Border agency says it’s doing all it can to stop children from dying from flu. Others aren’t so sure

By Elizabeth Cohen and John Bonifield, CNN

(CNN)Despite reassurances from the federal government, some members of Congress say they worry migrant children won’t be safe from the flu this season.

In the last flu season, three children died of the flu while in the custody of US Customs and Border Protection.
As in many areas around the United States this year, the flu has made an early appearance along the Southwest border, with high levels of flu activity in Texas and Arizona.

At a news conference Monday, Mark Morgan, acting commissioner of US Customs and Border Protection, said his agency has complied with “a lot” of the flu-fighting recommendations issued in January by the US Centers for Disease Control and Prevention.
“It’s really incredible what has transpired,” he said.
The CDC made its 10-page report after visits to five CBP facilities in Texas and Arizona, prompted by reports of respiratory illnesses among migrants.
Despite the CDC’s recommendations to take steps to fight the flu, two more migrant children died of the flu after the report was sent.
Now some members of Congress say they don’t want to just take Morgan’s word for it that the agency has improved its strategies for fighting the flu in facilities with potential for overcrowding.
“This is about saving lives,” Rep. Rosa DeLauro, a Connecticut Democrat, told CNN after Morgan’s press conference. “They’re not numbers. We have Wilmer, who was 2 years old; Felipe, who was 8; and Carlos, who was 16.”
She was referring to Wilmer Josue Ramirez Vasquez, Felipe Gomez Alonzo, and Carlos Hernandez Vasquez, the three migrant children who died of the flu last season.

She also pointed out that the CDC recommended “ongoing” monitoring of sick migrants in its report in January, but a recently released video from May shows Carlos lying on the floor for hours before someone found him dead.
The CDC experts aren’t the only ones criticizing the CBP’s infection control measures.
In August, doctors at Harvard Medical School and Johns Hopkins wrote an eight-page letter to DeLauro detailing similar concerns and recommendations. DeLauro forwarded the letter to the US Department of Homeland Security.
The letter asked DHS to answer 19 influenza-specific questions for every facility that holds children, and to provide supporting documentation.

Four months later, DeLauro said she still has not received a response from DHS.
“I am a member of the Congress, and we have jurisdiction over this area, and we have been stonewalled,” she said. “This is a failure of responsiveness.”
In an email Tuesday, a DHS spokesperson told CNN that a response to DeLauro is “overdue,” but that the department had given briefings on medical issues to staff members of several congressional committees.

A scathing CDC report

In its 10-page report, which was issued in January, CDC experts wrote that border patrol agents lacked training to identify acutely ill migrants, and that there were “limited” options for isolating sick migrants.
“Current infrastructure is not sufficient to assure rapid and adequate infection control measures,” the CDC experts concluded. “With inadequate DHS medical infrastructure, illness in the border patrol facilities stresses both the border patrol staff and the community medical infrastructure.”
An official with CBP who is familiar with the agency’s medical infrastructure questioned whether the CDC experts were holding border patrol authorities to the right standard.
He said the CDC is a public health agency with “limited experience in this law enforcement kind of frontline setting.”
“The conditions that CBP functions under are different than a lot of the situations where CDC functions,” he said. “Do we have the ability [to function like] the CDC or a county public health department or at an emergency room level? No.”
The CDC experts recommended vaccinating migrants against the flu, but CBP has maintained that the migrants are only with them for a matter of days, and they should be vaccinated later on.
The CDC also recommended improved triaging of migrants to check for signs of the flu, better infection control measures, and guidelines for the use of anti-viral drugs.
The CBP official said his agency has made “remarkable progress” this year.
He said most CBP facilities — “dozens and dozens of them” — have “essentially addressed all of the issues” in the CDC report.
“From Brownsville, Texas, to Imperial Beach, San Diego, we have over 500 medical personnel on contract. On any given day we have 250 medical personnel providing medical support efforts along the Southwest border. We brought on additional physician supervisors. We brought on pediatric advisors. We brought on behavioral health advisors. We brought on patient safety quality managers,” he said.
DeLauro said such reassurances were not enough.
“Don’t just tell me, ‘Don’t worry about it, we’re working on it.’ What does that mean? It’s obfuscation,” she said. “Give me the documentation. You tell me what you have done, and you lay it out so that we can review it.”

Lawmaker: ‘We need very strong oversight’

Rep. Raul Ruiz, a California Democrat and an emergency room physician, agrees.
“That’s not acceptable,” he said. “That’s why we need very strong oversight by Congress.”
In June, Ruiz introduced a bill to establish basic standards of care for migrants in CBP custody. The bill passed the House of Representatives in July.
At Monday’s news conference, Morgan noted that his agency is always trying to do better.
“We’re currently re-looking at those medical protocols to see where we can improve and every single day we’re trying to improve the medical care that we provide,” he said.
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