In public health, threats are measured by their capacity to cause widespread harm, disrupt healthcare systems, and create lasting damage to community wellbeing. By these metrics, the activities of U.S. Immigration and Customs Enforcement and Border Patrol have emerged as a genuine public health crisis comparable to localized viral outbreaks—one that is spreading fear through communities, driving patients away from medical care, and overwhelming healthcare infrastructure in ways that will reverberate for generations.

The evidence is now overwhelming. In Minnesota, where Operation Metro Surge has deployed approximately 3,000 federal officers, physicians are witnessing what they describe as unprecedented chaos in healthcare settings. Dr. Roli Dwivedi, former president of the Minnesota Academy of Family Physicians, told reporters that in 19 years of practice, she has never seen this level of fear—not even during COVID-19. Pregnant women are missing prenatal appointments. Babies are skipping critical jaundice follow-ups. A child with appendicitis went undiagnosed for days because his family feared going to the hospital, resulting in a burst appendix. A patient with kidney cancer was detained and transferred to Texas without his medications; even after legal intervention secured his prescriptions, doctors remain uncertain whether he is actually receiving treatment.

These are not isolated anecdotes. A KFF/New York Times survey found that nearly half of likely undocumented immigrant adults report avoiding medical care due to immigration-related fears since January 2025. More troubling still, this fear has spread beyond undocumented populations: 14 percent of lawfully present immigrants and 8 percent of naturalized U.S. citizens report the same avoidance behavior. The chilling effect has become indiscriminate, creating a shadow pandemic of foregone care that crosses legal boundaries.

The Trump administration’s January 2025 decision to rescind protections for sensitive locations—previously shielding hospitals, schools, and places of worship from enforcement activity—has fundamentally altered the healthcare landscape. ICE agents now appear in hospital lobbies, waiting rooms, and, according to healthcare workers, even patient care areas without proper warrants. At Hennepin County Medical Center, Minneapolis’s busiest emergency room, staff have resorted to encrypted chat groups to share information about agent movements, and reports have emerged of patients being unnecessarily shackled even while receiving treatment. Half of the hospital’s diverse workforce—nurses and physicians from Somalia, Latin America, and Myanmar—are reportedly too afraid to come to work.

The pediatric consequences are particularly alarming. Physicians for Human Rights has documented children as young as six years old presenting with anxiety disorders related to fears of family separation. Children are arriving at emergency rooms unaccompanied because parents are afraid to accompany them. Research has consistently shown that children who experience parental detention or deportation exhibit elevated rates of post-traumatic stress disorder, major depression, and developmental delays—conditions that studies indicate can persist years after family reunification. We are witnessing, in real time, the creation of a generation marked by preventable trauma.

The crisis extends into ICE detention facilities themselves, where the federal government has abdicated its legal obligation to provide medical care. Since October 2025, ICE has failed to pay third-party medical providers for detainee treatment, leaving essential services including dialysis, oncology care, prenatal treatment, and chemotherapy without a functioning payment mechanism. Internal government documents described the situation as an absolute emergency that could lead to medical complications or loss of life. The detained population has ballooned from under 40,000 in January 2025 to over 73,000 today, yet medical claims processed actually decreased from $246 million in 2024 to just $157 million in 2025—a nearly $300 million gap that represents either unpaid care or care never delivered.

Pregnant women in detention face particularly grave circumstances. Civil rights organizations have documented cases of women being detained despite informing officers of their pregnancies, held in solitary confinement, denied prenatal vitamins, and given inadequate food and water. One pregnant woman detained in Louisiana reported experiencing heavy bleeding and cramps while awaiting deportation, yet was told repeatedly that she needed a referral to see a doctor—a referral that never came. A Senator Jon Ossoff investigation identified 14 credible cases of pregnant women being mistreated in detention, including descriptions of pregnant women sleeping on cell floors and one woman miscarrying alone after days of bleeding.

The parallels to outbreak response are instructive. When a novel pathogen emerges, public health officials measure its impact through case counts, hospitalization rates, and the strain on healthcare systems. ICE enforcement now meets all these criteria. The cases are the patients avoiding care, the children developing anxiety disorders, the detainees denied treatment. The hospitalization rate manifests in the emergency visits that become necessary when treatable conditions go unaddressed—the diabetic who delays insulin pickup until crisis, the wound that festers into an ICU admission. The healthcare system strain appears in the staffing shortages caused by terrified workers, the unpaid medical claims piling up at detention facilities, and the physicians forced to practice medicine in an atmosphere of surveillance and fear.

