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The Trump administration acknowledged in a court filing Monday that it had grabbed a Maryland father with protected legal status and mistakenly deported him to El Salvador, but said that U.S. courts lack jurisdiction to order his return from the megaprison where he’s now locked up.
The case appears to be the first time the Trump administration has admitted to errors when it sent three planeloads of Salvadoran and Venezuelan deportees to El Salvador’s grim “Terrorism Confinement Center” on March 15. Attorneys for several Venezuelan deportees have said that the Trump administration falsely labeled their clients as gang members because of their tattoos. Trump officials have disputed those claims.
But in Monday’s court filing, attorneys for the government admitted that the Salvadoran man, Kilmar Abrego Garcia, had been deported accidentally. “Although ICE was aware of his protection from removal to El Salvador, Abrego Garcia was removed to El Salvador because of an administrative error,” the government told the court. Trump lawyers said the court has no ability to bring Abrego Garcia back now that he is in Salvadoran custody.
Simon Sandoval-Moshenberg, Abrego Garcia’s attorney, said he’s never seen a case in which the government knowingly deported someone who had already received protected legal status from an immigration judge. He is asking the court to order the Trump administration to ask for Abrego Garcia’s return and, if necessary, to withhold payment to the Salvadoran government, which says it’s charging the United States $6 million a year to jail U.S. deportees.
Trump-administration attorneys told the court to dismiss the request on multiple grounds, including that Trump’s “primacy in foreign affairs” outweighs the interests of Abrego Garcia and his family.
“They claim that the court is powerless to order any relief,’’ Sandoval-Moshenberg told me. “If that’s true, the immigration laws are meaningless—all of them—because the government can deport whoever they want, wherever they want, whenever they want, and no court can do anything about it once it’s done.”
Court filings show that Abrego Garcia came to the United States at age 16 in 2011 after fleeing gang threats in his native El Salvador. In 2019 he received a form of protected legal status known as “withholding of removal” from a U.S. immigration judge who found he would likely be targeted by gangs if deported back.
Abrego Garcia, who is married to a U.S. citizen and has a 5-year-old disabled child who is also a U.S. citizen, has no criminal record in the United States, according to his attorney. The Trump administration does not claim he has a criminal record, but called him a “danger to the community” and an active member of MS-13, the Salvadoran gang that Trump has declared a foreign terrorist organization.
Sandoval-Moshenberg said that those charges are false, and that the gang label stems from a 2019 incident when Abrego Garcia and three other men were detained in a Home Depot parking lot by a police detective in Prince George’s County, Maryland. During questioning, one of the men told officers that Abrego Garcia was a gang member, but the man offered no proof and police said they didn’t believe him, filings show. Police did not identify him as a gang member.
Abrego Garcia was not charged with a crime, but he was handed over to U.S. Immigration and Customs Enforcement after the arrest to face deportation. In those proceedings, the government claimed that a reliable informant had identified him as a ranking member of MS-13. Abrego Garcia and his family hired an attorney and fought the government’s attempt to deport him. He received “withholding of removal” six months later, a protected status.
Left: Abrego Garcia. Right: Garcia at CECOT according to his lawyer. (U.S. District Court for the District of Maryland)
It is not a path to permanent U.S. residency, but it means the government won’t deport him back to his home country, because he’s more likely than not to face harm there.
Abrego Garcia has had no contact with any law-enforcement agency since his release, according to his attorney. He works full time as a union sheet-metal apprentice, has complied with requirements to check in annually with ICE, and cares for his 5-year-old son, who has autism and a hearing defect, and is unable to communicate verbally.
On March 12, Abrego Garcia had picked up his son after work from the boy’s grandmother’s house when ICE officers stopped the car, saying his protected status had changed. Officers waited for Abrego Garcia’s wife to come to the scene and take care of the boy, then drove him away in handcuffs. Within two days, he had been transferred to an ICE staging facility in Texas, along with other detainees the government was preparing to send to El Salvador. Trump had invoked the Alien Enemies Act of 1798, and the government planned to deport two planeloads of Venezuelans along with a separate group of Salvadorans.
