More than a plague: How colonialism, class and incarceration feed disease outbreaks
For a historian with an interest in the intersection of factors that propel an epidemic, 2020 offered a living case study. Edna Bonhomme, a historian of science with a PhD from Princeton, was living at the time in shared housing in Berlin, one of 11.7 million foreigners in Germany. As a person of Haitian descent, she is acutely aware of the complexities of Black life in a country where racism has its own face, similar but also different from anti-Black racism in the U.S.
She began speaking to Black women with different experiences from hers: a kink-positive sex worker from the U.K., an asylum seeker, a cancer survivor, exploring the strange ways that the COVID-19 pandemic and resulting lockdowns interacted with a wide variety of privileges and privations, histories of oppression and struggle against it.
From Berlin, she watched the Black Lives Matter demonstrations after the murder of George Floyd, and she read Virginia Woolf, and histories of plagues: on plantations in the U.S. south; in Liberia, where a crisis of resources for public health exacerbated a 2014 outbreak of what turned out to be Ebola; in German-colonized East Africa. "From Berlin," she wrote, "I was afforded the space to write, breathe, and be debt free." And to write "A History of the World in Six Plagues," a new book which traces human history through our relationship with illness.
Delving into childhood memories and the history of her family, migrants to Miami from Haiti, literature of all kinds, and historical accounts of plague, Bonhomme's account is indeed structured around six historical and modern plagues, but in each section she follows where the subject takes her. This approach results in nuanced, grounded examinations of the actual, material conditions in which the epidemics of sleeping sickness, cholera, influenza, HIV, Ebola and COVID-19 she describes took (or continue to take) place. Not leaning on any one interpretive framework that might exclude relevant factors, Bonhomme considers the highly intersecting and variable impact of colonialism, racialization, gender roles and attitudes towards the human body, and, most strikingly perhaps, class, specifically in its intersection with race.
Bonhomme weaves in engaging and poignant personal experiences as well. Her traumatic experience of quarantine in an extended hospital stay in Miami as a four-year-old with typhoid fever becomes a motif as she addresses the infection-limiting benefits of isolation and confinement — and the loneliness, dislocation and even chaos to which confinement can lead. Connecting forced and chosen quarantines with experiences of incarceration, she explores also the solidarity that can arise in situations of the greatest difficulty and oppression. Also woven through the text is that surreal experience of living through the early pandemic years in Berlin, of leaving shared housing to live more traditionally with her partner (a kind of chosen quarantine at the time), of being Black in Berlin (a different kind of isolation), of choosing to get married — an impulsive and rebellious choice, at a time when isolation was the rule — and of experiencing a miscarriage minutes before they were expected at Copenhagen City Hall, where they'd absconded to wed.
This interview has been edited for clarity and length.
How did you settle on the six examples of illnesses you chose?
I decided to focus on epidemics that were also tied to important historical events and institutions. And so I started off with the plantation as a site that, on the one hand, I would describe as a torture camp, a site in which people were forced to work, and it was quite difficult, and it was also profitable for some people, but it was also a site that made people sick [with cholera.] Various scholars have looked at that and unpacked [questions like] what was happening to Black lives on plantations, and how do we make sense of people's ability to survive?
Part of the reason that I wanted to think about sleeping sickness is because it was considered a massive epidemic, and specifically because it interfered with, or at least Europeans thought that the disease interfered with, labor. The other diseases — the flu, HIV, Ebola and COVID — are ones that we live with today. With each of the epidemics that I chose, it wasn't just a case of thinking about what was the most popular, or perhaps even what had the most impact, but rather, how did people who were tied to these various institutions, in which confinement was very much part of perpetuating some form of oppression at different times... how do people figure out ways to survive in spite of those various forms of oppression and those various institutions?
You talk about the labor impact of sleeping sickness. That immediately made me think of the intersecting issues with COVID of frontline workers who would typically be racialized, and often women who have had to assume higher levels of risk, and often without a lot of clarity or ability to confront the fact that they're at higher risk for a whole other range of structural reasons. So I wonder if you could could address those parallels.
