Less than a mile away from the bridge that separates Matamoros from Brownsville, asylum seekers live in tents or makeshift shelters made from propped-up tarps, each one just a few inches or feet apart from the next. Clothes are strung up to dry between nearby trees or on the yellow safety barriers that line the camp. It’s nearly impossible to follow the oft-repeated coronavirus prevention recommendations suggested by the World Health Organization. Asylum seekers remain in close quarters, sharing portable toilets, communal showers, and a cellphone charging station.

Recently, signs posted around the camp have served as reminders for people to wash their hands or keep their distance from one another. Volunteer doctors who provide medical services to migrants there have emphasized the importance of keeping their tents well ventilated and instructed them to use homemade masks. These are less effective than medical-grade masks, but in crowded conditions, a fabric face covering can reduce droplet spread from coughs and help prevent migrants from touching their faces.

Roughly 2,500 people remain at the migrant camp while they await their asylum hearings in the U.S. Prior to the coronavirus pandemic, the average wait time for asylum seekers at the Gateway International Bridge in Brownsville was nearly four months. Now that’s set to rise: on April 1, the Department of Homeland Security and the Executive Office for Immigration Review announced that they would be postponing all hearings of nondetained individuals, including those subject to the Migrant Protection Protocols (MPP), through May 1. Asylum seekers who had a hearing scheduled before then were guided to present themselves at their designated point of entry in order to receive a new hearing date. Roughly 4,600 MPP hearings have been postponed. According to Kennji Kizuka, a senior researcher at Human Rights First, 48 percent of those cases belonged to asylum seekers who have been waiting in Mexico for at least six months.

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Prior to the institution of the Trump administration’s MPP or “Remain in Mexico” policy, which forces migrants to wait in Mexico for their hearings, many asylum seekers were released into the U.S. before their hearings with ankle monitors. They would often stay with family members in the country. In Mexican border towns, migrant shelters were virtually nonexistent. But since the policy was instituted, more people have found themselves effectively stranded in Mexico for months, many of them without adequate funds for long-term housing.

Under normal circumstances, legal advocates argued that the MPP put asylum seekers at risk as they face threats of violence and extortion in Mexico, or are left to stay in unsanitary migrant camps or overcrowded shelters while they wait for their hearings. Now, with the threat of the coronavirus looming over them, fewer volunteers and nonprofit groups are crossing to bring food and clothing, and migrants’ crowded living arrangements leave them particularly vulnerable to the virus.

The U.S. Customs and Border Protection’s own guiding principles for MPP state that individuals with known physical or mental health issues “are not amenable to MPP” and should not be sent back to Mexico to await their proceedings. Though doctors and legal advocates have tried to secure exemptions for migrants with chronic conditions or those whose medical conditions would make them more susceptible to the coronavirus, they’ve struggled, as the exemptions are essentially granted at the whim of federal officials at ports of entry and vary from city to city.

And the situation in the camps is unhealthy. Cindy Johnson, a United Methodist deaconess and one of many local volunteers who regularly provide help to the migrants in the camp, has been able to continue bringing medical supplies such as vitamins, masks, and medicine. On her most recent visit, she says, someone asked her to bring back a fishing net, as some of the asylum seekers fear that dwindling supplies might mean they’ll have to turn to the river for regular meals. “The conditions in the camps have always been poor,” Johnson said. “No one should be living there, but for now, we’re trying to help them be as careful as possible. We have to worry about [the coronavirus], the flu, and, once it gets hotter, the mosquitos and the problems they bring.”

The conditions at the camps have always sparked concerns from doctors and medical volunteers who regularly provide services there. As of April 9, there were no confirmed cases of COVID-19 in the camps, but several migrants are sick, and there are seven confirmed cases in Matamoros, while the Mexican state of Tamaulipas was up to 56.

“At this point we’ve just sort of accepted that it’s not an if, it’s a when,” says Helen Perry, executive director of nonprofit Global Response Management (GRM), which operates a mobile clinic in the camps. “Social isolation is not a thing here.”

Mexican officials previously announced plans to relocate a sizable number of asylum seekers from the camp to a nearby stadium to provide more space. Volunteers who visit the camps have heard conflicting reports from the migrants themselves, some of whom say they were told to prepare to be moved this weekend.

Perry says her team hasn’t gotten any official word from Mexico’s National Institute of Migration, but, having visited the stadium, she’s confident it won’t be large enough to accommodate everyone in the camp.

Anticipating an outbreak, doctors have started acquiring supplies to deal with potential cases and treat respiratory illnesses. With a population of more than 520,000, Matamoros has about a dozen intensive care unit beds and ten ventilators in its hospitals. The GRM team received approval from the Mexican government to set up a twenty-bed field hospital for the camp, with ventilators, breathing treatments, and up to four ICU-level beds. They are currently waiting for crossing permissions in order to receive their equipment from Brownsville.

To date, Perry says they’ve had about fifteen patients who had clinically concerning symptoms and were sent for coronavirus testing. These patients have been isolated in nearby hotel rooms or in isolation spaces they’ve set up on the outskirts of the camp. Though it’s possible to isolate a handful of potentially infected individuals, it would be extremely difficult to quarantine large numbers of people in such close quarters.

“There aren’t sufficient resources here to face an outbreak,” Dairon Elisondo Rojas, a Cuban doctor and asylum seeker working with Global Response Management, said. “Sure, [the local hospitals] have ICU beds, but what if there’s a surge? The situation could be catastrophic. We have about 2,500 people stranded here at the border who can potentially get this virus, and they already have a hard time getting treated in the local hospitals. They’re very vulnerable.”

The situation is one shared by migrant camps across the border. More than eight hundred miles away in Ciudad Juarez, dozens of asylum seekers leave local shelters or the nearby migrant camp every morning before sunrise to meet at the international bridge, where they must present themselves to get new court dates. While they’ve been waiting in Mexico for their hearings, many of them have faced threats of violence or extortion, and some have been kidnapped.

“We don’t need to treat people this way,” said Taylor Levy, an immigration attorney who offers free legal advice to migrants. “Seeking asylum is legal—these people are trying to do things the right way. Most of them feel resigned and helpless, particularly the people who don’t have the finances to get out of these shelters that they know are hotbeds for contagion.”