Faour Fraihat v. US Imm. & Customs Enforcement ( 2021 )


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  •                 FOR PUBLICATION
    UNITED STATES COURT OF APPEALS
    FOR THE NINTH CIRCUIT
    FAOUR ABDALLAH FRAIHAT; MARCO          No. 20-55634
    MONTOYA AMAYA; RAUL ALCOCER
    CHAVEZ; JOSE SEGOVIA BENITEZ;              D.C. No.
    HAMIDA ALI; MELVIN MURILLO             5:19-cv-01546-
    HERNANDEZ; JIMMY SUDNEY; JOSE             JGB-SHK
    BACA HERNANDEZ; EDILBERTO
    GARCIA GUERRERO; MARTIN
    MUNOZ; LUIS MANUEL RODRIGUEZ             OPINION
    DELGADILLO; RUBEN DARIO
    MENCIAS SOTO; ALEX HERNANDEZ;
    ARISTOTELES SANCHEZ MARTINEZ;
    SERGIO SALAZAR ARTAGA; INLAND
    COALITION FOR IMMIGRANT JUSTICE;
    AL OTRO LADO,
    Plaintiffs-Appellees,
    v.
    U.S. IMMIGRATION AND CUSTOMS
    ENFORCEMENT; U.S. DEPARTMENT
    OF HOMELAND SECURITY;
    ALEJANDRO MAYORKAS; TAE D.
    JOHNSON; STEVE K. FRANCIS; COREY
    A. PRICE; PATRICK J. LECHLEITNER;
    STEWART D. SMITH; JACKI BECKER
    KLOPP; DAVID P. PEKOSKE,
    Defendants-Appellants.
    2                FRAIHAT V. USICE
    Appeal from the United States District Court
    for the Central District of California
    Jesus G. Bernal, District Judge, Presiding
    Argued and Submitted December 9, 2020
    Seattle, Washington
    Filed October 20, 2021
    Before: Marsha S. Berzon, Eric D. Miller, and
    Daniel A. Bress, Circuit Judges.
    Opinion by Judge Bress;
    Dissent by Judge Berzon
    FRAIHAT V. USICE                             3
    SUMMARY *
    Immigration
    The panel reversed the district court’s grant of a
    preliminary injunction in a class action in which plaintiffs
    contended that as to all immigration detention facilities
    nationwide, U.S. Immigration and Customs Enforcement’s
    directives in response to the COVID-19 pandemic reflected
    “deliberate indifference” to medical needs and “reckless
    disregard” of known health risks; and remanded with
    instructions that all orders premised on the preliminary
    injunction be vacated.
    In April 2020, the district court entered a preliminary
    injunction and provisionally certified two nationwide
    subclasses: (1) ICE detainees with certain risk factors
    placing them at heighted risk of severe illness and death from
    COVID-19; and (2) ICE detainees whose disabilities placed
    them at heighted risk of severe illness and death from
    COVID-19. The district court found that plaintiffs were
    likely to succeed on the merits of three claims: (1) deliberate
    indifference to the medical needs of detainees, in violation
    of the Fifth Amendment; (2) punitive conditions of
    confinement, in violation of the Fifth Amendment; and
    (3) violation of section 504 of the Rehabilitation Act,
    
    29 U.S.C. § 794
    . The district court’s preliminary injunction
    applied to all immigration detention facilities in the United
    States and imposed a broad range of obligations on the
    federal government, including ordering ICE to identify and
    track detainees with certain risk factors; requiring ICE to
    *
    This summary constitutes no part of the opinion of the court. It
    has been prepared by court staff for the convenience of the reader.
    4                    FRAIHAT V. USICE
    issue a comprehensive Performance Standard covering
    COVID-19-related topics, and setting directives for
    releasing detainees from custody altogether.         The
    government appealed in June 2020, but did not seek a stay
    pending appeal.
    In September 2021, the parties asked to refer this case to
    the Court’s mediation program. The panel denied that
    request, concluding that it came much too late. Given the
    substantial judicial and court resources that the parties
    already required be expended on their behalf, the panel
    declined their request to now use further resources in the
    form of the mediation program—itself a not unlimited
    resource.
    On appeal, the government argued that the district court
    erred both in issuing a preliminary injunction and in granting
    provisional class certification. Noting that it had jurisdiction
    to reach the latter issue, the panel concluded it need not do
    so here. The panel explained that the district court’s class
    certification ruling depended on, and was in service of, its
    preliminary injunction, and therefore, if the preliminary
    injunction was infirm, the class certification order
    necessarily fell as well.