Yeah, so I think they are two very different diseases. COVID is a highly infectious airborne disease that was quite novel to us in terms of when it emerged in 2019 and it's something that we're still living with and still learning from. With long COVID, there are the studies suggesting that [sufferers are] more likely to have cognitive difficulties and so forth. So COVID is still fresh. It's still new. It was quite global in terms of its impact.
By contrast, something like sleeping sickness is spread through a fly, the tsetse fly. And it was quite regional in the sense that it has mostly been something that has impacted people in sub-Saharan Africa. I wanted to differentiate the two in terms of not just the biology and the modes of transmission, as well as the regions they come from, but also to point out that the vulnerability and the risk are fundamentally different.
Ultimately, for people who are marginalized in some capacity, those who are frontline workers, essential workers, those who don't have the ability to have paid rest and time off, or to be able to self-isolate for whatever reason, and have the freedom both to move and to be still, a disease can be more formidable than for those who do have the privilege to have a safer space to rest.
So I was also thinking about policy. The decision to confine people in the case of sleeping sickness, and with COVID-19, the decision to move people back to work in high-risk situations, knowing that it's only certain people who actually had to do that. In other policy-making relating to pandemics, is that a common theme? One of the things I really appreciated in this book is the combination of class, which is something that is so rarely frankly discussed in North American discourse, with racialization and gender issues. So I'm just curious about how often that question of whether people of people as productive labor plays a role through the other examples that you saw.
Absolutely. In fact, the slavery question is a question of labor, and it's a question of racialization of a particular form, a set of laborers who didn't have much of a choice or agency outside of escaping or attempting to escape, or in some cases, inflicting physical harm to the body and the self, or suicide. Being sick and not having the care that was needed to recover, is essential to the question around how we think about epidemics.
Beyond that, particularly with the slavery chapter on cholera, there's also this: for some plantation owners and enslavers, it was kind of acceptable for there to be a poor quality of life, so long as there wasn't a major threat to the enslaved subjects, because all they needed is to make the market profit margins. And so the question around workers having to move through their labor even when they're sick, whether it's something as mild as the common cold, the flu, or as major as COVID, is a major issue.
Beyond infectious diseases, one of the major issues in the U.S. context ... What does it mean that, especially in the U.S., where there's not a universal health care system, if the person, even if they have health care through their job — what does it mean for them to have to continue working while receiving chemotherapy, and how does that impact their ability to survive post-treatment, post-chemotherapy?
Unfortunately, I know how that impacts someone quite well. Someone in my family was diagnosed with cancer in the early stages of the pandemic, had to continue working in order to maintain their insurance and at one point passed out and had a brain aneurysm while working, and that really made it difficult. And then a couple of years later, they died. So that's America, ultimately. And that is something that we have to think about, like how forced labor, or even just like forced labor through what Marx would call wage slavery, continues and does a number on and damages the body's ability to heal.
Speaking of public health, we're right now witnessing this massive attack on it in the U.S. You've discussed private communities of care, there's the Black Panthers, there are COVID-cautious groups, there was mutual aid through the HIV/AIDS crisis, and it sort of relates to the other question: to what extent can these be an adequate alternative to public health?
These mutual aid networks, in which people are providing direct action, direct services, direct resources, even just circulating funds and redistributing it within a social network, can be quite vital for a community, and such an important indication of how people are ultimately good and want to help each other. Like, I don't want to discount the power and beauty of communities coming together, especially during crisis. We've seen this with the Los Angeles fires and how people have been helping with that. Nevertheless, obviously, I would say there's a limitation to what people, especially with their heavy hearts, can provide, and that there's a limit to also the money and the resources that can be distributed.
To an extent it can be a lot more effective for governments to do that work of distributing resources and so forth because of the infrastructure that governments have. Nevertheless, we're currently witnessing the temerity of the U.S. Department of Health and Human Services, which is not an opinion that is unique to me, but it's something that we're seeing in real time, with one of the most prime examples of that recklessness — the measles outbreak — which, as we know, is a very contagious disease, extremely preventable, there's a vaccine that's highly effective, and yet what we're seeing is that vaccine skepticism is becoming normalized, and the number of cases has exacerbated.
