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The health care community has a responsibility to anticipate worst-case scenarios and develop response plans for epidemics that may be years or decades away. It should model how outbreaks might cause shortages in medical supplies and devise protocols to compensate for them. It should plan for what would happen if those protocols fail and shortfalls in staff or equipment make it difficult to provide care to each and every patient.

Crises like Covid-19 are stark reminders of the importance of making such preparations. They also reveal the gaps in our planning, along with scenarios that were so strange or unimaginable that we failed to see them coming.


Who could have foreseen that a once-in-a-century pandemic would strike at a pivotal moment for U.S. immigration policy, one that could strip tens of thousands of health care workers of their ability to practice medicine and take them away from their patients at the very moment they are needed most?

Unimaginable though it may be, that outcome may soon come to pass. In the coming weeks, the Supreme Court will render a decision on Department of Homeland Security v. Regents of the University of California, a case that will determine whether nearly 700,000 individuals protected by Deferred Action for Childhood Arrivals (DACA) will remain in the workforce, protected from deportation.

If the court strikes down DACA, then every DACA recipient — including 29,000 physicians, nurses, health aides, and technicians — could be forced from the United States within two years. Some could have only weeks.


That would thwart America’s pandemic response. The CDC estimated in mid-April that Covid-19 infections had removed 9,300 health care practitioners from the workforce. If DACA is ruled invalid, that number will quadruple. Hospitals would lose essential staff. The medical practitioners who remain would work longer and more dangerous hours. Patients would be likely to suffer worse outcomes. In short, Covid-19 would become more protracted, and potentially even more deadly.

This is just the beginning.

As physicians and leaders of health institutions, each of us has had the opportunity to work alongside DACA recipients. These young leaders have stood out as some of the most dedicated and promising medical professionals we’ve ever met. And losing them — during a pandemic or not — is a burden that neither the health care community nor our country can afford to bear.

If you were to meet Dr. Jirayut Latthivongskorn, who goes by New, you would agree. One of us (S.H.) got to know New when he was a student at the UCSF School of Medicine, and the other (P.C.) worked with him during her time at San Francisco General Hospital. Neither of us knew his immigration status back then, but we were both struck by New’s warmth, his sharp judgment, and his deep commitment to the practice of medicine. It came as no surprise to us when he became the first medical student with DACA to graduate from UCSF.

Today, New is caring for some of the Bay Area’s most vulnerable people, including patients with Covid-19, as a resident at San Francisco General Hospital. He worries about what will happen with the Supreme Court ruling, but that isn’t stopping him from providing the best possible care for his patients. “This pandemic is just another example of DACA recipients doing what we’ve always done,” he says. “We show up and show that we are a part of the fabric of America.”

Joana Cabrera is another young leader who is showing up. After graduating from the University of California, Berkeley, Joana came to work at the Chan Zuckerberg Biohub, which brings together researchers and engineers from Stanford, UC Berkeley, and UCSF. At the Biohub she designed and developed a custom device that is enabling UCSF to increase its coronavirus testing capacity. Thanks in part to the work Joana and her colleagues have done, the UCSF/Biohub expansion lab is now offering free coronavirus testing to all 58 county public health departments in California.

Joana and New are exemplary young leaders, but the reality is that America’s hospitals, clinics, and research institutions are full of talented professionals just like them. What happens if these young people are deported? What medical breakthroughs could we one day miss? And how many patients will struggle to get care, especially during the worst pandemic we’ve faced in a century?

That last question has an answer. Experts estimate that physicians and medical students with DACA will care for as many as 5 million patients over the course of their careers.

For these reasons and more, the two of us have spent the last several years advocating for young people with DACA. Three days after the federal program was abruptly halted in 2017, the University of California became the first university to file a legal challenge over its rescission. The Chan Zuckerberg Initiative signed onto an amicus brief in the lawsuit, and has since worked to highlight the contributions DACA recipients make to society — and to stopping the Covid-19 pandemic.

In recent days, we were glad to see that the Supreme Court will officially consider these contributions in its deliberations. We are hopeful that the justices will choose to preserve the status of DACA recipients in its ruling.

We also know that a truly lasting solution will come not through the courts but through Congress, which alone has the power to pass legislation that puts DACA recipients on the path to citizenship.

That is where you come in. Legislators, policymakers, and journalists are paying close attention to what the medical and scientific communities are saying right now. Your words carry immense weight during this pandemic, and you can use them to advocate for the young health care professionals who are every bit as vital to our response as masks and ventilators.

And we urge you to go one step further. The U.S. will need many more health care practitioners in the months and years ahead, not only to help with pandemic response and recovery but also to serve in roles and regions of the U.S. that have long been understaffed. Right now, we aren’t on track to meet that demand. That’s why we need broader reforms that will help immigrants without DACA enter the workforce as health care professionals, as well as reforms that will attract more practitioners to the U.S. in the first place. You can urge our lawmakers to make that happen.

There’s no time to waste. New, Joana, and thousands of our colleagues in medicine are counting on our support right now. And millions of Americans will one day count on theirs.

So help us make sure Congress and the American public know just how essential DACA recipients are. Their lives, and many more, may hang in the balance.

Priscilla Chan is a pediatrician and co-founder and co-CEO of the Chan Zuckerberg Initiative. Sam Hawgood is a pediatrician and chancellor of the University of California San Francisco.

