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Rapid response to:


Covid-19: control measures must be equitable and inclusive

BMJ 2020; 368 doi: (Published 20 March 2020) Cite this as: BMJ 2020;368:m1141

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Rapid Response:

Re: Covid-19: control measures must be equitable and inclusive. Covid-19 should trigger release of detainees from Immigration Removal Centres

Dear Editor
Correct and consistent implementation of government advice on Covid-19 presents an impossible challenge for Immigration Removal Centres (IRCs) 1.
As with all places of detention, those incarcerated in IRCs are denied control over many aspects of their lives. Cells and bathrooms are shared, outside space and fresh air limited, and cleanliness is difficult to maintain. Sustained and effective social distancing is an impossibility for all within IRCs. Many detainees are especially vulnerable due to their age, co-existing physical illnesses and, in a high proportion of cases, mental illness. These vulnerabilities predispose to a marked deterioration in health caused by immigration detention. IRCs are high risk for clusters of Covid-19 2, and staff provide a conduit for infection to and from the community. Healthcare staff and healthcare resources within the IRC would be more useful helping the mainstream NHS at this time of crisis.
The stated rationale for the use of IRCs is to hold migrants in the immediate period before removal from the UK. In practice, many individuals are held for months. Immigration detention is not a punishment for a criminal offence, but rather part of an administrative process. Mechanisms to identify and protect vulnerable detainees are almost entirely ineffective, and inquests into deaths in detention have raised concerns about standards of care and neglect. Access to lawyers and international flights are increasingly restricted, so continued detention may now be unlawful in a large number of cases.
As Covid-19 cases soar, it is inexcusable to continue with using immigration detention. All immigration detainees must urgently be released in order to protect detainees and staff, to dissipate this needless potential hub of infection, and allow redeployment of valuable healthcare staff and resources. Outbreaks of Covid-19 within the IRCs are inevitable and may already be occurring. Following legal action, 300 immigration detainees have been released 3. We call for urgent release of the remainder of detainees in IRCs and also those in prisons who are held under immigration powers. Covid-19 is an added reason for the government to heed previous advice from the BMA and others and close the IRCs.4,5
Mary Kamara clinical advisor, Medical Justice
Teresa Wozniak retired general practitioner
Hilary Pickles retired Director of Public Health
1. Berger Z D, Evans N G, Phelan A L, Silverman R D. Covid-19: control measures must be equitable and inclusive. BMJ 2020;368:m1141
2. Coker R 2020 Report on Coronavirus and Immigration detention
4. BMA Medical Ethics Committee. Locked up, locked out 2018.

Competing interests: Mary Kamara works for and Teresa Wozniak and Hilary Pickles are trustees for Medical Justice, a charity that supports immigration detainees

22 March 2020
Hilary G Pickles
retired Director of Public Health
Mary Kamara, Teresa Wozniak
c/o Medical Justice, London N7 7DT