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Thank you for your tireless efforts to protect the public’s health during the COVID-19 pandemic.
We, undersigned health professionals and members of the public, are profoundly disturbed to
witness the treatment of migrants, including many families with children, at the U.S. border. You
have continued to re-issue a public health order that forms the basis of Custom and Border
Patrol’s expulsions of migrants seeking asylum at our borders, in contravention of international
and United States law. (1) As Human Rights Watch states, “US law gives asylum seekers the
right to seek asylum upon arrival in the United States, even if they arrive without inspection or
prior authorization.” (2)
In March 2020, your predecessor, then-director of the Centers for Disease Control and
Prevention Dr. Robert Redfield, issued the “Order Suspending The Right To Introduce Certain
Persons From Countries Where A Quarantinable Communicable Disease Exists,” apparently as
a result of direct intervention of then-Vice President Pence and over the objections of senior
CDC scientists. (3) This order, referred to as “Title 42” after the Public Health Service Act in
which it is based, led to hundreds of thousands of expulsions of asylum seekers during the
Trump administration and has continued to be used in this way since January 2021.
In addition to the direct mortal danger for people expelled or deported to places from which they
fled in fear for their lives, this order instills inhuman behavior at many levels of government. The
inhumane acts directly stemming from this order’s extension since you became CDC director
have included expulsion of a Honduran woman in labor (4) and the confrontation of Haitian
migrants in Del Rio, Texas, by Border Patrol agents on horseback wielding reins in mid-
September (5). A Border Patrol memorandum from April 2020, regarding implementation of the
Title 42 order that you have been reaffirming (6), specifically instructs agents to expel asylum
seekers immediately in clear contravention of asylum law (7).
While under the Biden administration the inclusion of unaccompanied children in the order has
been revoked, you most recently reaffirmed the “Title 42” order on August 2, 2021 (8). Infection
control considerations are not different between unaccompanied children and hence cannot
form the basis for the current distinction between unaccompanied children who are now
exempted, versus families and adults who are still to be immediately expelled without an
opportunity to request asylum; the distinction appears to be political.
This order has no basis in science. The order does not protect Border Patrol agents, migrants or
the American public from COVID-19 (9). Instead, your order reinforces a dehumanizing trope of
migrants as vectors of disease (10). Implementation of testing, masking, ventilation and
vaccination can protect Customs and Border Patrol staff, asylum seekers, border communities,
and migrants’ destination communities from COVID-19; resources for these measures are
urgently needed in border communities and in the low-income, frontline communities that most
frequently take in asylum seekers coming from the border. Congregate settings, cited in your
August 2 order as in the previous orders issued under the Trump administration as the sites of
COVID-19 transmission introduced by migrants, are not required to process asylum seekers;
alternatives to detention have been and are currently used successfully (9).
We request that you revoke the “Title 42” order now, or publicly state the current scientific basis
for its continuation.
Respectfully,
Signatories’ Institutions
(1) https://www.uscis.gov/humanitarian/refugees-and-asylum/asylum/asylum-frequently-asked-
questions/questions-and-answers-asylum-eligibility-and-applications
(2) https://www.hrw.org/news/2021/04/08/qa-us-title-42-policy-expel-migrants-border
(3) https://apnews.com/article/virus-outbreak-pandemics-public-health-new-york-health-
4ef0c6c5263815a26f8aa17f6ea490ae
(4) https://www.newsweek.com/mexico-asylum-seeker-tijuana-pregnant-labor-sent-back-
1580091
(5) https://www.nytimes.com/2021/09/21/us/politics/haitians-border-patrol-photos.html
(6) https://www.documentcloud.org/documents/6824221-COVID-19-CAPIO.html
(7) https://www.propublica.org/article/leaked-border-patrol-memo-tells-agents-to-send-
migrants-back-immediately-ignoring-asylum-law
(8) https://www.federalregister.gov/documents/2021/08/05/2021-16856/public-health-
reassessment-and-order-suspending-the-right-to-introduce-certain-persons-from
(9) https://www.publichealth.columbia.edu/research/program-forced-migration-and-
health/letter-cdc-director-walensky-hhs-secretary-becerra-and-dhs-secretary-mayorkas-
august-2021-title-42-0
(10) https://www.wired.com/story/calling-the-caravans-migrants-diseased-is-a-classic-
xenophobic-move/