Epidemiologists and Public Health Experts Reiterate Urgent Call to End Title 42

One Year into Biden Administration and Two Years after the Onset of COVID-19, Epidemiologists and Public Health Experts Reiterate Urgent Call to End Title 42 

For Immediate Release: January 14, 2022

Contact: Monette Zard, Director of the Program on Forced Migration and Health in the Heilbrunn Department of Population and Family Health at Columbia University Mailman School of Public Health, mz2621@cumc.columbia.edu

As we approach the one-year anniversary of the Biden administration entering office, epidemiologists, physicians, and public health experts reiterate their urgent call for the administration to end its use of the scientifically-baseless Title 42 policy that illegally and inhumanely expels asylum seekers at the southern U.S. border without due process. Throughout the past year, leading public health experts have repeatedly called on the Biden administration, as they did the Trump administration, to revoke the Title 42 order that continues to politically exploit the COVID-19 pandemic to expel, block, and return to danger asylum seekers and individuals seeking protection.  The Omicron variant highlights that community transmission within the US, and not introduction of the virus from Mexico, is driving the spread of COVID-19, and that public health authorities need to focus on mitigation measures that are known to work. Title 42 is not among these measures and, if anything, makes matters worse.

Initially pronounced by the Trump administration in March 2020, the order has been repeatedly extended since then, exacting a terrible toll on the lives and wellbeing of asylum seekers who have been deprived of their right under domestic and international law to seek protection, and returned to face violence and death. In the last year alone, Human Rights First has documented over 8,700 cases of asylum seekers and migrants kidnapped, raped, or attacked after being blocked from entering the US or expelled to Mexico. Despite President Biden’s commitment while campaigning to revoke Trump’s inhumane immigration policies, the order has been extended nine times under his watch. 

“We are profoundly disappointed that the Biden administration continues to disregard science in favor of a cruel and discriminatory policy that does nothing to safeguard public health and instead returns to danger men, women, and children who are doing nothing other than exercising their right to seek asylum,” said Dr. Michele Heisler, medical director of Physicians for Human Rights and professor at the University of Michigan Medical School and School of Public Health. “Two years into this pandemic, there is no excuse for the Biden administration’s continued failure to uphold its legal commitments to people seeking safety at the southern border.”

The Title 42 order does not, nor was it ever intended to, protect public health. Since its inception, the  order has been strongly criticized by public health and medical experts who note that these expulsions have no basis in science, discriminate against asylum-seekers, and fuel racist tropes about migrants as vectors of disease. White House medical advisor Dr. Anthony Fauci asserted that COVID-19 transmission “is not driven by immigrants” and that “expelling [migrants] is not the solution to an outbreak.” This is borne out by the congressional testimony of Dr. Anne Schuchat, a former Acting Director of the CDC, who noted that, “the bulk of the evidence” available to the CDC at the time the order was enacted did not support the policy. We now know that even prior to the pandemic, the Trump administration reportedly sought to utilize this obscure law multiple times, only to face resistance from his own cabinet secretaries and lawyers that the law and its purpose were being misinterpreted. 

“The Title 42 order is not and has never been about public health. Rather it represents a cynical manipulation of public health arguments to advance political policies of immigration control,” said Dr. Ron Waldman, an epidemiologist at the CDC for more than 20 years who is now president of Doctors of the World-USA and Professor Emeritus at the Milken Institute School of Public Health, George Washington University. “Despite President Biden’s promises to end the harmful immigration practices of the previous administration, his administration, acting through the Centers for Disease Control and Prevention (CDC), has fully embraced, defended, and used this inhumane policy for a year now. They now own it, and the horrific human suffering it has inflicted.”

In September 2021, epidemiologists, former officials from the Centers for Disease Control and Prevention (CDC), and other leading public health experts wrote to the Department of Health and Human Services Secretary Becerra, Department of Homeland Security (DHS) Secretary Mayorkas, and CDC Director Walensky condemning the “scientifically baseless and politically motivated” Title 42 expulsion policy, which DHS continues to wield to block and expel asylum seekers to life-threatening dangers under the guise of protecting public health. In this letter, experts conclude that the Delta variant and “the likely emergence of future variants of concern serve as a reminder that a pandemic response cannot rest on a single intervention.” 

