The pandemic of SARS-CoV2 (the novel coronavirus that causes Covid-19) has shown us once again the degree to which health across the world is interconnected through human mobility. As the pandemic unfolds, it has laid bare how existing social and economic conditions—as well as political decision-making based on nationalist principles rather than solid public health data—can produce death and destruction. As we continue to document and assess the lived experiences of this disaster, a major area of focus will be the various scales of migration alongside the arbitrary opening and closing of borders to those attempting to cross them.“This patchwork of border shutdowns has become a contemporary political experiment in the weaponization of public health.”
Covid-19 abruptly halted the movement of people via border shutdowns and travel restrictions, with some countries barring entry to anyone not a citizen or permanent resident, and other countries suspending entry from certain regions of the world altogether. This patchwork of border shutdowns has become a contemporary political experiment in the weaponization of public health. It is distinctly possible that the virus could provoke a signficant shift in, for example, freedom of movement in the Schengen Area in a postpandemic Europe or upend the right to territorial asylum, with deliberate public health messaging all that is needed to turn away people. But is this a unique phenomenon or are there historical precedents that offer lessons?
While international borders have historically closed in response to pandemics, the closures and states of exception that accompany them make available new exercises of state power and the diversion of resources away from critical public health interventions. This is taken from a centuries-old playbook, but with important caveats for the current moment. Stemming disease was a major justification for border controls stretching at least as far back as the fourteenth century. During the Black Death, Italian city-states invoked closed borders to contain the plague, issuing passes to travelers and imposing an isolation period of 40 days for incoming ships (bringing us the term “quarantine,” although the practice of separating the diseased from the healthy has been around much longer). From this time forward, restrictions on travel and trade emerged as a primary policy tool against the spread of communicable disease. This was the case even when it was ineffective, such as during yellow fever outbreaks in the United States and France beginning in 1790s that were mosquito-borne and thus not particularly responsive to border closures. In many places, the military was given authority over disease outbreaks, prioritizing border controls and quarantine throughout the twentieth century.
At the same time, increasingly strict immigration policies and practices in many countries, ranging from denial of access to invasive physical inspections, have been rationalized as communicable disease prevention. Indeed, many of the current failures in fighting the pandemic are inherited from the nineteenth century’s preoccupation with border controls, which history tells us is a failed strategy. While restrictions on travel can stop outbreaks in the early stages before a global pandemic, a focus on border control is also a diversion of investment in basic public health preventive practices.“Despite travel bans and border closures, it has become evident in our world of massive cross-border movement that these are not particularly effective ways of containing communicable disease.”
History offers important social and political lessons: Border controls in response to crises tend to become permanent, with new infrastructures and regulations persisting well after their initial intended purpose. For example, the enforcement of the quarantine period in maritime practice persisted for centuries after plague outbreaks. As a result of the Covid-19 pandemic, the governance of international migration is likely to change substantially, in ways comparable to or even greater than the changes that came about after the September 11, 2001, terrorist attacks. Despite travel bans and border closures, it has become evident in our world of massive cross-border movement that these are not particularly effective ways of containing communicable disease. The reach of the global pandemic, in addition to lessons from other recent disease eradication efforts, confirm that prolonged border controls are more an expression of xenophobic policy than an enduring solution to an infectious threat. Today, there is far more to gain through international cooperation than by keeping borders locked down.
Health impacts on (im)migrant populations in the United States
As attention focused on the political and economic impacts of halting mobility across borders, immigrant populations have faced a number of often-invisible struggles. Social exclusion and immigration-status precarity shapes the day-to-day experiences of migrants that have already established their lives in new countries. The pandemic has only further illuminated how legal status impacts access to health resources and exacerbates preexisting inequities. Their experiences have underscored existing insights on the production of social inequality while opening up new ways of thinking about the interplay between migration and health.
In the United States, as in many other countries, immigrants make up outsize shares both of essential workers in the fight against the pandemic and those in the industries hardest hit by its economic impact. Six million immigrants work in frontline occupations, such as healthcare, food production, and transportation; another six million work in industries such as food service and domestic household services that have been economically devastated, making up 20 percent of the total workers in those industries. Immigrants frequently live in densely populated centers, where they have higher rates of susceptibility to the disease due to crowded living conditions and exposure to mass transit systems. They tend to earn less, lack health insurance, and be unable to take paid sick leave or work from home, all of which negatively impact outcomes if they are infected or develop symptoms of Covid-19.“Immigrant communities also experience significant barriers to testing and treatment , as they may be unwilling to engage with official testing sites or visit hospitals because of their immigration status, even if symptoms become severe.”
Immigrant communities also experience significant barriers to testing and treatment, as they may be unwilling to engage with official testing sites or visit hospitals because of their immigration status, even if symptoms become severe. This fear also diminishes use of services, including a reluctance to access health services due to policies such as the change in the “public charge” rule that went into effect in early 2020. This rule penalizes the utilization of some forms of public assistance, such as Medicaid, which can negatively impact the adjustment of immigration status later. This fear remains despite US Citizenship and Immigration Services explicitly encouraging immigrants to seek medical services if they are symptomatic, and emphasizing that treatment or preventive services will not negatively affect a future public charge analysis of their case.
