Updated at 7:23 p.m. on Sept. 11

An immigrant detention center in Virginia with a severe coronavirus outbreak ignored public health guidance, failed to provide basic medical care for people who became ill with COVID-19, and continues to pose a significant health risk for medically vulnerable detainees, according to an inspection report produced as part of a lawsuit against the facility.

The inspector, Dr. Homer Venters, is an epidemiology expert and the former chief medical officer for New York City jails. He advocates for reforms to the prison health system, and was brought in by plaintiffs in the case against the facility. Venters said that as a result of deficiencies in its coronavirus response, the Farmville Detention Center in Farmville, Va. should consider releasing people at high risk for severe COVID-19 complications.

“The multiple and systematic deficiencies in the [Farmville Detention Center] approach to health services are unlikely to be addressed quickly, and from a medical standpoint, being detained in the [Farmville Detention Center] represents a significant health risk for high-risk patients,” Venters wrote in his report.

A judge allowed the inspection as part of a lawsuit against the facility brought by a coalition of legal advocacy groups, including the National Immigration Project and the Legal Aid Justice Center, who are representing several people detained at Farmville. They chose Venters for the inspection, and his findings were made public in court documents Friday.

Simultaneously, a competing report by an inspector selected by Farmville leadership stated that the facility had no extensive issues with its COVID-19 response. Dr. William Reese, who inspected the facility on the same day as Venters, said that Farmville had responded to the coronavirus in a way that was “consistent with the CDC guidance.”

However, Venters’ report echoes what people detained at the facility and their lawyers have been saying for months. It alleges that Farmville staff failed to respond to a severe COVID-19 outbreak and left detainees without proper medical care as the virus spread through the facility, at one point infecting 93% of people in the facility whose test results had been reported. Venters’ report also made specific recommendations for policy changes he wanted to see the facility implement immediately.

An ICE spokesperson said the agency was unable to comment on pending litigation beyond Reese’s report.

At least 339 people detained at Farmville have tested positive for COVID-19. At least seven Farmville detainees have been hospitalized as a result of the virus, and one has died. Though an ICE spokesperson claimed at the height of the Farmville outbreak that most people who tested positive at the facility were asymptomatic, detainees at the facility and their lawyers said otherwise, and described an environment where many detainees were actively exhibiting symptoms associated with the virus.

Reports of illness at Farmville began in June, a few weeks after ICE transferred 74 detainees to Farmville from coronavirus hotspots in Florida and Arizona.

An ICE spokesperson said at the time that the purpose of the transfers was to free up space in overcrowded facilities and “promote social distancing.” However, a current Department of Homeland Security official and a former ICE official told The Washington Post that the primary reason detainees were transferred to Farmville was to help bring ICE agents to respond to protests against police brutality in the District. Government rules prohibit ICE employees from traveling on “ICE Air” charter flights unless people being detained by ICE are also on the flight. In an August court hearing in the federal lawsuit over Farmville’s pandemic response, ICE’s lawyer said that both the desire to create social distancing and the rules around chartered flights motivated the transfers.

ICE did not confirm the Post’s reporting. In an emailed statement on Friday, Henry Lucero, the executive associate director of enforcement and removal operations, said that “the June 2 transfer of detainees to Farmville was made as part of a national effort to spread detainees across the detention network to facilitate social distancing and mitigate the spread of COVID-19.”

ICE said that the people who were transferred were quarantined and did not enter the general population. But within a month, it became clear that the virus had spread beyond the quarantined detainees to the rest of the facility.

There are currently no active cases of the coronavirus at the facility, according to ICE’s website. But Venters said the outbreak, and the facility’s poor response to it, caused lasting and ongoing damage at Farmville.

“The level of animosity and disengagement among detainees is more acute at [Farmville Detention Center] than any other facility I have inspected, and flows directly from the reality that widespread COVID-19 was caused by the mass transfers into the facility in June and that the predictable consequences of these transfers, detainees becoming ill, were ignored by staff,” Venters wrote.

In June, some of the people detained at Farmville responded to the lack of medical care with protests, and guards deployed pepper spray in response. During Venters’ August inspection, Farmville leadership said all people who submitted sick call requests met with health staff within 24 hours, but none of the detainees Venters interviewed said they were seen within that time frame.

“The gross disparity between the facility administration’s contention that 100% of sick call requests result in timely care and the reports of patients that none of their sick call requests result in timely care merits immediate remedy,” Venters wrote.

At the time of Venters’ inspection, Farmville leadership also said they did not have a protocol for checking on detainees for persistent symptoms after they were no longer infectious.

Of the 21 detained people Venters spoke to during his visit, 19 said they had tested positive for COVID-19, and eight of them reported having ongoing symptoms, “including headaches, chest pain, shortness of breath, facial paralysis and weakness.” Only one reported seeing a physician since he was released from medical isolation.

Venters also criticized the facility’s screening procedures. Farmville health staff did not appear to ask specific questions about COVID-19 in daily screenings and temperature checks of detainees. This, Venters wrote, “is a critical departure from CDC guidelines, which make clear that eliciting the presence of symptoms in detention settings is essential.” Venters also found that while about 50% of people detained at Farmville were Spanish-only speakers, none of the health staff performing the screening spoke Spanish and the screenings were performed without an interpreter.

Venters identified a breakdown in trust among detainees, exemplified by a lack of widespread mask wearing in the facility. While he observed all staff wearing masks, Venters said fewer than a quarter of people detained in the facility were wearing masks during the inspection.

When Venters asked them why they weren’t wearing masks, detainees said it was because the COVID-19 outbreak at the facility had destroyed their trust in the institution’s guidance.

“Most often, detained people stated that the facility had caused them to become infected with COVID-19 because of the mass transfer in June of people from facilities with known COVID-19 cases and that COVID-19 symptoms and requests for health care had been ignored in the following weeks,” says the inspection report. “As a result, they reported not believing and not being interested in whatever the facility suggested regarding COVID-19.”

Reese’s report took issue with the widespread lack of mask-wearing and social distancing he observed among detainees. “It is unclear why the Detainees chose not to wear or, in some cases, removed their masks during my inspection,” Reese wrote.

Venters’ report included a series of recommendations for Farmville, including a request that the facility immediately implement a monthly “quality assurance review” of its response to sick calls, alter its COVID-19 screening procedure, and implement a weekly in-person briefing on the pandemic with detainees. Venters also recommended that everyone who has tested positive for the virus be assessed by a physician for the presence of ongoing symptoms and health problems as a result of their COVID-19 infection.

Venters said ICE should review any cases where people detained at Farmville required hospitalization in the past year, for COVID-19 or for another reason. Venters said the review should include the 72-year-old man, James Hill, who died in August after contracting COVID-19 at Farmville.

Venters said it is essential for the facility to organize its pandemic response as flu season begins.

“With both COVID-19 and seasonal influenza likely to impact detained people in the coming months, there is an urgent need to protect those most likely to experience morbidity or mortality,” Venters wrote.

This story was updated to include new information reported by The Washington Post about the reasons why people in ICE custody were transferred to Farmville from coronavirus hotspots in June.