National Nurses United, representing 225,000 registered nurses, has called for the abolition of ICE and warned that the current enforcement regime is terrorizing communities and causing irreparable harm to the working class. The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the Minnesota Academy of Family Physicians have all raised alarms. The UN High Commissioner for Human Rights has called on the United States to ensure compliance with international law, noting that children are missing school and medical appointments out of fear of family separation.

A public health threat is measured not only by its immediate casualties but by its long-term consequences—the downstream effects that ripple through communities for years. Untreated chronic conditions become acute crises. Missed vaccinations create vulnerability to outbreaks. Children traumatized by family separation carry that burden into adulthood, with documented increases in depression, anxiety, and physical health conditions. The psychological trauma of forced family separation has been found by Physicians for Human Rights to meet the legal definition of torture under the UN Convention Against Torture.

Two American citizens have now been fatally shot by ICE agents in Minnesota in January 2026 alone—Renee Good, a 37-year-old mother of three and legal observer, and Alex Pretti, an ICU nurse who worked with the Minnesota Veterans Administration health care system. The violence has prompted calls from Governor Tim Walz for ICE’s immediate withdrawal and a lawsuit from Attorney General Keith Ellison seeking to remove federal agents from the state. When healthcare workers must decide whether showing up for their shift puts them at risk, when patients must calculate whether a hospital visit might result in their detention or deportation, when pregnant women give birth at home rather than risk encountering enforcement agents—we have moved beyond immigration policy into the realm of public health emergency.

The medical community’s response should be unequivocal: ICE and Border Patrol enforcement activities, as currently conducted, represent a clear and present danger to public health. Like any pathogen that spreads fear, disrupts care, and causes lasting harm to human bodies and minds, this threat demands a coordinated public health response—one that prioritizes the restoration of sensitive location protections, the guarantee of medical care in detention, and the recognition that healthcare systems cannot function when transformed into sites of enforcement. The health of entire communities depends on it.

ENDNOTES

1. American Community Media, “Minnesotans Are Afraid to Access Healthcare Amid Massive ICE Surge,” January 25, 2026.

2. InForum, “Minnesota physicians describe ‘chaos and fear’ in health care settings,” January 20, 2026.

3. KFF, “Health Care Providers Warn of Impacts of Increased ICE Presence at Health Care Facilities,” January 22, 2026.

4. KFF/New York Times Survey of Immigrants, 2025.

5. CBS News Atlanta, “ICE stopped paying for detainee medical care as population surged, Ossoff investigation finds widespread neglect,” January 21, 2026.

6. Popular Information, reporting on ICE medical payment lapse, January 2026.

7. ACLU, “Nonprofits Urge ICE to End Detention of Pregnant People Following Reports of Abuse and Medical Neglect,” October 22, 2025.

8. The 19th/Louisiana Illuminator, “A pregnant mother in ICE detention says she’s bleeding – and hasn’t seen a doctor in weeks,” January 23, 2026.

9. Senator Jon Ossoff Investigation, Report on Medical Neglect at ICE Detention Centers, 2025.

10. CIDRAP, University of Minnesota, “Minnesota residents delay medical care for fear of encountering ICE,” January 2026.

11. Physicians for Human Rights, “ICE Tactics and Deportation Fears Limit Access to Health Care for Children of Immigrants: Survey,” November 19, 2025.

12. National Nurses United, “Nurses demand Congress abolish ICE, invest in health care,” January 23, 2026.

13. Sahan Journal, “Health care workers push for changes as ICE causes fear at HCMC,” January 13, 2026.

14. ACLU, “Pregnant and Postpartum Women Face Neglect and Abuse in ICE Detention,” October 27, 2025.

15. Physicians for Human Rights, “You Will Never See Your Child Again: The Persistent Psychological Effects of Family Separation,” 2021.

16. JURIST, “UN rights chief, Democratic lawmakers demand answers as ICE custody deaths mount,” January 24, 2026.

17. Electronic Privacy Information Center (EPIC), Report on Surveillance and Healthcare Access, as reported by WIRED, January 2026.

18. MinnPost, “Medical residents: ICE presence causing public health crisis, constant anxiety that could become chronic,” January 2026.

19. Louisiana Illuminator, “Pregnant mother at Louisiana ICE site says she’s bleeding and hasn’t seen a doctor in weeks,” January 26, 2026.

WORDS: SCINQ Editorial Staff