And while the current secretary for the Department of Health and Human Services has promised to support vaccines, one of the top vaccine regulators, I think it was, Dr Peter Marks, has said that he's not doing enough, and that is indicative of, I would say a callousness [toward] human life. Because ultimately, when one then says that the government is not responsible and people have to be on their own, whether or not they have the capacity to do so or not, it means that ultimately those who are the most "fit" will be able to survive, those with the most money, the resources and so forth, as opposed to ensuring that everyone has an equal opportunity to survive, to be cared for. Again, I'm always moved and impressed and content by the love and the care that people can provide within a community structure. And people should continue to do that — but it's not enough, and hopefully people can come together collectively to demand that the government should also be providing that care work.
You've also talked a lot about carceral societies and a wide variety of carceral situations. Right now we're seeing the open rise of some of things that have existed and affected some communities for years, but now are becoming blatant and very open. That is to say that a profoundly carceral and punitive society, with punishment based on class and racial lines, has always been a thing, but now we're seeing the open rise of deportation, isolation, surveillance and very strict punishment. You write in the book, "a world without prisons has become a far off possibility." You wrote that before the second Trump administration, I think. So what does this mean for plagues you've already described, like measles, and the effect there?
If I were writing another book and I wanted to expand what plague and epidemics mean, then I would actually think about non-infectious diseases as well. And I alluded to this in one of my previous answers by pointing to cancer. But of course, there are other epidemics that we are living with, particularly the opioid epidemic, which is very much an epidemic that is perpetuated by poverty, that is tied to desperation, that is tied to the ways in which communities have been devastated in a post-industrial context of jobs being gone and so forth, and that that epidemic is something that people are living with, and I would say, is something that various communities, particularly in the Appalachians and Midwest, are still struggling with.
In the book, when I talk about the prison question, it's how chronic diseases, early aging, specifically, tuberculosis, airborne diseases, are very much more likely to be present in a prison system than for a non-incarcerated population. Beyond that, if we think about this current moment in the United States, where there's an open war on migrants. Migrants who, in some cases are speaking about Palestine, students, what I would consider to be babies. These are young, idealistic, in some cases teenagers, and if anything, we should be commending them for being brave, and yet they're being hunted down by the U.S. government, or, most recently, people being taken by the U.S. government, accused of being part of gangs without any type of due process, suddenly deported to El Salvador.
What implications does that have, not just for people's mental and physical state, but just for others who might also be fearing, "will I be next?" I think that ultimately, the question around deportations, with the question around anti-immigrant policies, is really a chaotic process that is also tearing apart, in some cases, the members of families that have multinational citizenship and/or resident statuses. And so in a sense, it's not purely about infectious diseases and epidemics per se, but rather the kind of the fear that it stokes within communities.
I think one thing that people have been writing about, and I'm also doing some research on right now, is how U.S. foreign policy is going to, especially with the cuts to USAID, impact the spread of epidemics currently in Latin America, Africa and elsewhere. What various countries of the African continent are doing, luckily, is they had realized back in 2014 with the Ebola crisis that they could not rely on the U.S., and so the formation of the African CDC since then has meant that there's far more coordination between African nations. I actually attended an online press conference that they had last week, because they do regular press conferences just to answer questions posed to the African CDC in a way that I'm like, "Oh, wow. This is great. Like, this is what should be done."
But the reason I point this out is just to say that in the short term, and actually even medium term, it costs lives for us not to continue to fund the USAID, especially with specific programs around antiretroviral therapy. And at the same time, people are making do, particularly on the African continent, because they had already had a little taste of bigotry and exclusions more than a decade before.
You describe how social networks play a role in survival under duress. You mentioned Palestine, which reminds me of resistance that has often emerged, specifically within the prison system in Israel. You said TB, and I think of Nelson Mandela. In some of the other examples you talk about, groups for both mutual aid and more long term resistance to oppressive systems have come from prison systems. I wonder if you could describe where it's relevant to dealing with the plague, perhaps the HIV example, how those sites of either very strict quarantine and isolation or actual formal prison systems, how those can also spawn resistance?