Abrego Garcia’s family has had no contact with him since he was sent to the megaprison in El Salvador, known as CECOT. His wife spotted her husband in news photographs released by Salvadoran President Nayib Bukele on the morning of March 16, after a U.S. district judge had told the Trump administration to halt the flights.
“Oopsie,” Bukele wrote on social media, taunting the judge.
Abrego Garcia’s wife recognized her husband’s decorative arm tattoo and scars, according to the court filing. The image showed Salvadoran guards in black ski masks frog-marching him into the prison, with his head shoved down toward the floor. CECOT is the same prison that Department of Homeland Security Secretary Kristi Noem visited last week, recording videos for social media while standing in front of a cell packed with silent detainees.
If the government wants to deport someone with protected status, the standard course would be to reopen the case and introduce new evidence arguing for deportation. The deportation of a protected-status holder has even stunned some government attorneys I’ve been in touch with who are tracking the case, who declined to be named because they weren’t authorized to speak to the press. “What. The. Fuck,” one texted me.
Sandoval-Moshenberg told the court that he believes Trump officials deported his client “through extrajudicial means because they believed that going through the immigration judge process took too long, and they feared that they might not win all of their cases.’’
Officials at ICE and the Department of Homeland Security did not respond to a request for comment. The Monday court filing by the government indicates that officials knew Abrego Garcia had legal protections shielding him from deportation to El Salvador.
“ICE was aware of this grant of withholding of removal at the time [of] Abrego Garcia’s removal from the United States. Reference was made to this status on internal forms,” the government told the court in its filing.
Abrego Garcia was not on the initial manifest of the deportation flight, but was listed “as an alternate,” the government attorneys explained. As other detainees were removed from the flight for various reasons, Abrego Garcia “moved up the list.’’
The flight manifest “did not indicate that Abrego Garcia should not be removed,’’ the attorneys said. “Through administrative error, Abrego Garcia was removed from the United States to El Salvador. This was an oversight.” But despite this, they told the court that Abrego Garcia’s deportation was carried out ‘’in good faith.’’
When search-and-rescue teams deploy to any of the numerous natural or man-made disasters around the world, they bring along their own teams of highly trained dogs to help discover victims in need. When these dogs are not in the field, they frequently take part in training sessions simulating events such as earthquakes, wildfires, and water or avalanche rescues. Gathered below are images of some of these rescue dogs and their handlers, on the job and in training, from the past several years.
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One thing that could be said about many—and possibly all—of the more than 100 men removed from the United States by the Trump administration under the archaic Alien Enemies Act of 1798 is that Donald Trump has been convicted of more crimes than they have.
Trump, after all, was convicted of 34 felony counts by a jury of his peers in New York City for faking business records in order to cover up his hush-money payment to the adult-film actor Stormy Daniels in 2016. His administration has acknowledged in court that many of the men deported to a gulag in El Salvador “do not have criminal records in the United States.” Many appear to not have criminal records elsewhere either.
During the 2024 presidential campaign, Trump and his advisers loudly declared that they would engage in a “mass deportation” of undocumented criminals. Many Americans heard criminals and seem to have assumed that innocent people would not be targeted. But the reality of Trump’s immigration project is that a “criminal” is anyone the administration wants to deport, regardless of whether they have committed a crime. There’s been no earnest attempt to prove that these people did anything wrong; no deference to the Fifth Amendment, which guarantees that no “person” can be “deprived of life, liberty, or property, without due process of law.” Its protections are supposed to restrain the government and do not solely apply to citizens. Even so, immigration law is extraordinarily deferential to the federal government when it comes to these kinds of deportations—so deferential that if the Trump administration had solid evidence of gang involvement, deporting these men through a more routine process could have been straightforward.
ICE rounded these men up in early March, and then put them on a plane to the Central American nation, alleging that they were members of Tren de Aragua, a Venezuelan gang. The men were then imprisoned in El Salvador’s Centro de Confinamiento del Terrorismo, or CECOT, a prison infamous for reported human-rights violations including, allegedly, torture. The ACLU and Democracy Forward filed a challenge on behalf of five of the men shortly after they were apprehended, and managed to secure a judicial order preventing them from being removed from the United States, which the Trump administration seems to have defied.