    In concluding that the preliminary injunction must be set
    aside, the panel held that plaintiffs failed to demonstrate a
    likelihood of success or serious questions on the merits. The
    panel wrote that neither the facts nor the law supported a
    judicial intervention of the magnitude here, and that the
    standards governing plaintiffs’ request reflected not only the
    all-embracing relief they sought but the core principle,
    grounded in the separation of powers, that far-reaching
    intrusion into matters initially committed to a coordinate
    FRAIHAT V. USICE                       5
    Branch requires a commensurately high showing sufficient
    to warrant such a significant exercise of judicial power.
    First, the panel addressed plaintiffs’ claim that ICE
    “failed to promulgate and implement medically necessary
    protocols and practices to protect medically vulnerable
    people” from COVID-19. The panel concluded that
    plaintiffs did not make a clear showing that ICE acted with
    deliberate indifference to medical needs or in reckless
    disregard of health risks, explaining that the various ICE
    mandates and guidance documents demonstrated that far
    from recklessly disregarding the threat of COVID-19, ICE
    in the spring of 2020 (and earlier) took steps to address
    COVID-19. The panel also rejected plaintiffs’ contrary
    arguments, which the district court had accepted, and held
    that plaintiffs had not made a clear showing of entitlement
    to relief commensurate with the scope of their request.
    Second, the panel concluded that plaintiffs had not
    shown a likelihood of success on their claim that ICE’s
    COVID-19          policies     reflected      unconstitutional
    “punishment.” The panel observed that if a particular
    condition or restriction of pretrial detention is reasonably
    related to a legitimate governmental objective, it does not,
    without more, amount to punishment. The panel easily
    concluded that there was a legitimate governmental
    objective here, explaining that ICE was holding detainees
    because they were suspected of having violated the
    immigration laws or were otherwise removable. The panel
    concluded that just as ICE’s national directives did not
    reflect deliberate indifference, they did not create excessive
    conditions of “punishment” either. The panel also rejected
    plaintiffs’ theory that a presumption of punitive conditions
    arose here.
    6                    FRAIHAT V. USICE
    Third, the panel concluded that plaintiffs had not
    established a likelihood of success on their statutory claim
    under the Rehabilitation Act, which prohibits a program
    receiving federal financial assistance from discriminating
    based on disability. As relevant here, plaintiffs bringing a
    section 504 claim must show that they were denied the
    benefits of the program solely by reason of a disability.
    Here, the panel concluded that plaintiffs had not identified
    any “benefit” that they were denied. Plaintiffs at most
    demonstrated that they were subjected to inadequate national
    policies; they did not show they were treated differently
    from other detainees “solely by reason” of their disabilities.
    Finally, the panel concluded that because plaintiffs had
    not demonstrated a likelihood of success on any claim, it
    need not address the other preliminary injunction factors that
    plaintiffs also would have needed to establish.
    Judge Berzon dissented from both the majority’s opinion
    vacating the district court’s preliminary injunction and its
    order denying the parties’ joint request for mediation. Judge
    Berzon wrote that, in vacating the district court’s
    preliminary injunction, the majority applied incorrect
    standards three times. First, the majority recited but did not
    engage with the applicable sliding scale approach for
    reviewing a preliminary injunction. Second, it correctly
    identified but then flouted the court’s mandate to review the
    grant of a preliminary injunction for abuse of discretion, not
    de novo. Third, it evaluated plaintiffs’ Fifth Amendment
    reckless disregard claim under a subjective, instead of the
    proper, objective, standard.
    Judge Berzon wrote that the majority repeatedly
    characterized as “sweeping,” “far-reaching” and of great
    “magnitude,” an injunction that was actually limited,
    FRAIHAT V. USICE                        7
    modest, and deferential to the government’s primary role in
    crafting policy and administering the detention facilities.
    Beyond these analytical errors, Judge Berzon concluded that
    the majority did precisely what it chastised the district court
    for: by declining the parties’ joint request for mediation, the
    majority imposes its own will on the parties.
    COUNSEL
    Scott G. Stewart (argued), Deputy Assistant Attorney
    General; Anna L. Dichter and Lindsay M. Vick, Attorneys;
    William K. Lane III, Counsel; Christopher A. Bates, Senior
    Counsel; Jeffrey S. Robins, Deputy Director; William C.
    Peachey, Director; Ethan P. Davis, Acting Assistant
    Attorney General; Office of Immigration Litigation, Civil
    Division, United States Department of Justice, Washington,
    D.C.; for Defendants-Appellants.