So one thing I would say is that I was lucky enough to organize and learn so much from formerly incarcerated people when I used to live in New York City and being involved in reading groups for people where we discussed the New Jim Crow. And beyond that, the kind of prison literature that helped inform me, everything from Antonio Gramsci's prison letters and notes to George Jackson's letters as well, helped to show me and even beyond that, just like Malcolm X, his autobiography as someone who was incarcerated. I had a political education that allowed me to see the power, strength and intellectual prowess of people who have been incarcerated, even though I would say mainstream U.S. society would suggest that those who have been incarcerated should be disposed of.
In thinking about the prison and that education that I had, I also wanted to see how it was connected to the HIV/AIDS epidemic and how people in prison were coping with that. When I studied public health, there was this particular way of thinking about the prison as a "vector of disease." And I put this in quotes because so often people could be perceived as just potentially highly infectious without thinking about the human stories, about who they were, their names and so forth. I think that I wanted to have a perspective and a case study in my book about survival and about women coming together in one of the most oppressed spaces to do the work of not just theorizing what the prison can do to the body and the harm it causes, but also how mutual aid is happening and how people can exercise agency even under duress.
The case of Bedford Hills Women's Correctional Facility in upstate New York, and how they formed the AIDS Counseling and Education Program during the height of the HIV/AIDS epidemic is also, in my opinion, a continuation of freedom fighters who are incarcerated and try to make do in these spaces, people who become part of a community, in some cases, and try to ensure the survival of the collective. I would say we can often move inside and outside of various forms of marginalization, but we can also exercise our own privilege, particularly when we form collectives.
What would an anti-oppressive but also effective response to infectious plague look like?
What I thought about this question is, how do we build systems of public health and public health policy more specifically, that don't feel oppressive, that aren't just a top-down approach where people feel like they can't trust authorities? And part of what people are thinking about is participatory observation, where public health officials actually work alongside communities. They have town halls, there's active surveys and so forth, asking people what they know or don't know and that they are also part of making decisions, in a sense, and a non-oppressive public health policy would be one in which it could be a democratic perspective.
Unfortunately, there's a lot of mistrust in the United States, and in other countries as well, when it comes to public health officials, because the government doesn't provide — it feels like the government doesn't provide — much to society. And so in order to have an anti-oppressive system, one actually has to start building trust within communities and to really make things far more democratic, so that at least people's basic needs are taken care of, but that people's questions could also be answered, and that there could be active debates, not online, but actually in person. Even beyond that, I think that basic education in biology would also be helpful.
There's a clear love of literature, of diverse sources of knowledge and thinking, that runs through the book that's really lovely. I've always had a fascination with both prison literature and plague literature, which are very intersecting, overlapping things. I wonder if you could talk about those, about literature, and how those two types of literature played out in your writing of the story.
During the early portion of the COVID-19 lockdowns, I fell in love with literature again, and I wanted an opportunity to think about how being home, turning inwards, and just taking the time to reflect on what was happening outside also meant that I was okay and reveled in being able to enter into a space of fiction, into a literary world where I could suspend everything that was happening outside these walls. Literature, especially when the prose was enlightening and also jumped from the page, I felt would inspire me. But beyond that, I also wanted to get a sense of how writers, especially those that lived through wars, crises, outbreaks, how they made sense of it, and to an extent, some of the writers that I mentioned in the book, whether it's Virginia Woolf, Susan Sontag, even W.E.B Dubois, they exercise some type of privilege by virtue of having the time, the space to sit in silence and to write and to think and to be respected, once they were celebrated.
And so I wanted to be able to be in conversation with these people, most of whom are dead, and have a way of, of not just referencing them, but showing that their words, the philosophical purchase, matters. And hopefully, for those who read the book, they can also be inspired to pick up some of that literature and find themselves thinking, Oh, wait, this perspective on the sick bed might help me during a time when I find myself dealing with surgery and so forth. So yeah, it's the literature that is what carried me through, but it's also something that's carrying me through life right now, especially as a parent now. My book is not a COVID book per se, but it's really a book about survival and how people make sense of outbreaks no matter where they are.

