Intended for healthcare professionals

Letters Public inquiry into UK’s response to covid-19

Covid-19: unjustified risk to people held in immigration removal centres

BMJ 2020; 370 doi: (Published 07 July 2020) Cite this as: BMJ 2020;370:m2673
  1. Mary Kamara, clinical adviser,
  2. Rachel Bingham, clinical adviser
  1. Medical Justice, London N7 7DT, UK
  1. m.kamara{at}

We agree with McKee and colleagues that any delay in finding solutions to the challenges of covid-19 must be avoided.1 As they say, there is a disproportionate burden on ethnic minority populations,2 including those held in immigration removal centres for administrative reasons before potential removal to their country of origin.

Experts warned that these institutionalised settings could function as “epidemiological pumps,” and recommended urgent measures to prevent the spread of infection.3 But 653 people remain detained under immigration powers—313 in immigration removal centres and the rest in prisons.4

These people include those classed as “adults at risk,” many with risk factors for severe covid-19 infection, yet only a handful of covid-19 tests have been carried out.5 Prohibition of visits has further isolated detainees, including those with mental health problems, and the impact is yet to be fully understood. Meanwhile the Home Office appealed to the judiciary to limit the granting of bail, citing among other reasons the lack of suitable accommodation after release.6 Such accommodation is a vital part of the public health response, and detention is not an acceptable alternative.

As for international collaboration, we should learn from our neighbours, many ahead of us in the epidemic curve. Spain, for example, emptied its detention centres in response to the covid-19 pandemic.7 The UK should follow suit before avoidable deaths occur.

Immigration detention harms health, and we regard it as part of the “deeply dysfunctional system” that McKee and colleagues refer to. Well documented harms of detention predate the pandemic,1 but covid-19 has added unjustified risk to the health of detainees and staff. We hope that this vulnerable group of people is not overlooked in any public inquiry, especially as none are serving a criminal sentence—their detention is optional, and the risk to their health entirely avoidable.


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