People detained by Immigration and Customs Enforcement (ICE) have long reported not getting adequate health care while they’re locked up. Some of the most notable cases have involved detainees who died, and others who left ICE custody sicker than when they entered.

That’s why advocates are lobbying for the release of HIV-positive immigrants currently held in U.S. detention centers, citing fears their health could be at risk amid the nationwide outbreak of COVID-19, also known as novel coronavirus.

The nonprofit group Immigration Equality filed a complaint with the Office of Civil Rights and Civil Liberties in the Department of Homeland Security last week, claiming that the U.S. Immigration and Customs Enforcement’s refusal to release vulnerable immigrants from custody puts their lives in danger.

As VICE previously reported, the Centers for Disease Control and Prevention said people with HIV can be especially vulnerable to opportunistic infections. Limited research has indicated that people with HIV may not face any greater risk of infection from COVID-19, as long as they adhere to their prescribed antiretroviral medication and are not otherwise immunocompromised. However, the New York City Department of Health and U.S. Department of Health and Human Services caution that any disruptions in an individual’s medication could put them at greater risk for contracting coronavirus.

“The already extremely poor medical care in ICE detention combined with the effects of COVID-19 could lead to countless deaths of detained HIV-positive individuals,” Immigration Equality warned in a statement.

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While Immigration Equality said no person with HIV should be held in an immigration detention facility during the coronavirus outbreak, its complaint highlighted six cases of asylum seekers who “are parole eligible, have qualifying sponsors, are not flight risks, and do not present any danger to the community.” Each of these individuals applied for parole and were denied, and the complaint alleged that these requests were sometimes refused before deportation officers reviewed “the extensive evidence submitted by counsel in support of Complainants’ parole applications.”

Immigration Equality Executive Director Aaron Morris said that ICE “doesn't have the ability, the resources, or the skill set” to keep these populations safe during a critical period for U.S. public health. As of Monday afternoon, at least 140,000 people across the U.S. have been diagnosed with COVID-19 according to the CDC, and last week the first recorded case of coronavirus in ICE custody was reported at Bergen County Jail in Hackensack, New Jersey.

ICE did not immediately respond to requests from VICE for comment prior to publication. But on its website, the agency claims that it is continuing “to work diligently to ensure employees are operating under the safest and most practical conditions to reduce the risk of exposure and prevent further spreading of COVID-19 during the course of ongoing daily operations.”

According to Morris, Immigration Equality has heard “horror stories” about conditions that could allow the further spread of coronavirus among immigrants in detention facilities.

“Some of our clients have not been told what COVID-19 is or how to stay safe,” he told VICE. “None of them can social distance. They’re often in a dorm room with bunk beds with a hundred people. One of our clients told us that they were going to run out of soap. It's impossible to stay healthy in such an unhygienic, unsanitary situation.”

Brian Griffey, the regional researcher and advisor for North America at Amnesty International, said his organization had received similar complaints from a facility located in Aurora, Colorado. Griffey said that “trans women, some of whom are living with HIV, continue to be held in extremely close quarters without adequate access to sanitizer [or] protective wear,” as well as any other preventative measures.

“The workers there have not reportedly been conducting themselves with adequate personal protection equipment and have not shared information about potential transmission of COVID-19 to people living in the facility,” Griffey told VICE. “We've heard this also from other facilities: Some of the detainees have been put into segregation or isolation in detention without any clear explanation of whether or not there is a risk of them having been infected with the virus.”

Complaints about medical treatment for people with HIV and trans women have long plagued ICE facilities. The deaths of two HIV-positive asylum seekers sparked a national outcry after they died nearly exactly a year apart to the day: Roxsana Hernandez, a 33-year-old from Honduras, and Johana Medina Leon, a 25-year-old from El Salvador. Both were transgender and died while in ICE custody.

Reports of Hernandez’s death said she suffered cardiac arrest, while an independent autopsy showed hemorrhaging on her ribs, suggesting possible abuse. But a subsequent investigation published in NBC News claimed she died of complications resulting from HIV, including pneumonia and dehydration. An ICE spokesperson could not confirm whether Hernandez had been receiving antiretroviral treatments intended to lower the viral load of individuals living with HIV and encourage production of healthy CD4 T-cells, or whether she had ever been offered such medications.

Morris said denial of even basic HIV care, which can be life-threatening, is an extremely frequent occurrence in ICE facilities.

“There are regular interruptions in people’s medication,” he said. “They are often delayed from the very start. A few of our clients have gone months without HIV medication. Individuals who are stuck in these facilities are getting terrible HIV care and so they have low CD4 counts and high viral loads, or at least that’s what we expect because part of the problem is they won't give the individuals their medical records. They don’t tell them how sick they are.”

Marco Castro-Bojorquez, the co-founder of HIV Racial Justice, said ICE simply does not have to further endanger the lives of already vulnerable individuals if there are other options at hand. Thousands of non-violent offenders have been released from jails in states like New York, New Jersey, and Mississippi amid fears of a COVID-19 outbreak.

“They can put an ankle bracelet on them and let them out,” Castro-Bojorquez told VICE. “Most of them have families. If we’re dealing seriously with coronavirus, nobody should be in the type of facilities where they're in close proximity with each other. Most people will be in danger to lose their lives. Those are just people like you, me, and everybody else. They should be given the same benefits that all of us are because they also have human rights.”

The Department of Homeland Security has yet to respond to the complaint, which was filed just days after ICE announced it would be suspending all visitation to immigrants in detention centers.

Morris expressed doubt whether the complaint would be responded to, however, as many governments offices shut down in order to adhere to Centers for Disease Control guidelines regarding social distancing. While the Office of Civil Rights and Civil Liberties within the Department of Homeland Security has not officially announced it has closed, he noted that the U.S. Citizenship and Immigration Services and the immigration courts “have suspended service.”

But Immigration Equality held out hope that DHS would act “before it's too late.”

“I feel a sense of urgency because the window of opportunity for getting them out is closing,” Morris said. “When the facilities start to test for COVID-19, they're going to lock them down completely.”