  • I’ve been alive for 75 years now, living 60 miles from the Mexican border, and I find it incredibly demoralizing to see these uninformed and dehumanizing comments about DACA recipients. There are shortages of medical professionals in our country; the main reasons for layoffs at this point in time is money and resources. Small town and rural hospitals are disappearing at an alarming rate of speed. The majority of DACA recipients are already adults who were brought to this country as small children, and others were born here, working paying taxes, consuming goods. You want to send them to countries where they have never lived and with no connection? Do you understand the laws? We have never had open borders. There have always been laws in place, border patrol, and barriers along much of our border with Mexico. Our health care system has gotten worse and worse with privatization of hospitals, and little or no government funding. This won’t be the last virus that threatens the world, either. Scientists and research matter! And since ours is a capitalist system, and our own birth rates are falling, do you think consumers will just suddenly appear out of nowhere? By the middle of this century, whites will be the minority in this country, as they already are in the rest of the world. No amount of deportation, no miles of walls, no amount of travel bans will prevent this. Whether we like it or not, humans are all in this current pandemic together, whether social distancing or not, and it would serve us better to remember that and to find ways collectively to deal with this now, and then to prepare for next time.

    • If all illegal aliens, including DACA, are not deported then they are magnets attracting another generation of illegal entry into this country. When will it end? Only if we start deporting each and every one of them. In 1986 we gave amnesty. It was supposed to be in return for border enforcement. It did not work. Now is the time.

    • The DACA problem far precedes the pandemic and would be a non-issue except for the obstruction of the left (of which Tucson is overrun with worse than illegal aliens).

      There are plenty of Americans that will do those jobs if the wages are fair!
      Quit subsidizing industries with cheap foreign labor!

  • Pandemic putting many US nurses out of work
    The COVID-19 pandemic has brought to focus the glaring need for nurses in the US while still leaving many nursing professionals out of work as health care systems cut costs to make up for missing revenue. “People would always say to me, being a nurse you’ll never have to worry about having a job. And here I am, newly 40 years old and unemployed for the first time since I started working,” said Mariya Buxton, a pediatric nurse from St. Paul, Minn.
    Full Story: BBC (4/29)

  • The authors would be more credible were it not for the fact that every set of facts leads to their same conclusion. Economy good = open borders. Economy bad = open borders. C19 = open borders. [YOUR NAME HERE] = open borders.

  • The illegal aliens can take the “know how” that we taught them for free in our schools, back to their countries where they belong. Just think about Mexico or Honduras or El Salvador missing out on these supposed geniuses and what they can do over there. Just think of the 700,000 that won’t be infecting our country and burdening our system, taking jobs from children of Americans.

    • This argument that Americans are missing out on jobs. 1; personally when it comes to medicine I want the best qualified person and I don’t care where they have ancestors…. I doubt yours go back very far on USA land. 2; I suspect The jobs you refer to are jobs most people don’t want to do, refuse to do, or are not qualified for and wouldn’t do the amount of hard work in order to qualify.

  • This is incredibly dishonest. There is no shortage of health care workers. There was an isolated shortage in New York but that did not last. Nationwide there is a surplus of health care workers as elective procedures have been cancelled.

    Moreover, in planning for a possible shortage DACA recipients and illegal aliens should never have been hired. It is irresponsible to hire people for a critical job when they are here illegally and could be deported at any time.

  • Don’t forget 10X the number of healthcare workers are illegals in jail. Yes. 1/3 of our nation’s prisoners are illegals. Advocates like the authors of this pieces share some of the responsibility for the misery their crimes have creates in our country.

    These magically medically talented illegals should go and bring their skills to their countries of origin. They will be able to help far more people there, and help to restore equal treatment under the law in the US. By making their home countries better, the next waves of illegals might be mitigated as well.
    Illegals should not be exempt from immigration law. My wife is a LEGAL immigrant. We went through health checks, financial checks and more to legally bring her here. All illegals must leave and try to come back legally if they can. Otherwise stay out.

    • The article refers to DACA recipients. It’s not discussing the merits of illegal immigration. DACA doesn’t encourage future immigration because, especially during the Trump administration as is highly selectively. I’ve known several individuals that have gone through the rigorous process of being an American Citizen, and some not so rigorous as well. The article points to the individuals that have a DACA access and are going to face uncertainty due to their legal work visas being at risk. DACA is a temporary solution for those at the time to those at the time that had access to it. It’s not accessible anymore. Similar to PPP loans. One time shot

  • First, there is no crisis of healthcare workers at the moment. Tens of thousands are on the sidelines waiting for hospitals and practices to reopen – it’s simply not true, especially with COVID waning. Regardless, market economies are remarkably good at moving talent into positions of need, should that become a problem.

    The article only shows one side of the “pain” story, while ignoring the larger social consequences that also have deleterious but more spread out – and so less acute, but no less real – effects.

    Allowing political pressure to cause selective enforcement of the law and different rules for different people – spread across so many spheres, over so many years – is bad medicine for a society.

    I’d like to know the author’s solution to amnesty bills like DACA creating incentives for illegal immigrants to come to America with children, some not even their own. Lawmakers are (correctly) loathe to split up families, and I am absolutely sympathetic to the plight of adults who were brought here illegally as children, but the plethora of unintended consequences created by open borders and endless amnesty bills must stop somewhere.

    The U.S. government is not responsible for the adult illegals’ situation – their parents are. However sympathetic we may be to both the parents and the children, DACA is bad policy that simply kicks the can down the road without a solution in trade.

  • DACA was unconstituional and is! Nobody says we have to deport DACA folks even if DACA is found to have been unconstituional. Obama knew it was unconstitutional and did it anyway. Trump offered a legislative and constitutionally sound deal on DACA in return for the wall and border security. In this time of coronavirus it is especially important to have people crossing our borders screened for diseases, and illegal drugs.

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