Boston doctors are urging CDC director Rochelle Walensky to revoke a public health order being used to expel migrants

Scores of doctors at Massachusetts General Hospital are calling on CDC Director Dr. Rochelle Walensky to reconsider the use of a public health order that is being employed by federal agencies to rapidly expel migrants from the U.S. border without giving them the chance to apply for asylum. 

More than 300 doctors and health care workers in the Mass General Brigham and Harvard Medical School systems have signed the letter sent to their former colleague, who served as the chief of the MGH Infectious Diseases Division before her appointment to the CDC, last week.

Dr. Fiona Danaher, director for the center of immigrant health at Mass. General, told Boston.com she and her colleagues were compelled to write the letter after seeing images capturing treatment of Haitian migrants who were being turned away “without any assessment of their safety.” 

“That’s all enabled by the Title 42 order, which has been in place throughout the pandemic,” Danaher said. “We’ve had concerns about it throughout the pandemic, but this was really a tipping point for us. So recognizing that Dr. Walensky is one of our own colleagues, as the former chief of infectious diseases at Mass. General before she went to the Centers for Disease Control and Prevention, we decided to reach out to her.”

The public health order is based in Title 42 of the Public Health Service Act, which gives federal officials the ability to take significant steps to limit the transmission of infectious disease during a pandemic. 

The potential power is not new, but it was invoked by the Trump administration in March 2020 to shut down the northern and southern borders, shutting out migrants and turning away those seeking asylum with the argument that the action was taken to prevent the spread of COVID-19. At the administration’s direction, the CDC issued an order “suspending the right to introduce certain persons into the United States from countries where a quarantinable communicable disease exists.” 

It was later reported that the Trump administration had long been looking for opportunities to use the public health law to curtail and block immigration. 

Those opposed to the use of the order, which has been extended under the Biden administration, say it is being used as a political measure to prevent legal immigration under the rhetoric of public health.

“The reality is that the rates of COVID-19 are higher in the United States than they are in many of the places these migrants are coming from,” Danaher said. “And there has never been any data to suggest that migrants are driving the COVID-19 epidemic in the United States. In fact, in the places where there has been testing of migrants upon release from Customs and Border Protection, they have generally had a lower rate of COVID-19 than is present in the communities they are being released into. It’s the converse.”

The messaging around Title 42 has been politically expedient, the doctor said. 

And the effects of the order are being seen in Boston, including increasing levels of hate crimes against Asian Americans being blamed for bringing the virus to the country, she said.

That kind of rhetoric is encouraged by the order, the doctor said.

“It suggests that foreigners are somehow responsible for spreading the disease,” Danaher said. “We saw one of our own colleagues verbally assaulted outside of the hospital for being Asian American after she had just completed a shift taking care of sick COVID patients, putting herself at risk.”

The impacts of the order have been a problem since last year, she stressed.

“But Boston is home to the third largest population of Haitian immigrants in the country and to see the way that the Haitian migrants were treated in Del Rio, and the distress among our own patients and colleagues who are from Haiti after that happened, was really too much,” the doctor said. “We felt like we had to speak out.”

They aren’t the only ones. 

Another letter was sent to Walensky on the subject, organized by Dr. Julia Koehler, a pediatric infectious disease physician at Boston Children’s Hospital. 

According to Koehler, the letter had 250 signatures when it was sent to the CDC director, but the number now tops 550. The effort emerged after a conversation among members of the American Academy of Pediatrics’ national Immigrant Health Council, and has support from medical professionals across the country. 

“The Title 42 order in fact harms public health, it does not protect public health,” Koehler told Boston.com. “Forcing people into crowded, unsanitary and unsafe camps and facilities,​ as this order does in communities straddling our border, accelerates viral spread. Just like in Boston, where spread of the virus in Latino and Black communities was left unchecked, and spilled over into the wealthy suburbs where people could work from home, viral outbreaks don’t stay on one side of the border.”

The order undermines credible public health measures, while using public health as a “pretext for political goals,” the doctor said. 

Like Danaher, Koehler also pointed to the “fresh wave of blatant racism” unleashed by enforcement of the order as a motivator for speaking out. 

“The order itself contains and enforces the racist trope that migrants are vectors of disease,” she said. “Anti-Black and anti-Latino racism are the unspoken subtext of this order.”

Both letters are calling on Walensky to produce the scientific basis for the continued use of the order. 

Neither of the organizers have gotten a response to their letters so far.

Danaher said she and her co-workers at Mass. General Brigham are hoping that by going on-record as Walensky’s colleagues, as well as medical and public health professionals, they can provide the CDC chief with the support she needs to encourage other arms of the federal government to reconsider the order and its necessity. 

“There’s a long history in this country of foreigners being scapegoated for epidemics and portrayed as vectors of disease,” she said. “It’s really harmful, not just for the individuals who are being denied their opportunity to seek safety in this country, but also for public health in terms of how people try to protect themselves during this pandemic. And it encourages racism and xenophobia in our communities. So we really feel that this order should be rescinded.”

Read the letters below: 

Title 42 Letter to Dr. Walensky From MGB & HMS Colleagues by dialynn dwyer on Scribd

2021-10-06 CDC Director Dr. Walensky Letter Title 42 by dialynn dwyer on Scribd

Information from the Associated Press was used in this report.

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