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles


New York Times
an hour ago
- New York Times
‘I Feel Like I've Been Lied To': When a Measles Outbreak Hits Home
He was a chiropractor by training, but in a remote part of West Texas with limited medical care, Kiley Timmons had become a first stop for whatever hurt. Ear infections. Labor pains. Oil workers who arrived with broken ribs and farmers with bulging discs. For more than a decade, Kiley, 48, had seen 20 patients each day at his small clinic located between a church and a gas station in Brownfield, population 8,500. He treated what he could, referred others to physicians and prayed over the rest. It wasn't until early this spring that he started to notice something unfamiliar coming through the door: aches that lingered, fevers that wouldn't break, discolored patches of skin that didn't make sense. At first, he blamed it on a bad flu season, but the symptoms stuck around and then multiplied. By late March, a third of his patients were telling him about relatives who couldn't breathe. And then Kiley started coughing, too. His wife, Carrollyn, had recently tested positive for Covid, but her symptoms eased as Kiley's intensified. He went to a doctor at the beginning of April for a viral panel, but every result came back negative. The doctor decided to test for the remote possibility of measles, since there was a large outbreak spreading through a Mennonite community 40 miles away, but Kiley was vaccinated. 'I feel like I'm dying,' Kiley texted a friend. He couldn't hold down food or water. He had already lost 10 pounds. His chest went numb, and his arms began to tingle. His oxygen was dropping dangerously low when he finally got the results. 'Positive for measles,' he wrote to his sister, in mid-April. 'Just miserable. I can't believe this.' Twenty-five years after measles was officially declared eliminated from the United States, this spring marked a harrowing time of rediscovery. A cluster of cases that began at a Mennonite church in West Texas expanded into one of the largest outbreaks in a generation, spreading through communities with declining vaccination rates as three people died and dozens more were hospitalized from Mexico to North Dakota. Public health officials tracked about 1,200 confirmed cases and countless exposures across more than 30 states. People who were contagious with measles boarded domestic flights, shopped at Walmart, played tuba in a town parade and toured the Mall of America. Want all of The Times? Subscribe.


Chicago Tribune
11 hours ago
- Chicago Tribune
US measles count now tops 1,200 cases, and Iowa announces an outbreak
The U.S. logged fewer than 20 measles cases this week, though Iowa announced the state's first outbreak Thursday and Georgia confirmed its second Wednesday. There have been 1,214 confirmed measles cases this year, the Centers for Disease Control and Prevention said Friday. Health officials in Texas, where the nation's biggest outbreak raged during the late winter and spring, confirmed six cases in the last week. There are three other major outbreaks in North America. The longest, in Ontario, Canada, has resulted in 2,179 cases from mid-October through June 17. The province logged its first death June 5 in a baby who got congenital measles but also had other preexisting conditions. Another outbreak in Alberta, Canada, has sickened 996 as of Thursday. And the Mexican state of Chihuahua had 2,335 measles cases and four deaths as of Friday, according to data from the state health ministry. Other U.S. states with active outbreaks — which the CDC defines as three or more related cases — include Arizona, Colorado, Illinois, Kansas, Montana, New Mexico, North Dakota and Oklahoma. In the U.S., two elementary school-aged children in the epicenter in West Texas and an adult in New Mexico have died of measles this year. All were unvaccinated. Measles vaccination rates drop after COVID-19 pandemic in counties across the USMeasles is caused by a highly contagious virus that's airborne and spreads easily when an infected person breathes, sneezes or coughs. It is preventable through vaccines and has been considered eliminated from the U.S. since 2000. There are a total of 750 cases across 35 counties, most of them in West Texas, state health officials said Tuesday. Throughout the outbreak, 97 people have been hospitalized. State health officials estimated less than 1% of cases — fewer than 10 — are actively infectious. Fifty-five percent of Texas' cases are in Gaines County, where the virus started spreading in a close-knit, undervaccinated Mennonite community. The county has had 413 cases since late January — just under 2% of its residents. The April 3 death in Texas was an 8-year-old child, according to Health Secretary Robert F. Kennedy Jr. Local health officials said the child did not have underlying health conditions and died of 'what the child's doctor described as measles pulmonary failure.' A unvaccinated child with no underlying conditions died of measles in Texas in late February; Kennedy said the child was 6. New Mexico held steady Friday with a total of 81 cases. Seven people have been hospitalized since the outbreak started. Most of the state's cases are in Lea County. Sandoval County near Albuquerque has six cases, Eddy County has three, Doña Ana County has two. Chaves, Curry and San Juan counties have one each. An unvaccinated adult died of measles-related illness March 6. The person did not seek medical care. Oklahoma added one case Friday for a total of 17 confirmed