    Brian P. Goldman (argued), William F. Alderman, Mark
    Mermelstein, and Jake Routhier, Orrick Herrington &
    Sutcliffe LLP, San Francisco, California; Matthew R.
    Shahabian and Melanie R. Hallums, Orrick Herrington &
    Sutcliffe LLP, New York, New York; Katherine M. Kopp,
    Orrick Herrington & Sutcliffe LLP, Washington, D.C.;
    Timothy P. Fox and Elizabeth Jordan, Civil Rights
    Education and Enforcement Center, Denver, Colorado;
    Jared Davidson, Southern Poverty Law Center, New
    Orleans, Louisiana; Stuart Seaborn, Melissa Riess, and Rosa
    Lee Bichell, Disability Rights Advocates, Berkeley,
    California; Maria del Pilar Gonzalez Morales, Civil Rights
    Education and Enforcement Center, Los Angeles,
    California; Shalini Goel Agarwal, Southern Poverty Law
    Center, Tallahassee, Florida; Christina Brandt-Young,
    8                  FRAIHAT V. USICE
    Disability Rights Advocates, New York, New York;
    Michael W. Johnson, Dania Bardavid, Jessica Blanton, and
    Joseph Bretschneider, Willkie Farr & Gallagher LLP, New
    York, New York; Leigh Coutoumanos, Willkie Farr &
    Gallagher LLP, Washington, D.C.; Veronica Salama,
    Southern Poverty Law Center, Decatur, Georgia; for
    Plaintiffs-Appellees.
    Stephen J. McIntyre, Marissa Roy, and Kevin Kraft,
    O’Melveny & Myers LLP, Los Angeles, California; Lisa B.
    Pensabene, O’Melveny & Myers LLP, New York, New
    York; for Amici Curiae Casa de Paz, Church World
    Service—Jersey City, Clergy & Laity United for Economic
    Justice, Detention Watch Network, El Refugio, and Freedom
    for Immigrants.
    Clifford W. Berlow, Michele L. Slachetka, Jonathan A.
    Enfield, E.K. McWilliams, and Reanne Zheng, Jenner &
    Block LLP, Chicago, Illinois, for Amici Curiae Public
    Health Experts.
    FRAIHAT V. USICE                       9
    OPINION
    BRESS, Circuit Judge:
    In March 2020, toward the beginning of the COVID-19
    pandemic, the plaintiffs in this case sought a preliminary
    injunction that would effectively place this country’s
    network of immigration detention facilities under the
    direction of a single federal district court. The named
    plaintiffs were five detainees housed at three detention
    centers. But plaintiffs made allegations and requested
    preliminary injunctive relief that far transcended their
    individual circumstances. They contended that as to all of
    the approximately 250 immigration detention facilities
    nationwide, U.S. Immigration and Customs Enforcement’s
    (ICE) directives in response to the COVID-19 pandemic
    reflected “deliberate indifference” to medical needs and
    “reckless disregard” of known health risks, in violation of
    the Fifth Amendment.
    The district court agreed with the plaintiffs. In April
    2020, it certified two nationwide classes and issued a
    preliminary injunction that applied to all immigration
    detention facilities in the United States. The injunction
    imposed a broad range of obligations on the federal
    government, including ordering ICE to identify and track
    detainees with certain risk factors that the district court
    identified; requiring ICE to issue a comprehensive
    Performance Standard covering a myriad of COVID-19-
    related topics, such as social distancing and cleaning
    policies; and setting directives for releasing detainees from
    custody altogether. Several months later, the district court
    issued a further order imposing more detailed requirements,
    such as twice-daily temperature checks, as well as
    procedures expressly designed to result in the release of
    10                   FRAIHAT V. USICE
    substantial numbers of detainees from ICE custody. The
    government has now appealed the preliminary injunction.
    We hold that the preliminary injunction must be set aside
    because plaintiffs have not demonstrated a likelihood of
    success on the merits of their claims. Our holding is a
    function of the sweeping relief plaintiffs sought and the
    demanding legal standards that governed their request.
    Plaintiffs did not seek individualized injunctive relief. Nor
    did they seek relief specific to the conditions at the detention
    centers in which they were housed. They instead challenged
    ICE’s nationwide COVID-19 directives, asking a district
    court mid-pandemic to assume control over the top-level
    policies governing ICE’s efforts to combat the viral
    outbreak. To obtain the extraordinary relief they sought,
    plaintiffs needed to come forward with evidence of
    constitutional and statutory violations on a programmatic,
    nationwide level. Plaintiffs did not do so.