So far, the Trump administration has provided only weak evidence that any of the men condemned to a foreign prison notorious for human-rights violations was guilty of anything. The administration’s defense of its actions, according to the declaration made by an ICE official, Robert Cerna, is that “the lack of specific information about each individual actually highlights the risk they pose. It demonstrates that they are terrorists with regard to whom we lack a complete profile.” In other words, the lack of evidence against these men is just further proof that they’re guilty.
Relatives of several of the deportees have insisted that these men have no gang affiliation, and say some of them fled Venezuela specifically because they were threatened by the exact gang they are now supposedly a member of. One of the deportees, Andry Hernandez, is an asylum seeker and a makeup artist who was tagged by ICE as a “gang member” because of two tattoos of crowns with the words mom and dad underneath them. An expert on Tren De Aragua told The New Yorker that “Tren de Aragua does not use any tattoos as a form of gang identification; no Venezuelan gang does.” In response to public outcry over Hernandez’s deportation, the Department of Homeland Security has insisted that Hernandez’s “social media indicates he is a member of Tren de Aragua.” If the government has such evidence, it hasn’t filed it in court. According to Hernandez’s attorney, the tattoos are “the only basis of the government’s assertion, in its filing, that he is connected to Tren de Aragua.”
To be deported by Trump, one does not need to be a drug dealer or a terrorist; apparently, having tattoos and being Venezuelan is enough. Another deportee, the Miami Herald reported, is Frengel Reyes Mota, who fled political instability in Venezuela and was pursuing an asylum case when he was apprehended at his regular ICE check-in. He may have been mistaken for someone else; he seems to have followed all the rules, and still that did not spare him.
As it flouts due process, the administration is also trying to invoke the state-secrets privilege—a legal rule that allows presidents to withhold evidence whose disclosure could harm national security—to keep the courts from intervening so that it can continue to imprison men in an overseas gulag indefinitely.
“Even if the [Alien Enemies Act] could be used against the gang during peacetime, there must be an opportunity for individuals to contest that they are, in fact, members of the gang,” Lee Gelernt, an ACLU attorney litigating the case, told me. If no such opportunity exists, “it means that anybody could end up at an El Salvadoran prison for the rest of their lives, citizen or a noncitizen, that’s not a member of the gang.” He added, “The stakes could not be any higher.”
Despite the absence of evidence, the administration continues to refer to these men publicly as “gang members” and “terrorists,” and they have become fodder for Trumpist propaganda. Last week, DHS Secretary Kristi Noem filmed a depraved video with the prison as her background, advertising the Trump administration’s willingness to deport people overseas to be tortured by the bureaucracy of a strongman whose own government the American authorities have said is affiliated with organized crime. (Nor is it even clearly the case that the men in the video are those recently deported. Noah Bullock, the executive director of the human-rights group Cristosal, noted in Foreign Policy that “the middle-aged faces and full-body tattoos that appear in the footage from the megaprison suggest that they are gang members who have likely been in prison since well before the state of exception began.”)
As long as the Trump administration gets to look tough, it does not seem to care if the people it is hurting are guilty of nothing more than thinking America, the land of the free, would be a good place to start over. Inherent in this propaganda effort is a grim assumption about the character of the American people—that they will not only fall for this agitprop but see the abuse of innocent people as praiseworthy.
The power the Trump administration is claiming in this matter is incredibly broad, and rooted in a distortion of the already broad Alien Enemies Act. When the act’s 18th-century writers described “war” and “invasion,” they meant these terms literally, but the Trump administration is interpreting them metaphorically to apply to illegal border crossings.
“The president has ample authority under immigration law to deport members of violent criminal gangs, so there’s absolutely no need to abuse an inapplicable wartime authority,” Liza Goitein, a legal expert with the left-leaning Brennan Center, told me. “Trump’s invocation of the law is basically an illegal power grab, because we are not at war with Venezuela. Tren de Aragua is not the government of Venezuela. There has been no armed attack on the United States, which is what the term invasion means in the law. The legislative history and, frankly, the text of the statute are very, very clear that they were referring to actual hostilities, an act of war by a political entity.”
