Despite efforts the U.S. Immigration and Customs Enforcement says it has implemented to prevent spread of COVID-19 in detention facilities, detainees are still infected at a much higher rate than the rest of the country.

Researchers analyzed data from 92 of the nation’s 135 ICE detention centers and found the case rate among detainees was on average more than 13 times the rate of the U.S. population each month from April to August, according to the report published late last month in JAMA Open Network.

Case rates surpassed those in U.S. federal and state prisons, which were 5.5 times higher than in the general population from March 31 to June 6, according to a July research letter published in JAMA. 

The numbers are alarming, but study authors and experts say COVID-19 spread in ICE detention facilities may be worse. Lack of data transparency, minimal testing and anecdotal reports of inconsistent compliance with health guidelines suggest case numbers could be much higher. 

“We have an incomplete picture of what’s happening with testing,” said study author and Harvard Medical School student Dr. Parsa Erfani. “(But) it’s hard to stand by and just look the other way.”

ICE said in a statement to USA TODAY it is dedicated to the health and safety of all individuals in its custody and has taken steps to safeguard all detainees, staff and contractors, including reducing the number of detainees in custody, suspending social visitation and incorporating social distancing practices. 

For the study, Harvard Medical School and Boston Children’s Hospital researchers calculated monthly tests and case rates per 100,000 people using the average monthly population of detainees in detention facilities.

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