*2.4. Criticisms*

Despite the existence of the above standards, conditions in detention centers regarding healthcare have long been a subject of criticism from scholars, civil society organizations, and the UN.<sup>24</sup> For example, Detention Watch Network has referred to "ICE's shameful record of medical negligence ... poor sanitation, and demonstrated inability to properly respond to past infectious disease outbreaks" (Detention Watch Network 2020a, p. 1), and the medical care provided in immigration detention centers has been called "dangerously substandard" (Human Rights Watch 2018).

The UN Human Rights Committee last issued its observations on the U.S. in 2014, mandating that the U.S. ensure compliance with Articles 7 and 10 (United Nations Human Rights Committee 2014a, para. 20). The Committee is currently awaiting another report from the U.S. and, in particular, an update on "the conditions within immigrant detention facilities, both publicly and privately owned, including access to healthcare" (United Nations Human Rights Committee 2019, para. 21). The UN Committee Against Torture expressed concern about "reports of substandard conditions of detention in immigration facilities" (United Nations Committee against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment 2014, para. 19) and has specifically asked the U.S. to respond to such reports (United Nations Committee against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment 2017, para. 28). Moreover, the UN Working Group on Arbitrary Detention noted in a 2017 report on a visit to the U.S. that detainees in private facilities "expressed concern about ... the poor quality of food and drinking water ... and access to medical services" (United Nations Working Group on Arbitrary Detention 2017, para. 34).

When COVID-19 reached the U.S., the immigration detention system was therefore already struggling to meet the healthcare needs of detainees. Detention facilities were overcrowded, despite then-President Donald Trump's increasing the number of detention facilities (American Civil Liberties Union 2020, p. 14 (American Civil Liberties Union)). ICE was already under fire for its poor monitoring and prevention of disease in its facilities.<sup>25</sup> As the first few months of the pandemic demonstrated, immigration detainees were particularly vulnerable to the pandemic and did not have adequate resources to avoid its impact.