For now, the administration is targeting only Venezuelans, but it might sweep in other groups eventually. Because the text of the Alien Enemies Act refers to any “native” of an enemy power, it could theoretically cover not just undocumented immigrants but documented ones who share the ethnicity of members of an organization Trump has decided the U.S. is “at war” with. “Every ethnic group, every religious group, in this country has been associated with some criminal organization at some point,” Gelernt pointed out.
Although the Alien Enemies Act does not apply to American citizens, without due process, a citizen could be mistakenly deported to El Salvador, held indefinitely, and reliant on the same administration that deported them to realize the error and decide to retrieve them. As my colleague Nick Miroff reported, the Trump administration has already made one grievous mistake, admitting that it sent Kilmar Abrego Garcia, a Salvadoran man, to CECOT because of an “administrative error.” Despite that, it seems in no rush to get him back, telling a federal court that it was powerless to order him returned. In a post on X, Vice President J. D. Vance called Garcia “a convicted MS-13 gang member,” a false claim meant to justify deserting Garcia in a foreign prison based on a mistake.
Trump is seemingly intrigued by the possibility of sending American citizens to El Salvador’s gulag, having said, “If we had the legal right to do it, I would do it in a heartbeat.” He also posted recently on his social network, Truth Social, that Tesla-dealership vandals might be sent to “the prisons of El Salvador, which have become so recently famous for such lovely conditions.”
In effect, the Trump administration has asserted the sort of broad, unreviewable power that the George W. Bush administration asserted in detaining so-called enemy combatants in the War on Terror. But the process here seems to be even more capricious; those being deported are not being given access to counsel, nor are they being tried for any offenses, and the Trump administration seems far more indifferent to whether those detained are remotely connected to any crime. Although the ACLU is fighting their deportation, according to Gelernt, their clients in El Salvador are being held entirely incommunicado.
Beyond the fact that we have more evidence that Trump is a criminal than any of the men deported, we also have more evidence that the government of El Salvador is affiliated with gangs than we do of the men deported. In 2021, the U.S. Treasury Department sanctioned members of El Salvadoran President Nayib Bukele’s administration, who had been allegedly covertly meeting with gangs such as Mara Salvatrucha 13, and negotiated an agreement with “gang leadership” to “provide political support to the Nuevas Ideas political party in upcoming elections.” So the Trump administration is deporting people not only to an overseas gulag but into the custody of a government that, according to both the Justice and Treasury Departments, is allegedly affiliated with the very gangs the administration is purporting to fight. Another way of looking at this is that the Trump administration is, by its conspiracy with the government of El Salvador, itself collaborating with foreign criminal organizations.
Perhaps some Americans who thought that Trump would deport only criminals are watching the news and telling themselves that the president must know what he’s doing; the deportees must be gang members or terrorists, just as the president says. But that’s nothing more than a comforting fiction, the sort common to authoritarian regimes where admitting fallibility is forbidden. They’d say the same thing about anyone, and those false claims would be amplified to deafening volume by the same right-wing propaganda machine that helped bring Trump to power in the first place. Who these men in El Salvador actually are and what they’ve actually done is irrelevant. All that matters is that to Trump, they look the part.
One day this fall, while on campus at Brown University, I was met by two students—cellphones raised, cameras recording. They had spun off from a larger group protesting Brown’s decision not to divest from Israel. They recognized me as a trustee of the university and saw an opportunity to take me to task. They followed me for perhaps a block or two, calling me a hypocrite.
For at least one of the students, the war in Gaza was not some cause du jour that he’d picked up from TikTok. He has Palestinian relatives on the ground. I knew this because I’d spoken with him before. That time, he was passionate but measured. Now, in protest mode, he was angry. I’m sure he felt betrayed by the decision, and I was one of the only people he could hold—at least verbally—accountable.
