The transformation of the lives of most Americans into the “new normal” necessitated by the response to COVID-19 is truly unparalleled. But for the most vulnerable members of our society — the impoverished and marginalized — the crisis has only served to further entrench preexisting conditions, constraints and fears. Many live within devastating intersectionality: poverty, food and housing insecurity, and lack of access to quality schools, health care and childcare. Immigrants — whether undocumented or documented — most often occupy this space.
The harsh reality for immigrants is that while they assume valuable positions in our society, they accept lower wages and their work poses greater hazards and fewer protections against injury, including the contraction and circulation of illnesses like COVID-19. Several meat packing plants, where workers include refugees who have immigrated from around the world, have become COVID-19 hotspots; e.g., the plant in South Dakota, where many of their employees are immigrants, comprises over 40 percent of the state’s positive cases.
Having survived warzones and agonizing nights of hunger in refugee camps, these immigrants now grieve the deaths of family members, friends and co-workers, and are themselves becoming ill from COVID-19. Regardless, even under these worst of circumstances, they must return to the grueling work their families’ futures depend on. And for undocumented immigrants who are classified as “essential” because they tend to the food supply, concerns are two-fold: arrest by ICE and an elevated risk of contracting COVID-19.
Immigrants suffer uniquely devastating vulnerabilities in the face of COVID-19. ICE targets “sensitive locations,” including medical facilities. And the “Public Charge” rule, implemented in February 2020 by U.S. Citizenship and Immigration Services (USCIS), means that those seeking a change or extension in their immigration status can be sorted on the basis of whether they are likely to receive public benefits (e.g., Medicaid, cash, food and housing assistance).
Further, “aliens” who have been deemed eligible to receive public benefits for more than 12 months in any 36-month period are ruled inadmissible for a stay in the U.S. Although the U.S.CIS has posted an alert concerning COVID-related help-seeking, it is unclear how COVID-related disruptions in work or access to public-provided health care will be judged. Thus, immigrant communities live in fear not only of the virus but of seeking help should they contract it.
There are also concerns about the undetected community spread among immigrants. In New York, public officials tried to communicate that no one should worry that their legal status would be questioned if seeking medical help for COVID-19 symptoms, and in Washington D.C., at a press conference on March 30, Mayor Bowser assured the city’s residents that first responders would not inquire about immigration status — this after several immigrants are believed to have died at home from the virus.
In the 138 ICE detention facilities across the U.S., visitation is suspended, and detained individuals and their families are entirely cut off from one another. COVID-19 cases have been diagnosed in these facilities, along with reports of conditions that elevate the risk of transmission. In implicit acknowledgment of these reports and under pressure from advocates, ICE has moved to release those deemed to be at highest risk for contracting the virus.
Public officials, disease specialists and media commentators echo the reassurance that this challenge is temporary, that we will reopen the economy and ultimately reclaim our normal lives. However, for some, the current “new normal” is simply a variation on their old normal, and the other side of COVID-19 will find the most vulnerable among us even worse off. COVID-19 is a “mass trauma”, and we already have reports demonstrating the effects this trauma will have on the psychological well-being of many. Those who live at the periphery of our society, without access to mental health services, are particularly vulnerable to the enduring psychological burden of COVID-19.
The virus itself does not care about racial or ethnic categories, social or economic class, or immigrant status. The virus is random, but the differential susceptibility to COVID-19 across groups in the U.S. is predictable. The effects of the virus — whether the direct risk of infection or the associated economic, health and psychological impacts — is predetermined by policy decisions made at all levels.
As we strive to return to a “normal” that was comfortable for many, be discomforted by the knowledge that normal for immigrants are conditions that persistently endanger their lives and livelihoods, despite the critical niches they fill in our society. It is incumbent upon policymakers and federal agencies to address the structural and systemic barriers to health and wellbeing among vulnerable groups.
Guidance from prevention science — a well-established and highly impactful field — has generated scores of evidence-based strategies pertinent to the age of COVID-19; e.g., systems-change to reduce structural racism and concentrated poverty; criminal justice reform at court and corrections levels; interventions to address health disparities, provide mental health support for individuals and families, and reduce domestic violence; and effective public health messaging.
By envisioning a juster, more humane “normal” via applications from prevention science, we can improve the health wellbeing of those most impacted by COVID-19. As a result, we will all be stronger and better prepared when we face the next crisis — truly together.
Goldie McQuaid, Ph.D. is a postdoctoral fellow in the Department of Psychology, George Mason University and a member of the National Prevention Science Coalition to Improve Lives
Diana Fishbein, Ph.D. is a professor at The Pennsylvania State University, Director of Translational Prevention Research at the University of North Carolina, and Co-Director of the National Prevention Science Coalition to Improve Lives.