As a physician, I tend to view the burgeoning migrant border crisis as much as a public health emergency as it is a national security emergency. The distinction is becoming more and more blurred, since the 2 million or more migrants who have crossed our southern border illegally over the past year — many supposedly seeking asylum — present both problems.
Don’t get me wrong: Many of the millions who have escaped Venezuela or Central America for economic and political reasons certainly have legitimate causes to leave their countries.
From a public health point of view, we are hardly prepared to handle such huge numbers of migrants, many of whom have chronic health issues or other acute problems. There is no system in place to screen them, beyond care at local hospitals for medical emergencies, and there’s no way to track them after they leave.
Even migrants who are healthy can become ill or injured on the arduous journey to the U.S. and, once here, are then faced with street living or attempts to find places in overburdened shelter systems.
In New York City, for example, homeless shelters are overflowing, with more than 80,000 people sleeping in them every night; there is simply no room for the many thousands of migrants who have come here. A shelter has been opened at Floyd Bennett Field in Brooklyn, but many migrants have refused to relocate there.
And so, the health burden continues to fall on the city’s hospitals. New York City Health and Hospitals reports close to 30,000 migrant patient visits over the past year, with 40,000 vaccines administered along with medical screening. Yet, unfortunately, there is no way to provide proper followup.
Similar problems are occurring all across the country because of the constant influx of migrants, from Chicago to Denver to Los Angeles. The shelter system in Massachusetts is so filled with migrants that the state’s governor brought in the National Guard to help.
The existing patchwork health care also leads to an increase in chronic diseases, from hypertension to obesity and diabetes. There is a paucity of medication to treat these problems, which also include asthma and allergies in children, not to mention women far along in their pregnancies who have lacked all prenatal care.
What is the solution?
Having migrants keep records of all health encounters is one idea, but I have found that to be an inefficient method even among citizens with stable homes. The obvious solution is to cut through the partisan politics of the issue and to acknowledge that allowing such numbers of unscreened migrants into the country creates a public health crisis that simply can’t be solved once they are here.
Dr. Robert Redfield, the Trump administration’s Centers for Disease Control and Prevention (CDC) director, invoked Title 42 at the beginning of the COVID pandemic to require most migrants to return to Mexico or Canada in order to slow the public spread of COVID-19.
Title 42 has been controversial and was pulled back under the Biden administration — but it does underline the need to at least find a way to screen people’s health when they want to come here. Of course, screening before the fact makes a lot more sense than after.
This has been a longtime practice for legal immigrants, and it is a strong argument for making our border more secure. We can’t risk our public health simply because of a proven or unproven need for asylum.
Dr. Marc Siegel, clinical professor of medicine at New York University’s Langone Medical Center, is the author of numerous books, including “COVID: The Politics of Fear and the Power of Science.” He hosts and is medical director of SiriusXM’s “Doctor Radio” program.
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