Understandably, some of my colleagues who were singled out by protesters were more rattled by the experience. But in my view, these were students in America doing what students in America should do: questioning authority (in this case, me) and using their rights to free speech and free assembly to engage with issues they are passionate about.
That is not to say I didn’t find this period of campus unrest unpleasant or this particular incident annoying. No one likes to be called a hypocrite and accused of being indifferent to human suffering. And certainly no one wants to be shouted at. But I never for a moment felt that these students were a threat to me, let alone to America’s national security.
And yet, that is the justification the United States government is offering for its decision to revoke the visas and green cards of international students who have spoken out against the war in Gaza.
When I read about the detention of Rümeysa Öztürk, the first thing I thought is that she must have been very hungry. The Tufts University doctoral student had been fasting since dawn when a group of hooded and masked plainclothes officers surrounded her near her home in Somerville, Massachusetts. I imagine that the friends who were planning to host her for iftar that evening were merrily preparing their table, oblivious that Öztürk had been seized in the street, handcuffed like a criminal, and put inside the back of an unmarked car in what looked, to passersby, like “a kidnapping.” Perhaps, when Öztürk didn’t respond to their texts, the friends—all hungry themselves—began without her. Their concern must have curdled into fear as the night wore on.
Öztürk’s friends and colleagues were shocked when they learned what had happened. They must have known, of course, about the detentions of students at other universities that began in early March with the seizure of Mahmoud Khalil from his New York City apartment. Khalil, a recent Columbia University graduate and a green-card holder born in a refugee enclave in Syria, was a pro-Palestinian activist and one of the organizers of a march where some attendees praised Hamas. Although the Trump administration has not accused Khalil of any crime, it has portrayed him as a radical terrorist.
But Öztürk was different. “The only thing I know of that Rümeysa’s organized,” one of her friends told reporters, “was a Thanksgiving potluck.” No one seemed more stunned than Öztürk herself, who was chatting on the phone with her mother when the officers swarmed.
Undocumented immigrants are used to living in fear of ICE knocking on their door. But Öztürk is not undocumented. She is one of the roughly 1 million international students studying in the United States this academic year. She came from Turkey at the invitation of an American university, an invitation made possible by the State Department through the student-visa program. As long as Öztürk stayed out of legal trouble (which she had) and remained enrolled in school full-time (which she had), she had no reason to expect that she could be removed from the life she had been building here.
Öztürk was apparently detained because she co-wrote an op-ed for The Tufts Daily last year. When a reporter asked Secretary of State Marco Rubio why Öztürk’s visa was revoked, he replied that if a student applying for a visa said up front “that the reason you’re coming is not just because you want to write op-eds but because you want to participate in movements that are involved in doing things like vandalizing universities, harassing students, taking over buildings, creating a ruckus, we’re not going to give you a visa.” If a student took part in “that sort of activity” once here, he said, the government has the “right to remove you.” He added, “We’re looking every day for these lunatics.”
No one has alleged that Öztürk vandalized or took over any buildings. Did the op-ed create a ruckus? It urged the administration to take more seriously a vote from the student senate calling on the university to divest from Israel. In the context of the Israel-Palestine discourse of spring 2024, the op-ed is civility at its finest. In the context of op-eds, it is a snooze.
Rubio has been leaning on a Cold War–era law that he says allows him to personally revoke green cards and visas. The law refers to immigrants whose presence in this country the government has “reasonable grounds” to believe could “have potentially serious adverse foreign policy consequences for the United States.” A former head of America’s Immigration Lawyers Association pointed out that this provision of the law has not been applied since 1997.
Welcome to Donald Trump’s America, where the Cabinet texting about war plans on a nongovernmental messaging app is “not a big deal,” but an op-ed in a school paper is a threat to national security.
Rubio says he has signed off on deporting or revoking the visas of 300 or more people, an unknown portion of whom are student activists. Some have been snatched from their home or the sidewalks outside. Others, such as Rasha Alawieh, a medical-school professor at Brown whose H1-B visa was sponsored by Brown Medicine, have been turned away at the airport. In at least a few cases, more than a day went by before anyone figured out where the disappeared students had been taken.