    Like many aspects of government that were potentially
    unprepared for a highly contagious airborne virus, ICE’s
    initial response to the COVID-19 pandemic may have been
    imperfect, even at times inadequate. But the slew of national
    guidance, directives, and mandatory requirements that the
    agency issued and then frequently updated in the spring of
    2020 belies the notion that ICE acted with the “reckless
    disregard” necessary to support a finding of
    unconstitutional, system-wide deliberate indifference.
    ICE’s nationwide policies included instructions on
    sanitation, hygiene, and social distancing; treatment of
    detainees who may have been exposed to the virus; which
    programs and activities to suspend; and when to release
    detainees from custody because of their vulnerabilities to
    viral infection. Like all parts of our government, ICE took
    FRAIHAT V. USICE                      11
    actions in the face of scientific uncertainty and a constantly
    developing understanding of COVID-19.
    Whatever shortcomings could be discerned in ICE’s
    mandates in the spring of 2020, plaintiffs have not shown
    that ICE acted with deliberate indifference in issuing
    extensive nationwide directives that sought to mitigate the
    very health risks that plaintiffs claim ICE recklessly
    disregarded. The district court therefore erred in entering a
    preliminary injunction and in assuming the authority to
    dictate, at both a macro and a granular level, ICE’s national
    response to the COVID-19 pandemic.
    We appreciate plaintiffs’ and the district court’s
    concerns about the public health consequences of COVID-
    19 and the importance of protecting immigration detainees
    from harmful viral exposure. We of course share those
    concerns. Plaintiffs have identified COVID-19 infections
    among immigration detainees and have raised potentially
    valid questions about conditions at individual detention
    facilities, which other cases have likewise identified. We
    thus do not minimize the dangers that COVID-19 presents
    and the unique risks it imposes for persons in custody. The
    government here does not deny those risks, nor does it seek
    to absolve itself of responsibility for ensuring the safety of
    those whom it detains.
    But the question here is not whether COVID-19 poses
    health risks to detainees generally or even the individual
    plaintiffs in this case. While a preliminary injunction is
    always an extraordinary remedy, the relief sought here was
    extraordinary beyond measure.           Based on claimed
    deficiencies in ICE’s national directives, plaintiffs sought a
    sweeping injunction that would and did place the district
    court in charge of setting the COVID-19 policies that apply
    to every immigration detention facility in the United
    12                   FRAIHAT V. USICE
    States—for which the Executive Branch bears primary
    authority. As ICE was in the middle of confronting an
    unprecedented and evolving public health problem, it found
    its nationwide policies almost immediately subject to
    judicial revision.
    Neither the facts nor the law supported a judicial
    intervention of that magnitude. The standards that governed
    plaintiffs’ request reflected not only the all-embracing relief
    they sought but the core principle, grounded in the separation
    of powers, that far-reaching intrusion into matters initially
    committed to a coordinate Branch requires a
    commensurately high showing sufficient to warrant such a
    significant exercise of judicial power. Plaintiffs here did not
    make the showing required to justify the extraordinary relief
    they requested.
    For these reasons and those that we now explain, we
    reverse the preliminary injunction and direct that all orders
    premised on it be vacated.
    I
    A
    ICE, an agency of the Department of Homeland Security
    (DHS), is tasked with detaining certain non-citizens. Some
    of these persons were apprehended attempting to enter the
    United States without authorization.              
    8 U.S.C. § 1225
    (b)(1)(A)(i), (B)(iii)(IV); see also 
    id.
     § 1182(a).
    Others are in detention pending proceedings in which the
    government seeks to remove them from the United States,
    id. § 1226(a), or following orders of removal, id.
    § 1231(a)(1)–(2). Still others are held are under mandatory
    detention because they committed crimes in the United
    FRAIHAT V. USICE                             13
    States, or on terrorism-related grounds. Id. § 1226(c). 1 In
    Fiscal Year 2020 through April 4, 2020, ICE reportedly held
    an average daily population of 42,738 adult non-citizens
    across a nationwide network of over 250 detention facilities.
    These facilities differ in various ways. ICE owns some
    of the detention facilities; others are operated under contract
    with state or local agencies or government contractors.
    Some of the centers are “dedicated” facilities, which hold
    only ICE detainees, whereas others are “non-dedicated”
    facilities, which also hold non-ICE detainees. Some
    facilities are in remote or rural areas, while others are located
    closer to cities. Facilities also house differing numbers of
    detainees and are configured differently.
    Facilities also vary based on who provides medical care.
    Government employees, as part of the ICE Health Services
    Corps (IHSC), provide direct medical care at twenty
    facilities, which together hold about 13,500 detainees. The
    remaining facilities employ medical staff that the federal
    government does not directly employ. However, IHSC Field
    Medical Coordinators provide oversight of the medical care
    at those facilities.