and three probable cases. The state health department is not releasing which counties have cases. Arizona has four cases in Navajo County. They are linked to a single source, the county health department said June 9. All four were unvaccinated and had a history of recent international travel. Colorado has seen a total of 16 measles cases in 2025, which includes one outbreak of 10 related cases. The outbreak is linked to a Turkish Airlines flight that landed at Denver International Airport in mid-May. Four of the people were on the flight with the first case — an out-of-state traveler not included in the state count — while five got measles from exposure in the airport and one elsewhere. Health officials are also tracking an unrelated case in a Boulder County resident. The person was fully vaccinated but had 'recently traveled to Europe, where there are a large number of measles cases,' the state health department said. Other counties that have seen measles this year include Archuleta and Pueblo. Georgia has an outbreak of three cases in metro Atlanta, with the most recent infection confirmed Wednesday. The state has confirmed six total cases in 2025. The remaining three are part of an unrelated outbreak from January. Illinois health officials confirmed a four-case outbreak on May 5 in the far southern part of the state. It grew to eight cases as of June 6, but no new cases were reported in the following weeks, according to the Illinois Department of Public Health. The state's other two cases so far this year were in Cook County, and are unrelated to the southern Illinois outbreak. Illinois unveils online tool showing measles vaccination rates by schoolIowa has had six total measles cases in 2025. Four are part of an outbreak in eastern Johnson County, among members of the same household. County health officials said the people are isolating at home, so they don't expect additional spread. Kansas has a total of 79 cases across 11 counties in the southwestern part of the state, with three hospitalizations. All but three of the cases are connected, and most are in Gray County. Montana had 22 measles cases as of Friday. Fourteen were in Gallatin County, which is where the first cases showed up — Montana's first in 35 years. Flathead and Yellowstone counties had two cases each, and Hill County had four cases. There are outbreaks in neighboring North Dakota and the Canadian provinces of Alberta, British Columbia and Saskatchewan. North Dakota, which hadn't seen measles since 2011, was up to 34 cases as of June 6, but has held steady since. Two of the people have been hospitalized. All of the people with confirmed cases were not vaccinated. There were 16 cases in Williams County in western North Dakota on the Montana border. On the eastern side of the state, there were 10 cases in Grand Forks County and seven cases in Cass County. Burke County, in northwest North Dakota on the border of Saskatchewan, Canada, had one case. Measles cases also have been reported this year in Alaska, Arkansas, California, District of Columbia, Florida, Hawaii, Indiana, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, Nebraska, New Jersey, New York, Rhode Island, South Dakota, Vermont, Virginia and Washington. Health officials declared earlier outbreaks in Indiana, Michigan, Ohio and Pennsylvania over after six weeks of no new cases. Tennessee's outbreak also appears to be over. Cases and outbreaks in the U.S. are frequently traced to someone who caught the disease abroad. The CDC said in May that more than twice as many measles have come from outside of the U.S. compared to May of last year. Most of those are in unvaccinated Americans returning home. In 2019, the U.S. saw 1,274 cases and almost lost its status of having eliminated measles. The best way to avoid measles is to get the measles, mumps and rubella vaccine. The first shot is recommended for children between 12 and 15 months old and the second between 4 and 6 years old. Getting another MMR shot as an adult is harmless if there are concerns about waning immunity, the CDC says. People who have documentation of receiving a live measles vaccine in the 1960s don't need to be revaccinated, but people who were immunized before 1968 with an ineffective vaccine made from 'killed' virus should be revaccinated with at least one dose, the agency said. People who have documentation that they had measles are immune and those born before 1957 generally don't need the shots because so many children got measles back then that they have 'presumptive immunity.' Measles has a harder time spreading through communities with high vaccination rates — above 95% — due to 'herd immunity.' But childhood vaccination rates have declined nationwide since the pandemic and more parents are claiming religious or personal conscience waivers to exempt their kids from required shots. Measles first infects the respiratory tract, then spreads throughout the body, causing a high fever, runny nose, cough, red, watery eyes and a rash. The rash generally appears three to five days after the first symptoms, beginning as flat red spots on the face and then spreading downward to the neck, trunk, arms, legs and feet. When the rash appears, the fever may spike over 104 degrees Fahrenheit, according to the CDC. Most kids will recover from measles, but infection can lead to dangerous complications such as pneumonia, blindness, brain swelling and death. There's no specific treatment for measles, so doctors generally try to alleviate symptoms, prevent complications and keep patients comfortable.