Rubio’s interpretation of the law is just one more example of the Trump administration’s attempts to change America from a nation of rights to a nation of privileges that can at any moment be revoked. “We gave you a visa to come study and get a degree,” Rubio said about the students, “not to become a social activist that tears up our university campuses.”
Green cards may be a privilege, but once they reach American soil, these students also have rights—to speak freely, to peacefully convene, to enjoy due process under the law. Those rights don’t depend on citizenship status; they are embedded in the founding of this country. The students do not, as Rubio correctly points out, have the right to “tear up” campuses. But they absolutely can become social activists about any political issue they choose.
Criticism—even at its most odious—does not imperil a nation any more than being yelled at by students imperiled me. How could I hold my head high as an American if I didn’t defend their right to tell me what they think?
This article originally misstated which institution sponsored Rasha Alawieh’s visa.
My housewas dark. Tinfoil covered the windows. The only light I could tolerate came from dimmable red bulbs. Ten weeks before, I had tested positive for COVID. On week three of my infection, I went to the emergency room with a debilitating migraine. On my third trip to the ER, I was hospitalized for seven days. I came home to a changed life. All the clichés about headaches are true—a pile of bricks on the head, a vise grip on the temples, an axe through the skull. The pain altered my consciousness. Trying to move or access a thought was like trying to see past a flashlight shining in my eyes.
It was 2024—a point at which most people in America considered the pandemic long since over. But it wasn’t for me.
Some days, I couldn’t stop crying. It was more than despair at my circumstance: Long COVID can dysregulate mood and has been linked with depression. And the disease hijacked my stress-response system, leaving my body in a constant state of alarm. Any unexpected sound, even getting a text message, would set off a jolt of panic through my body, the same sensation as slamming on the brakes while driving. I lost my ability to cope. I broke a window in my house. I put a hole in the wall.
Researchers know more about long COVID than they once did, but it is still hard to define. The clearest consensus is that it’s a complex collection of symptoms that can affect almost every organ system in the body. Theories of why COVID can linger abound, and include ongoing inflammation, the virus never fully going away, and tissue damage. Many scientists agree that multiple factors likely contribute. Meanwhile, doctors are still struggling to treat the disease; less than half of doctors know how to diagnose long COVID and even fewer—28 percent—report knowing how to treat it, according to one 2023 survey. Long-COVID patients are still reporting that medical professionals don’t believe them, and though in some cases patients’ self-diagnosis might be off the mark, the reality is that many people living with long COVID simply aren’t getting the care they need.
In my case, that person who was in mind-numbing pain, unable to read, unable to write, unable to Google things or look at screens, unable to drive, drained by talking on the phone, spiraling in despair, and barely able to leave the house had to navigate the American health-care system. That I needed care for long COVID only made my predicament worse. From hearing chronically ill and disabled people speak about their experiences, I knew that to be sick in this country is a hell unto itself. But knowing something is true and experiencing it are different. I know that the Grand Canyon is deep, but I have never seen it with my own eyes. For our health-care system, I have been to the bottom.
According to the latest federal survey as of September 2024, more than one in 20 adults in the United States had long COVID—defined as symptoms that last longer than three months. (The survey does not ask about the severity of symptoms.) Vaccines may help protect against the disease, but getting COVID still means risking long COVID. The coronavirus can leave patients with blood clots, brain dysfunction, organ damage, immune problems, and more; about a quarter of people with the disease report that it significantly disrupts their ability to perform daily activities. There are no FDA-approved medications to treat long COVID. Many medical institutions created specialty clinics to see patients with the disease, but much of what even the best clinics can offer is symptom management. Pinning down recovery rates from long COVID has been difficult, but according to several studies, after two years, the majority of people living with long COVID had not fully recovered.
