Poor quarantine conditions may spread Covid-19
Oct 13, 2020
Venezuelan authorities’ treatment of approximately 130,000 citizens returning from other countries in many cases is abusive and is likely to amplify transmission of Covid-19, Human Rights Watch and the Johns Hopkins University’s Centers for Public Health and Human Rights and for Humanitarian Health said today. Foreign affairs ministers from Latin American countries scheduled to meet online the week of October 19, 2020, as part of the Quito Process should urgently address the returnees’ situation.
Tens of thousands of Venezuelans, most of whom were living in other Latin American countries, are returning to Venezuela because of the Covid-19 pandemic and its economic impact. Human Rights Watch and the Johns Hopkins centers found overcrowded and unsanitary quarantine centers for the people returning, with little access to food, water, or medical care. Some who protested the conditions were threatened with arrest. And due to Covid-19 testing delays and an unnecessarily elaborate testing protocol, many people have been quarantined for weeks longer than the 14 days the World Health Organization (WHO) recommends.
“Sending returnees to overcrowded and unsanitary quarantine centers, where social distancing is impossible, is a recipe for spreading Covid-19,” said Dr. Kathleen Page, a physician and faculty member of the Johns Hopkins University School of Medicine and the Johns Hopkins centers. “Requiring them to stay there longer than the standard 14 days only increases the risk they will become infected, serving no reasonable public health purpose.”
Since 2014, more than 5 million Venezuelans have left their country, fleeing a continuing human rights, humanitarian, political, and economic crisis. But Covid-19-related lockdowns in other Latin American countries left many Venezuelans who had been working in informal economies unable to afford food and rent. Since the pandemic began, approximately 130,000 Venezuelans have made an often-arduous journey home, according to Venezuelan officials and aid agencies’ estimates.
Latin American governments created the Quito Process in 2018 to chart a common response to the Venezuelan exodus. At their October meeting, the member countries should make a commitment to protect the rights of Venezuelans in their territories and consider adopting a regional temporary protection regime to grant Venezuelans in their territories legal status for a period of time. Officials should also cooperate to protect returnees’ rights and press Venezuelan authorities to end abusive quarantine conditions and consider alternatives – such as home quarantine – where feasible.
On June 11, Nicolás Maduro said that his government “will continue to receive all the Venezuelans who return with love.” Yet the government has repeatedly stigmatized returnees, accusing them of bringing the virus to Venezuela.
From June through September, Human Rights Watch interviewed 76 people, including 23 returnees, 10 women and 13 men, from Colombia, Brazil, Peru, Ecuador, and the United States, as well as journalists, aid workers, representatives of nongovernmental organizations, and residents of areas where returnees are arriving. Human Rights Watch analyzed information provided by international and Venezuelan groups, video statements by government officials, and protocols issued by the Venezuelan Health Ministry. A Johns Hopkins centers researcher participated in some interviews and reviewed Health Ministry documents.
As of October 12, Venezuela had confirmed 83,137 cases and 697 deaths due to Covid-19. The real number is most likely much higher.
People entering Venezuela are required to stay at quarantine centers known as Puntos de Atención Social Integral, or PASI. Returnees interviewed stayed in a total of 26 centers. Nineteen were primary reception centers in the border states of Táchira, Apure, and Bolívar. The rest were in the Capital District (city of Caracas) and the states of Aragua, Falcón, Guárico, Vargas, and Zulia.
While conditions in the centers vary, most returnees interviewed described them as severely overcrowded, with many people sharing a single room. Many also described unsanitary conditions, including a lack of water and electricity to run water pumps and of basic supplies needed for hygiene, such as soap. They said they had serious difficulties getting medical care and food, including formula and clean water for infants.
The Venezuelan government has a duty of care toward people in quarantine centers and is obligated to provide for their basic needs, including adequate food, safe water, access to sanitation, materials to ensure good hygiene, and medical care. The conditions described by returnees in some centers fall far short of meeting their basic needs, and in some cases may be severe enough to amount to degrading treatment forbidden under the International Covenant on Civil and Political Rights, among other instruments.
The conditions described by returnees are likely to contribute to the spread of the virus, Human Rights Watch and the John Hopkins centers said. The overcrowding makes social distancing impossible and increases the risk of coronavirus transmission. In some instances, people who entered the centers at different times or were at various stages of testing were not isolated from each other. At hotels used as PASI centers, quarantined people sometimes shared common spaces with hotel guests who did not wear facemasks.