The Hill
13 hours ago
- The Hill
Health care workers on alert for ICE raids in hospitals
President Trump's whittling away of protected places for immigrants has fueled fears among health care workers that Immigration and Customs Enforcement (ICE) agents will arrest patients in or around hospitals. In January, the Trump administration rescinded a Biden-era policy that protected certain areas like churches, schools and hospitals from immigration enforcement. And lawmakers in at least one state have introduced legislation aimed at making it easier for ICE to make arrests in hospitals. As the Department of Homeland Security (DHS) seeks to ramp up ICE raids at hotels, restaurants, farms and other sites, nurses worry their workplace could be next. 'We were all worried about what this meant,' Michael Kennedy, a nurse at a University of California, San Diego health facility located very near the U.S.-Mexico border, said of the policy changes under Trump. 'As we've seen these immigration raids ramp up, our first thought is about our patients and what that means for them.' ICE agents made a record number of migrant arrests in a single day this month and have appeared outside of courthouses in Seattle and stores in the New York City area. The agency's workplace raids in Los Angeles spurred days of protests, which in turn prompted a heavy-handed response from the Trump administration. Sandy Reding is a nurse at a hospital in Bakersfield, Calif., which serves communities of farm workers and employs a diverse staff. 'There is a lot of concern [about] ICE agents showing up with FBI or with the military, because we've seen a lot of reports on TV, and we have reports in our area where this is happening as well,' she said. Reding and her fellow nurses, she said, are also worried that the news of increased ICE raids will deter some patients from coming to the hospital to seek care. 'What we are going to see is a large burden on communities and hospitals if people delay care,' Reding said. 'And there are worse outcomes.' Nancy Hagan, an intensive care unit nurse at Maimonides Medical Center in New York City, said those concerns have come to fruition at her hospital. In May, she said, an immigrant New Yorker had appendicitis but waited too long to go to the emergency room. Their appendix burst, spreading infected tissue and bacteria to other organs, which ultimately killed them. 'Once patients hear that a hospital is no longer a safe place for them to go, they are afraid to come to the hospital,' she said. Hagan, a Haitian immigrant, added that she and her colleagues, who work at hospitals across the city, have noticed that emergency rooms appear to be emptier in recent months. Kennedy, the nurse in San Diego, said the Level 1 trauma center, which is typically packed, has been emptier than usual. He admitted the decline in patient visits could be seasonally related, but he said he believes that the possibility of ICE agents arresting immigrants is having a 'chilling effect.' 'I can't see how this doesn't affect our patients' willingness to seek care,' he said. 'I'm willing to bet that a lot of people are delaying care because they're afraid.' ICE did not get back to The Hill in response to questions on whether agents have arrested people in or around hospitals, or if there are plans to do so. DHS announced in January that it had rescinded former President Biden's guidelines on immigration enforcement at 'sensitive locations' that were first issued under former President Obama. 'The Trump Administration will not tie the hands of our brave law enforcement, and instead trusts them to use common sense,' a DHS spokesperson said at the time. The National Immigration Law Center said that while immigrants no longer have special protections at hospitals and other 'sensitive locations,' they still have basic rights. 'Instead, individuals will need to rely on basic constitutional protections in these spaces,' it said in a fact sheet. 'Specifically, the Fourth Amendment protects all individuals from unreasonable searches and seizures, and the Fifth Amendment ensures the right to remain silent when confronted by law enforcement.' The Emergency Medicine Residents' Association has distributed a flyer with step-by-step guidance for health care workers on dealing with ICE agents if they do enter hospitals.