Three months into my illness, I had been treated for migraines and a concussion—COVID’s impact can mirror a traumatic brain injury—but not long COVID. The tribe that I belong to, Cherokee Nation, runs the largest outpatient facility of any tribe in the U.S., but my primary-care provider there told me she didn’t know how to treat long COVID. I was referred to my tribe’s specialty clinic for rare and infectious diseases. When I managed to get that appointment, however, the provider told me he knew how to treat only pulmonary long-COVID symptoms (which many long-COVID patients don’t have). Nowhere in Indian Health Services, the treaty-based federal program that serves 2.8 million Native Americans nationwide, is there a long-COVID clinic. (An IHS spokesperson said the Biden administration would have needed to set up such a clinic.)
I started looking outside Indian Health Services and found a long-COVID clinic an hour’s drive from my house. When I called, I learned the clinic had shut down. The state where I live, Oklahoma, does not have a long-COVID clinic. My dad found one in Arkansas. Like many long-COVID clinics, it required that patients apply to get in. But after I submitted all the paperwork, I didn’t hear back.
I realized that to access care, I would need to travel. At the time, I was unable to drive, and my symptoms limited how much time I spent outside my house. When I called the Cleveland Clinic, I was transferred four times until I was accidentally forwarded to the customer-satisfaction survey. I spoke with one receptionist who told me her clinic didn’t take patients from out of state, and another who warned that traveling to her clinic probably wouldn’t be worth the time and money. (A spokesperson for the Cleveland Clinic wrote that patients should be able to make an appointment without a referral, and that the clinic and its staff “strive to provide patients with timely access to scheduling and care.”)
In my first telehealth appointment with a nationally recognized COVID clinic, the doctor wouldn’t discuss her recommendations but said I could read them in the patient visit notes. When I explained that my symptoms made reading impossible, she asked me if someone could read the notes for me. Later, my mom read me a copied-and-pasted list of healthy-lifestyle information, such as the benefits of taking a daily probiotic and the importance of getting enough sleep. The list included the doctor’s favorite bedtime teas. I told my mom to stop reading.
A few months into the pandemic, some patients reported that their symptoms weren’t going away. Through their advocacy, long COVID got its name. By 2022, hundreds of long-COVID clinics had opened across the country. There is no standard for what kind of care these clinics provide: Some are multidisciplinary teams, but many are one specialist or one nurse practitioner. This patchwork system of care has only deteriorated as attention on the disease has dwindled.
Many of the long-COVID clinics that popped up during the pandemic have closed. As part of my reporting for this story, I compiled a list of 171 clinics, drawing from the Survivor Corps website, a patient-led resource-and-advocacy group, and from searching online for long-COVID clinics by state. I then called each clinic to verify which ones were still operating. Of those, 79 were still open and accepting new patients, five were not accepting new patients or outside referrals, 61 had closed, and 15 were unreachable after two attempts. Eleven more were advertised as long-COVID clinics but don’t have a medical doctor or nurse on staff; they provide services such as speech or occupational therapy. (My assistant Sydney Anderson and intern Cheyenne McNeil, who have been helping me work through my illness, contributed to this reporting.)
Based on the list we assembled, 22 states have no long-COVID clinics accepting new patients. Given COVID rates in those states, we estimated that almost 3 million people who currently have long COVID reside there. Because of insurance policies, licensing and telehealth laws, and the cost of travel, not having a nearby clinic can easily mean that patients won’t access care. Of the long-COVID clinics that are still open, some have wait lists, do not accept outside referrals, do not take insurance, treat only specific long-COVID symptoms, or do not take patients from outside of their geographical area.
Getting in touch with the long-COVID clinics that are still open is another barrier. I spoke with operators who had never heard of their institution’s long-COVID clinic; I got transferred to the office that schedules COVID tests; I got transferred to disconnected lines; I called numbers that rang and rang and rang and rang. One day, I spent two hours on the phone and spoke with only three people who could provide information. When I called Yale New Haven Health System’s clinic, one of the most well-known in the country, I got transferred to a disconnected line. I called back and got transferred to the customer-satisfaction survey. I called a third time and left a message. I called a fourth time, trying a different number, and spoke with a receptionist who said the clinic was closed. (The clinic is still open; in a statement, Yale New Haven Health said that the phone number for the long-COVID clinic is on its website, that the volume of calls the clinic receives is very high, and that it had not previously heard of patients having difficulty accessing the clinic.)