Increased immigration enforcement in the United States over the past several years has led to hesitation among undocumented immigrants to utilize such services. The Trump administration has significantly increased the aggressive nature of its immigration enforcement tactics, including a return to large-scale worksite raids even during the pandemic. The constant surveillance and continued scrutiny of immigration status transforms public spaces into areas of risk of racial profiling and consequential deportation, decreasing the likelihood that undocumented immigrants will engage in a range of behaviors that typically keep them and their families healthy, such as walking their children to school, visiting outdoor parks, or obtaining essentials from the grocery store.1Baltimore: Johns Hopkins University Press, 2019More Info →
At the same time, as a result of lockdowns and other social distancing measures, many of the most vulnerable immigrants have been left feeling isolated from a social life that centered heavily on family and community gatherings. This isolation has been compounded by anti-immigrant rhetoric, as public harassment and discrimination targeted certain groups, such as Chinese- and Asian American communities more broadly. As the pandemic progressed in the United States, farmworkers have been particularly impacted by spikes in cases, and in places like Florida, “overwhelmingly Hispanic” farmworkers have been blamed for spreading the disease, despite evidence to the contrary.
Raids, detention, and deportations have continued in many places, despite the shutdown of other governmental activities, diverting resources away from tackling the pandemic. Following a highly-criticized March 2020 raid in Los Angeles, US Immigration and Customs Enforcement (ICE) issued a statement promising that it would delay some—but not all—enforcement actions:
“During the Covid-19 crisis, ICE will not carry out enforcement operations at or near health care facilities, such as hospitals, doctors’ offices, accredited health clinics, and emergency or urgent care facilities, except in the most extraordinary of circumstances. Individuals should not avoid seeking medical care because they fear civil immigration enforcement.”
Meanwhile, undocumented migrants staged hunger strikes in detention centers in Arizona, California, and New Jersey to draw attention to unsafe conditions and anxieties that Covid-19 would turn the facilities into death camps. Makeshift migrant camps across the border with Mexico, full of asylum seekers from Central America forced to wait there by the current administration’s Migrant Protection Protocols (MPP), have increased exposure to the virus among some of the most vulnerable.“Despite paying taxes for years, many immigrant families have missed out on public assistance and services meant to help communities weather the pandemic.”
Immigrants who are undocumented or with other irregular statuses were generally excluded from government assistance programs that emerged in response to the pandemic, such as unemployment or cash stimulus payments. The CARES Act, a $2 trillion coronavirus relief package in the United States, excluded undocumented workers and discriminated against families of mixed immigration status. This especially disadvantages US citizen children of undocumented parents, even though they already qualify for other public benefit programs. An additional regulation specifically blocked foreign nationals and undocumented students from relief grants provided to educational institutions under the Act. Despite paying taxes for years, many immigrant families have missed out on public assistance and services meant to help communities weather the pandemic. There have been some exceptions that recognized the importance of aiding this population, of course: California allocated $75 million for Disaster Relief Fund for immigrants living in the state illegally and New York City announced an Emergency Relief fund for 20,000 immigrant workers, regardless of legal status.
Covid-19 and the study of migration and health: Future research
It is a crucial time to speculate the forms that migration and immigration policies and practices will take post-Covid-19 in order to inform research and advocacy priorities moving forward. What should a research agenda for the study of migration and health look like post-Covid-19?“Migration scholars are accustomed to studying people on the move along with the state responses to this movement.”
Will global migration flows slow down or speed up? How and why? Migration scholars are accustomed to studying people on the move along with the state responses to this movement. However, the pandemic’s effect on migrant communities has been characterized more by immobility than movement, requiring a shift in our focus. Although some migrants have returned to their home countries, many others are stranded by travel restrictions and border closures, either in destination countries, zones of transit, or by having been unable to move abroad as intended. Thus, a theoretical and practical focus on the effects of forced immobility has become high priority. In addition, remittances are predicted to drop by at least 20 percent globally in 2020, with severe effects for families, communities, and countries worldwide. As this threatens the well-being of communities and countries of origin globally, it also calls into question the linkages between migration and development that underlie much of international cooperation on the issue.
Furthermore, discourses about protecting public health seem poised to replace securitization narratives that emerged post-9/11 for governments seeking to strengthen their external borders and limit immigration. Will public health increasingly be used as a rationale not only to control border crossings but to further disenfranchise communities postmigration? Over the past decades we have seen a respatialization of borders, which, through technologies of surveillance, now often appear to be both everywhere and nowhere at the same time. How will responses to pandemics further push borders into the interior and allow them to transcend actual physical boundaries? What will be the impacts on immigrant communities, especially as they interplay with intensified surveillance and exclusionary policies?
Amid new figures on widespread displacement around the globe, the search for long-lasting solutions for refugees and asylum-seekers will become more acute than ever. Covid-19 infections are now sharply on the rise in refugee camps, where basic measures such as social distancing, hand hygiene, and isolation are not possible or very difficult to implement. Across Europe in recent years, cities grappling with tight budgets have mobilized to create ecosystems of social innovation for supporting vulnerable groups, especially refugees and migrants. However, social distancing measures associated with the pandemic have turned this into a make-or-break moment for innovative architecture for social inclusion.“How can we innovate new methods in a world in which face-to-face interviews and extended local interaction with community members are no longer possible?”
In addition to establishing a post-Covid-19 research agenda regarding migration and health, what methods will we need to gather data? For instance, we are primarily qualitative, ethnographic researchers, who depend on first-hand engagement with migrant communities and households over extended periods of time to develop trusting relationships and understand everyday experiences. This type of data collection has necessarily come to a standstill with social distancing requirements and travel restrictions. As researchers, we too are largely immobilized. How can we innovate new methods in a world in which face-to-face interviews and extended local interaction with community members are no longer possible? In a world in which policies of enforcement and disease prevention vary drastically across all levels of government—and change from week to week—can academic research continue to depend on large-scale surveys and demographic samples? Can social scientists with the tools to answer fundamentally urgent questions about migrant communities and Covid-19 find new ways to rapidly publish and disseminate data?
These are some of the important considerations moving forward as we take stock of the field of migration and health following the pandemic, especially as Covid-19 has underscored the central importance of human mobility, interconnections across borders, and the persistence of neglected existing social and economic inequality around the globe.