Requiring people to stay beyond 14 days solely to await test results is unnecessary from a public health standpoint and inconsistent with WHO guidelines, and it effectively results in arbitrary detentions.
Aid workers reported better conditions in some PASI centers than others. No official common standard applies to all centers. State officials or security forces, including the Bolivarian National Guard, operate the centers, and conditions, along with access for aid workers, vary greatly, largely depending on who is in charge.
Local and international humanitarian organizations are assisting returnees and trying to improve conditions in PASI centers with funding from international cooperation, and representatives from some of these groups told Human Rights Watch that their access has improved in recent weeks. However, their capacity and reach across all the PASI centers is limited, so many returnees in PASI centers will not receive services adequate to meet their basic needs, Human Rights Watch said.
On July 10, Human Rights Watch requested information from Venezuelan authorities on policies addressing official hostility toward, and poor conditions for, returnees. They have not responded.
“Venezuelan returnees face a heightened risk of Covid-19 on both sides of the border,” said José Miguel Vivanco, Americas director at Human Rights Watch. “The Quito Process is an opportunity for governments to provide a lifeline to returnees and improve their own treatment of Venezuelans in the midst of Covid-19. They should seize it.”
For additional information on Human Rights Watch’s findings, please see below.
A declaration adopted by representatives of Quito Process member states on September 24 invites member states to “[a]ccompany and facilitate the process of voluntary return, through policies created and implemented with a human rights-based approach, coordination among Member States, and cooperation with competent international mechanisms.” Human Rights Watch recommends that foreign affairs ministers meeting in October as part of the Quito Process:
- Commit to developing an action plan to protect the rights of Venezuelans in their territories by ensuring that Venezuelans – like everyone else under their jurisdiction – have access to health care and adequate food, water, and other essentials for a life with dignity
- Adopt a collective and concerted response to Venezuelan migration, including through a region-wide temporary protection regime that would grant all Venezuelans legal status for a fixed but renewable period of time, at least pending adjudication of their individual claims by competent authorities
- Urge United Nations Secretary-General Antonio Guterres to ensure UN participation in formalizing a program to provide support to returnees on both sides of the border between Colombia and Venezuela. The effort should be carried out with participation of public health experts, led by the Pan American Health Organization. This effort should focus on ensuring that authorities can get accurate information about confirmed Covid-19 cases, that returnees’ stay in quarantine centers follows WHO recommendations, including limiting the stay of asymptomatic patients in quarantine centers to 14 days, and that quarantine measures respect human rights
- Contribute financial support to humanitarian efforts in border areas where a significant number of returnees are waiting. In addition to supporting the process to coordinate public health policies on both sides of the border, increased funding should be provided to international groups such as the UN High Commissioner for Refugees (UNHCR) and the International Organization for Migration (IOM) to protect the rights of returning Venezuelans, including by ensuring that all returns are voluntary and returnees are fully informed about the return process and conditions in their places of origin
- Work with Secretary-General Guterres and his humanitarian team, the European Union, the United States, Canada, and other countries to press Venezuelan authorities to allow a full-scale UN-led humanitarian response in Venezuela. Such a response should include, but not be limited to, addressing the situation for returnees. These authorities should also adopt measures recommended in the May 26 Human Rights Watch report on aid needed to address the humanitarian emergency and Covid-19 in Venezuela, in particular expediting the full deployment of the World Food Program there
- Urge Venezuelan authorities to allow humanitarian actors and the UN Office of the High Commissioner for Human Rights unrestricted access to monitor conditions in quarantine centers, and call on Venezuelan authorities to adopt measures to:
- end abusive conditions, including overcrowding and unsanitary conditions, at quarantine centers
- provide adequate food, water, and medical care to people there
- cease keeping asymptomatic people in quarantine for longer than 14 days absent new exposures to the virus
- consider allowing effective quarantine alternatives, such as home quarantine for people who have a place where they can do so safely
- Publicly condemn mistreatment of returnees by Venezuelan authorities and armed pro-government groups
The Return to Venezuela
Many South American countries have enacted nationwide lockdowns that effectively prevent their informal economies from operating. As a result, many Venezuelans living in those countries who depend on the informal economy are no longer able to afford adequate food and rent. Many have lost their jobs or some of their income. While some of these countries have established emergency financial assistance programs such as Colombia’s Ingreso Solidario, Ecuador’s Bono de Protección Familiar por Emergencia, and Peru’s Bono Familiar Universal, these are not always available to foreigners.