If you are healthy, this might all sound like the familiar nightmare of customer service to which we have all become accustomed. But for people who are sick, it is a wall that stands between them and the care they need. When you are sick, you look at that wall and think, I am not well enough to climb it.
The closure of long-COVID clinics in recent years has affected patients who need care. I talked with people who, like me, have been living with long COVID later in the pandemic. Ryan Parker lives in Portland, Oregon; is a member of the Northern Cheyenne tribe; and used to work in philanthropy. Like many people with long COVID, Parker tried to work through his illness. He told me he returned from one work trip so sick that he couldn’t get out of bed for a month. Last fall, the long-COVID clinic that was treating him closed. Because of the disease, Maeve Sherry has been disabled and unable to work for three years. They found a long-COVID clinic in Great Falls, Montana, three hours from where they lived at the time, but it closed in December of 2023, they said. There are now no long-COVID clinics in Montana. When Myisha Hill was still struggling to do household chores, take care of her kids, and even talk weeks after a COVID infection, she looked up the long-COVID clinic near where she lives in Las Vegas, she told me. But it, too, had closed. There are now no long-COVID clinics in Nevada.
A spokesperson for the University Medical Center of Southern Nevada wrote that the clinic closed “amid low demand.” Other clinics echoed this response, saying they suspended operations after patient numbers dwindled. A few clinics also stated that they now refer long-COVID patients to primary care. Several spokespeople told me as a reporter that their clinics were still open, but when I called as a patient, I was told the clinic was closed. And even when clinics are open, patients still face barriers: I spoke with people with long COVID who told me they couldn’t access care because a clinic didn’t take their insurance, their doctor didn’t send a referral, or the clinic rejected them as a patient.
The alternative to enrolling in a clinic is to try to see a regular neurologist or cardiologist. But many specialists have lengthy wait times, and long-COVID patients are twice as likely as the general public to report that this is why they can’t get care. Parker, for instance, is trying to see a specialist for myalgic encephalomyelitis/chronic fatigue syndrome, a form of debilitating fatigue that is common with long COVID. The first available appointment is nine months out.
And when patients are finally seen, the care itself might not be competent. Parker’s primary-care provider suggested that his debilitating fatigue was a product of anxiety. Several doctors have also told Kelly Rider that her problem was just anxiety—and one said it was perimenopause. Sometimes doctors prescribe things that exacerbate symptoms—such as exercise for chronic fatigue. When Diem-Han Dinh’s doctor ordered a stress test, she explained that she was unable to run. He didn’t believe her. At the stress test, she almost fainted.
Eight months into my illness, I boarded a plane and traveled with my mother to Rochester, Minnesota. The long-COVID clinic I finally got into was Mayo. The off-label medication they prescribed didn’t do much, but I learned about my illness and how to manage my symptoms, which has improved my quality of life. Other things have helped too. Thanks to an arsenal of migraine treatments, my headache—although not gone—is less severe. Thanks to eight months of vision therapy, I can now focus my eyes and am practicing reading. And, in writing this article, I have gotten back to reporting. What I had to go through to get here, I would not wish on anyone.
The resources our system of medical care can offer to those wanting to learn about, cope with, and heal from what COVID has done to their body are beyond inadequate, and are likely to get worse. In February, the Trump administration ordered the Department of Health and Human Services to dissolve its advisory committee on long COVID. In March, the department announced it would close its Office for Long COVID Research and Practice, and began canceling grants from the National Institutes of Health for COVID studies.
Sick and disabled people have been pushed to the margins of our society for a long time. There was a moment during the pandemic when I saw our collective concern focused on the ill. Living with long COVID, I sometimes wonder where that concern went. I feel like the wounded antelope picked off from the herd. Everyone else has moved on, while I am stuck in my illness. I could be angry at each individual hypocrisy—each person who preached the importance of masks only to go back to normal without me—but I am not. Instead, I am sad that what is more powerful than our concern for the sick is the indifference of our health-care system.