    1
    The parties dispute whether detention under 
    8 U.S.C. § 1226
    (c) is
    in fact mandatory in every circumstance. Plaintiffs filed declarations
    from a former Deputy Assistant Director for Custody Programs at ICE’s
    Office of Enforcement and Removal Operations and from an
    immigration practitioner asserting that ICE had previously released
    individuals held under “mandatory” detention “pursuant to ICE’s
    guidelines and policies, particularly where the nature of their illness
    could impose substantial health care costs or the humanitarian equities
    mitigating against detention were particularly compelling.” We need not
    decide whether the government may release individuals detained under
    section 1226(c) for circumstances other than those in section 1226(c)(2).
    14                   FRAIHAT V. USICE
    B
    In December 2019, the virus SARS-CoV-2 was
    identified in China as causing an outbreak of a new,
    communicable respiratory illness, now known as
    coronavirus disease 2019, or COVID-19. Following the
    spread of the virus to the United States, the Secretary of
    Health and Human Services on January 31, 2020 declared a
    nationwide public health emergency.
    This case focuses on ICE’s centralized actions in
    response to the COVID-19 outbreak. Because plaintiffs
    allege that ICE acted with deliberate indifference on a
    national level, it is necessary for us to review in some detail
    ICE’s system-level COVID-19 guidance and requirements.
    We do so through the period leading up to the district court’s
    preliminary injunction in April 2020.
    1
    We begin in January 2020. As an initial response to the
    virus, ICE implemented applicable parts of its pre-existing
    “pandemic workforce protection plan,” which “provides
    specific guidance for biological threats such as COVID-19.”
    That same month, DHS also issued “additional guidance to
    address assumed risks and interim workplace controls,
    including the use of masks, available respirators, and
    additional personal protective equipment.”
    By March 2020, ICE Enforcement and Removal
    Operations (ERO) had convened a group of experts,
    including “medical professionals, disease control specialists,
    detention experts, and field operators to identify additional
    enhanced steps to minimize the spread of the virus.” As
    more information about the novel coronavirus became
    available, ICE responded by issuing multiple guidance
    FRAIHAT V. USICE                       15
    documents specifically directed at reducing the risk of
    COVID-19 infections among its detainee population.
    On March 6, 2020, IHSC promulgated “Version 6.0” of
    its “Interim Reference Sheet on 2019-Novel Coronavirus
    (COVID-19).” Although this version is the only one in the
    record, it is apparent that multiple previous versions existed.
    This document contained six pages of “recommendations”
    on managing COVID-19, including detailed procedures for
    screening, monitoring, assessing, isolating, and testing
    detainees.
    The document first called for “intake medical screening”
    to determine a detainee’s “exposure risk.” This involved
    assessing whether detainees had traveled through countries
    with “widespread or sustained community transmission,” as
    defined by the Centers for Disease Control and Prevention
    (CDC), or had “close contact” with a person confirmed to
    have had COVID-19. “Close contact” was defined as “being
    within approximately 6 feet (2 meters) of a COVID-19 case
    for a prolonged period of time” (such as “while caring for,
    living with, visiting, or sharing a healthcare waiting area or
    room with a COVID-19 case”) or “having direct contact with
    infectious secretions of a COVID-19 case (e.g., being
    coughed on).” If a detainee had such defined “exposure
    risk,” he or she was to be assessed for fever and respiratory
    symptoms.
    The results of IHSC’s recommended intake screening
    process were to inform the facility’s subsequent actions.
    Detainees with exposure risk but who did not exhibit
    COVID-19 symptoms were to be monitored for fever or
    respiratory complications on a daily basis for 14 days. These
    detainees were to be housed “in a single cell room if
    available,” or else “as a cohort.” (According to the CDC,
    “[c]ohorting refers to the practice of isolating multiple
    16                  FRAIHAT V. USICE
    laboratory-confirmed COVID-19 cases together as a group,
    or quarantining close contacts of a particular case together
    as a group.”) In addition, ICE detention facilities were to
    document each at-risk detainee on a centralized tracking
    tool, request a medical alert, and (if the detainee was not
    being held at an IHSC-staffed facility) notify the Field
    Medical Coordinator in charge of that facility.
