Work

COVID-19 in migrating people at the US-Mexico border during Title 42 immigration restrictions

Year: 2026

Type: article

Abstract: Introduction: In March 2020, the US government implemented the policy of 'Title 42,' which restricted entry of asylum seekers on the stated basis of COVID-19 prevention. In the subsequent years, informal settlements for displaced persons developed and increased in size near the US-Mexico border. We sought to determine the risk of COVID-19 in this setting and compare this to nearby communities at the border. Methods: We conducted an observational study of COVID-19 using data from a humanitarian relief operation at informal settlements at the US-Mexico border from March 2020 to March 2021. People who used this clinic had travelled through irregular routes of migration in Latin America. We reviewed patient characteristics, symptoms and point-of-care SARS-CoV-2 test results during the study period. We compared COVID-19 percent positivity in the camp with the surrounding communities in Mexico and Texas, USA, over 4-week periods. Results: In 6764 clinical encounters, there were 3737 SARS-CoV-2 tests completed with 482 positive results (12.9%, 95% CI 11.8% to 14.1%). Percent positivity was higher in people aged 30-39 years (16.5%) and 40-49 years (16.2%) compared with other age groups (p<0.001) and was 61.5% in pregnant women. Percent positivity was higher in asymptomatic people with suspected close contact exposures than in people with symptoms (15.2% vs 6.9%, p<0.001). Percent positivity was never higher in the camp than in the surrounding community in Matamoros, Tamaulipas, Mexico, and for 8 of the 13 4-week periods, not higher than in Cameron County, Texas. Conclusion: COVID-19 percent positivity was typically lower or the same in this population of migrating people as in the surrounding communities, which provides further evidence against the use of pandemic-era immigration restrictions through Title 42.

Source: BMJ Public Health

DOI: 10.1136/bmjph-2025-003358