health care. Pleas to release detained immigrants who do not pose a threat to public safety have yet to be answered.