    Detainees with no known exposure risk but who were
    symptomatic were to be considered for a possible COVID-
    19 test. (Although such tests have become more widely
    available, that was not the case at the beginning of the
    outbreak; the IHSC document indicates that at the time it was
    issued, testing through commercial laboratories had only
    recently become possible.) IHSC indicated that “[d]ecisions
    on which patients receive testing should be based on the
    epidemiology of COVID-19, as well as the clinical course of
    illness.”      Additionally, “[p]roviders [we]re strongly
    encouraged to test for other causes of respiratory illness,
    including infections such as influenza.” The document
    included a link to instructions for collecting specimens to
    facilitate testing.
    IHSC provided a different set of recommendations for
    symptomatic detainees with known exposure risk. These
    detainees were to be isolated following a detailed procedure.
    A “tight-fitting surgical mask” was to be placed on the
    detainee. A medical provider, “preferably the Clinical
    Director or designee,” was to be “[p]romptly consult[ed],”
    and the detainee was to be documented on the centralized
    tracking tool. The detainee was to be placed “in a private
    medical housing room, ideally in an airborne infection
    isolation room if available”; if no such room was available,
    the detainee was to be housed “separately from the general
    FRAIHAT V. USICE                      17
    detention population.” When detainees left these isolation
    rooms, they “should wear a tight-fitting surgical mask.”
    IHSC also recommended a system of notifications
    related to this group of symptomatic detainees. For these
    detainees, the local or state health department was to be
    notified and consulted for guidance, and, if the detainee had
    “underlying illness” or was “acutely ill,” or if symptoms did
    not resolve, the ICE Regional Clinical Director or Infectious
    Disease program was to be consulted. ICE healthcare staff
    were also to be notified through the Infection Prevention
    Officer, the Facility Healthcare Program Manager, the
    Infection Prevention Group, or (for non-IHSC facilities) the
    Field Medical Coordinator assigned to the facility. In turn,
    ICE officials were to “immediately” “notify the Regional
    Infection Prevention Supervisory Nurse.”
    In bold, oversized font, the Interim Reference Sheet also
    recommended implementing additional hygiene protocols
    for symptomatic detainees with exposure risk. Detention
    facilities should “[i]mplement strict hand hygiene and
    standard, airborne and contact precautions, including
    use of eye protection.” They should also “[i]ncrease hand
    hygiene and routine cleaning of surfaces,” with the
    guidance document noting that “[a]ppropriate personal
    protective equipment includes gloves, gowns, N95
    respirators, and goggles or face shields.” During the
    initial screenings and in later consultations, IHSC further
    recommended that facilities “[e]ducate all detainees to
    include the importance of hand washing and hand hygiene,
    covering coughs with the elbow instead of with hands, and
    requesting sick call if they feel ill.” This recommendation is
    repeated throughout the document.
    Finally, the Interim Reference Sheet contained a list of
    “[i]infectious disease public health actions.” Detainees with
    18                  FRAIHAT V. USICE
    “[k]nown exposure to a person with confirmed COVID-19”
    were recommended to be cohorted “with restricted
    movement” for 14 days, during which time they would be
    monitored for symptoms daily. Detainees with “exposure to
    a person with fever or symptoms being evaluated or under
    investigation for COVID-19 but not confirmed to have
    COVID-19” were to be similarly cohorted and monitored for
    14 days, unless the individual in question received a
    diagnosis that excluded COVID-19. All such cohorting was
    to be reported through IHSC’s routine protocols, and all
    “asymptomatic and afebrile” detainees being cohorted were
    to be documented in the tracking tool.
    ICE also issued separate guidance to reduce its detainee
    population where possible. On March 18, 2020, one week
    after the World Health Organization first characterized the
    COVID-19 outbreak as a “pandemic,” ICE issued guidance
    that “directed” its Field Office Directors (FODs) and Deputy
    Field Office Directors (DFODs) “to review the cases of
    aliens detained in your area of responsibility who were over
    the age of 70 or pregnant to determine whether continued
    detention was appropriate” in light of the pandemic. The
    record indicates that FODs have considerable authority
    within ICE. One former FOD described his duties in that
    role as “provid[ing] operational and policy oversight for
    ERO’s interior enforcement efforts within the local area of
    responsibility, spanning 43,000 square miles, three district
    courts, a cadre of nearly 200 employees, and 1,400 detention
    beds.”
    2
    On March 23, 2020, soon after States began issuing stay-
    at-home orders for the first time, the CDC published a
    document entitled “Interim Guidance on Management of
    Coronavirus Disease 2019 (COVID-19) in Correctional and
    FRAIHAT V. USICE                      19
    Detention Facilities.” ICE soon thereafter would reference
    and incorporate the CDC’s Interim Guidance in its own
    directives. But we discuss the CDC’s guidance now as part
    of the chronological history.
