By Edward Kissam. Ethnic Media Services.
With the emergence of avian flu and other public health threats, Trump's war on immigrants will complicate efforts to identify and treat outbreaks and implement vaccination initiatives.
President Trump’s inaugural address on Monday signaled his continued commitment to characterizing immigrants as criminal invaders and an impediment to his campaign mantra of “making America great again.”
Following his speech, Trump signed a series of executive orders (declaring a national emergency at the southern border and ending birthright citizenship, as well as ending the use of the CBP1 app, among others) that will not only inflict pain on immigrants and their neighbors, but also on thousands of American businesses and families.
Worse still, these measures will undermine efforts to protect public health just as the country faces a series of existing and emerging threats that put us all, immigrants and non-immigrants, at risk.
One of the lessons of COVID-19 is that the best response to a pandemic is to work hard to prevent it from starting. Public health researchers have been warning for decades about evidence of zoonotic diseases (transmission from animals to humans) such as HIV, SARS-1 (the predecessor of COVID-19), MERS, Ebola and many others.
Avian influenza (H5N1) is the most recent, with 66 confirmed cases and one confirmed death to date in the United States, according to the Centers for Disease Control and Prevention.
The systematic persecution of agricultural workers, Half of whom are unauthorized immigrants , will greatly increase the risk that this now latent epidemic will develop into something much more disastrous.
Research shows that in places where immigration enforcement is especially severe, about 251% of unauthorized immigrants (as well as their family members who are in the country legally) do not receive health care. That alone will undermine efforts to address overall disparities in access to health, and wipe out at least a decade of progress toward public health equity.
Trump's anti-immigrant campaign will also undermine childhood vaccination campaigns against preventable diseases like measles, as well as COVID-19 vaccines for at-risk older farmworkers, a dangerous shift in attitude heightened by the election of an anti-vaccine crusader to lead HHS and a vaccine skeptic to lead the CDC.
Even more alarming is the widespread detention raids of non-citizens by CBP and/or ICE ( as happened earlier this month in parts of California's Central Valley , where there is a statewide emergency order to combat avian influenza) will inevitably complicate the already difficult task of quickly identifying and treating potential avian influenza infections in the farmworker population.
At present, while the impact of avian influenza remains primarily economic and there is still no evidence of human-to-human transmission, genomic analysis has identified a viral mutation that could potentially increase human infection and thus increase transmission.
Given the risks, a crucial goal should be to minimize exposure and infections among farmworkers who are in regular contact with infected dairy cows or poultry to avoid dangerous mutations.
A second step would be to rapidly identify people who have contracted H5N1 and provide them with free antiviral treatment to speed recovery and, by reducing the viral load, decrease the risk of transmission.
Other steps should include:
- Prohibit warrantless arrests of persons suspected of being in the United States illegally.
- Initiate a vigorous public campaign to encourage farmworkers and their families to get vaccinated with the seasonal influenza vaccine currently available without collection of personally identifiable information.
- A 360-degree “surround sound” community campaign to assure farmworkers and their families of the confidentiality of personal information provided to secure medical care.
- Expand CDC's current monitoring of family members and close contacts of farmworkers who contract avian influenza to all farmworkers' social networks.
- And a vigorous public health campaign to encourage farmworkers and their families to seek immediate medical attention for flu-like respiratory illnesses, especially conjunctivitis (a symptom that may be more common in avian flu than in seasonal flu).
Earlier this month, outgoing Department of Health and Human Services Secretary Xavier Becerra announced a $306 million investment in Monitoring and preparing for avian influenza . Another $590 million will go to the pharmaceutical company Moderna, given its success in rapidly developing the COVID vaccine. These investments of just under $1 billion are a drop in the ocean compared to the An estimated $88 billion per year for the detention and deportation of unauthorized immigrants.
Moving forward with greater efforts to protect the United States from avian flu is affordable, feasible, and can dramatically reduce the risk of another pandemic. The business-oriented Trump administration would need to focus on the well-being of workers in the poultry and dairy industries, whose labor is essential to the operation of these multibillion-dollar industries.
In a rational social and political environment, these “common sense” measures (to borrow a phrase from Trump’s inaugural address) would be relatively easy to implement. But that is not the environment we find ourselves in.
However, any progress made in terms of technological tools to combat bird flu will be ineffective, as Trump's unjustified campaign against immigrants makes it impossible to identify and treat outbreaks and launch vaccination initiatives.
Even as we enter an era where anti-immigrant voices are louder than ever, it is important to continue to remind local, state and federal elected officials that we are all in this together.
Ed Kissam led several national research projects on U.S. farmworkers over the past 30 years. He served as a farmworker outreach expert on several COVID-19 initiatives during the pandemic and published extensively on efforts to improve the strategy. He currently serves on the Advisory Board for the CDC-funded H5N1 Outreach and Research Program at the National Center for Farmworker Health.
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