Widespread community transmission of the Omicron variant is the driving source of COVID-19 spread within the US, underlining the fact that Title 42 is not an evidence-based pandemic response. As our letters to both the Trump and Biden administrations concluded in May 2020 and January, July and September of 2021, the application of science-based public health measures, which this group of public health experts has outlined and previously shared with U.S. officials, such as high-quality masks, timely testing, and social distancing would allow for the safe and effective processing of asylum seekers at the southern border.  The CDC acknowledged as much in their August 2 update of the Title 42 order where they noted that mitigation measures – such as masks, avoiding congregate settings, social distancing, testing, provision of vaccines[1], quarantine, and isolation – can effectively limit the transmission of COVID-19. The advent of the Omicron variant reinforces the importance of these measures across the board and highlights harms caused by policies such as Title 42 which use spurious public health claims for political gain.  With an annual budget of nearly 5 billion per annum for U.S. Border Patrol alone and support from the Department of Homeland Security as a whole, it strains credulity to claim that U.S. agencies “lack the capacity” to safely process asylum seekers, as has been posited by the CDC.  

“The administration has the capacity and the evidence-based public health measures to safely restore asylum; what they lack is the political will,” said Monette Zard, associate professor and director of the Program on Forced Migration and Health at Columbia University’s Mailman School of Public Health.

“Rather than throwing up our hands and saying we can’t, we should do what we know works. We know how to prevent COVID. We should be using tried and true public health measures to safely process asylum seekers, relying on multiple layers of protection, including: testing, masking, good ventilation, social distancing, and the provision of vaccinations. These are tried and tested public health tools, which work together to keep people healthy and safe,” said Dr. Megan Coffee, an infectious disease specialist and assistant professor at Columbia University’s Mailman School of Public Health. “Omicron has been a game changer in many ways, but it has not changed what works. The same public health measures work. We just need to use them. We should continue to stress the importance of public health.”

Each day it remains in effect, the Title 42 order continues to harm those seeking asylum at our borders and threaten public health. In fact, DHS’ implementation of Title 42 exacerbates the very risks the administration says it must avoid. Its practice of holding some asylum seekers in congregate settings for days or weeks and flying them to other parts of the border to expel them increases the risk of COVID-19 spread, further confirming that the policy is not intended to, nor does it, protect public health.  

“It is lamentable that one year on, the administration and the CDC continue to uphold this scientifically baseless order,” said Dr. Paul Spiegel, director of the Center for Humanitarian Health and professor of the practice at the Johns Hopkins University Bloomberg School of Public Health. “Not only does Title 42 place asylum-seekers in harm’s way, depriving them of their right under domestic and international law to seek protection in the US, but in the process it makes us all less safe because it undermines trust in the very institutions and decisions that should be grounded in science and driven by a concern for the public health.”

“It is unacceptable for the Biden administration to pass off the use of Title 42 as a “public health response” to Omicron or any other COVID-19 variant,” said Dr. Rachel Moresky, Director of the Columbia Global Emergency Medicine Fellowship and Associate Professor at Columbia University’s Mailman School of Public Health. “In practice, the sustained use of Title 42 is a cover for immigration control. Public health measures like masking, testing, providing vaccinations, and social distancing would make it possible to safely process asylum seekers and other migrants arriving at the border. Closing the border and failing to implement such measures jeopardizes the lives of asylum seekers.”

One year on, it is shameful that the Biden administration continues to misuse public health to justify this discriminatory policy. In doing so, the administration is exposing asylum seekers to immeasurable and often irreparable harm. By succumbing to political pressures rather than following the science, the CDC is undermining and eroding the trust that is foundational to the effective practice of public health. The Title 42 order must be fully revoked now.


[1] While vaccinations should be made available, as public health experts have previously explained, the lack of vaccines is not a public health justification for expelling or denying access to asylum seekers.