    The Interim Guidance document was dedicated to
    providing “recommended best practices specifically for
    correctional and detention facilities,” based on “what is
    currently known about the transmission and severity of
    coronavirus disease 2019 (COVID-19).” The Guidance
    included among its “intended audience” those “law
    enforcement agencies that have custodial authority for
    detained populations (i.e., US Immigration and Customs
    Enforcement . . . ).” But the CDC acknowledged (in bold)
    that its Guidance document did not “differentiate[]”
    between “different facilities types . . . and sizes” and that
    “[a]dministrators and agencies should adapt [its] guiding
    principles to the specific needs of their facility.”
    The CDC Interim Guidance provided approximately
    20 pages of “detailed recommendations,” including on the
    following topics: “Operational and communications
    preparations        for       COVID-19”;         “Enhanced
    cleaning/disinfecting and hygiene practices”; “Social
    distancing strategies to increase space between individuals
    in the facility”; “How to limit transmission from visitors”;
    “Infection control, including recommended personal
    protective equipment (PPE) and potential alternatives during
    PPE shortages”; “Verbal screening and temperature check
    protocols for incoming incarcerated/detained individuals,
    staff, and visitors”; “Medical isolation of confirmed and
    suspected cases and quarantine of contacts, including
    considerations for cohorting when individual spaces are
    limited”; “Healthcare evaluation for suspected cases,
    including testing for COVID-19”; “Clinical care for
    20                   FRAIHAT V. USICE
    confirmed and suspected cases”; and “Considerations for
    persons at higher risk of severe disease from COVID-19.”
    The CDC provided extensive recommendations on each of
    these topics.
    A few days later, on March 27, 2020, ICE issued a six-
    page memorandum containing an “Action Plan” for
    addressing COVID-19, for the stated purpose of “ensur[ing]
    a unified and preventative response.” The memorandum,
    addressed to ICE “Detention Wardens and Superintendents,”
    directly applied to dedicated or IHSC-staffed facilities. “For
    intergovernmental partners and non-dedicated facilities,” the
    memorandum instead deferred to governmental public
    health authorities. But the Action Plan nevertheless
    “recommend[ed] [the] actions contained in this
    memorandum be considered as best practices” for all
    facilities. The document contained guidance from various
    ICE components, consisting of IHSC, ERO, Custody
    Management Division (which “provides policy and
    oversight for the administrative custody” of ICE detainees),
    and Field Operations.
    ICE’s Action Plan acknowledged that “[t]he
    combination of a dense and highly transient detained
    population presents unique challenges for ICE efforts to
    mitigate the risk of infection and transmission.” Among
    other things, the Action Plan provided guidance on how to
    limit visits and gatherings within detention facilities to
    reduce the risk of coronavirus introduction and spread.
    Detainee visitations, in-person staff training, volunteer
    visits, and non-oversight facility tours were suspended. But
    in recognition of the “considerable impact of suspending
    personal visitation” and the importance of detainees
    “maintain[ing] community ties,” detention facilities were
    advised to “maximiz[e]” detainee use of telephone,
    FRAIHAT V. USICE                        21
    videoconferencing, and email, “with extended hours where
    possible.” Visits by contractors performing essential
    services, legal visits, and presentations by legal rights groups
    remained permitted, but the Action Plan provided guidance
    for minimizing exposure risk from those activities.
    The Action Plan addressed a variety of other topics as
    well, including hygiene and social distancing practices.
    Facilities were to make alcohol-based hand sanitizer
    available to detainees and staff “to the maximum extent
    possible.” Hand sanitizer “with at least 60 percent alcohol”
    was also to “be available in visitor entrances, exits, and
    waiting areas.” In addition, facilities were directed to
    “implement modified operations to maximize social
    distancing,” such as “staggered mealtimes and recreation
    times.” The document also provided a procedure for
    ensuring the safety of detainees being released from custody.
    Additionally, and while referring to previously
    disseminated guidance on how to screen detainees, the
    March 27, 2020 Action Plan also provided detailed
    instructions for “[e]nhanced health screening[s]” of ICE and
    facility staff to prevent staff from bringing the virus into the
    detention facility. This guidance applied to “ICE detention
    facilities in geographic areas with ‘sustained community
    transmission,’” as defined by the CDC. Finally, the
    document explained that “[t]he CDC remains the
    authoritative source for information on how to protect
    individuals and reduce exposure to COVID-19,” and it
    referred to multiple CDC documents, including the Interim
    Guidance document discussed above.
    3
    On April 4, 2020, ICE replaced its March 18, 2020
    detention review guidance with new guidance, entitled
    22                   FRAIHAT V. USICE
    “COVID-19 Detained Docket Review,” that governed
    determinations whether to release detainees from custody
    because of the risk of COVID-19. The theory behind
    reducing the detainee population was not only to remove
    from detention facilities those non-citizens with particular
    vulnerabilities to disease, but to create additional social
    distancing opportunities for those who remained in custody.
    This new April 2020 guidance was again addressed to Field
    Office Directors and deputies, and it expanded the risk
    factors that would prompt a review of a detainee’s continued
    detention.
    The April 4, 2020 Docket Review guidance listed several
    categories of detainees “that should be reviewed to re-assess
    custody.” This new list expanded on “a list of categories of
    individuals identified as potentially being at higher-risk for
    serious illness from COVID-19,” which the CDC had
    previously developed. As of April 4, 2020, ICE now
    directed FODs and DFODs to “re-assess” the custody of
    detainees who were pregnant, who had delivered babies in
    the last two weeks, who were over 60 years old, or who had
    chronic, immunocompromising conditions. Conditions in
    this latter category included, but were not limited to, blood
    disorders, chronic kidney disease, illnesses or treatment that
    would result in compromised immune systems (such as
    radiation therapy or chemotherapy, transplants, or “high
    doses of corticosteroids or other immunosuppressant
    medications”), endocrine disorders, metabolic disorders,
    heart disease, lung disease, and neurological, neurologic,
    and neurodevelopment conditions.
    The April 4, 2020 guidance instructed FODs and
    DFODs, “[a]s part of [the] ongoing application of the CDC’s
    Interim Guidance,” to “please identify all cases within your
    [area of responsibility] that meet any of the criteria above
    FRAIHAT V. USICE                       23
    and validate that list with assistance from IHSC or your Field
    Medical Coordinator.” Once a detainee was verified as
    meeting one of those criteria, the Docket Review guidance
    instructed officers to “review the case to determine whether
    continued detention remains appropriate in light of the
    COVID-19 pandemic.” However, while “[t]he presence of
    one of the factors listed above should be considered a
    significant discretionary factor weighing in favor of release,”
    the ultimate determination was to depend on the basis for the
    detainee’s detention.
    The April 4, 2020 guidance explained that aliens subject
    to mandatory detention under 
    8 U.S.C. § 1226
    (c) “may not
    be released in the exercise of discretion during the pendency
    of removal proceedings even if potentially higher-risk for
    serious illness from COVID-19.” Additionally, the guidance
    observed that “pursuant to [
    8 U.S.C. § 1231
    (a)(2)], certain
    criminal and terrorist aliens subject to a final order of
    removal may not be released during the 90-day removal
    period even if potentially higher-risk for serious illness from
    COVID-19.”
    The document then turned to detainees being held under
    discretionary detention under 
    8 U.S.C. § 1226
    (a). It
    mandated that “[c]ases involving any arrests or convictions
    for any crimes that involve risk to the public . . . must be
    reviewed and approved by a Deputy Field Office Director
    . . . or higher before a determination is made to release.” The
    document provided examples of such crimes: those that
    “involve[] any form of violence, driving while intoxicated,
    threatening behaviors, terroristic threats, stalking, domestic
    violence, harm to a child, or any form of assault or battery.”
    But the guidance noted that “[t]his list is not intended to be
    comprehensive.” “[T]he age of an arrest or a conviction”
    could be a mitigating or aggravating factor but would not
    24                   FRAIHAT V. USICE
    “automatically outweigh public safety concerns.”
    Furthermore, citing 
    8 C.F.R. § 236.1
    (c)(8), the Docket
    Review guidance reminded officers that even for non-
    citizens under discretionary detention, “release is prohibited,
    even if the alien is potentially higher-risk for serious illness
    from COVID-19, if such release would pose a danger to
    property or persons.”
    Finally, the Docket Review guidance addressed
    “arriving aliens and certain other aliens eligible for
    consideration of parole from custody.” “[A]bsent significant
    adverse factors,” that a detainee was “potentially higher-risk
    for serious illness from COVID-19” may justify his release
    under 
    8 C.F.R. § 212.5
    (b)(5), based on a determination that
    “continued detention is not in the public interest.”
    Furthermore, “field offices remain[ed] responsible for
    articulating individualized custody determinations” for
    “other aliens for whom there is discretion to release,” “taking
    into consideration the totality of the circumstances presented
    in the case.” The April 4, 2020 guidance mandated that
    “[t]he fact that an alien is potentially higher-risk for serious
    illness from COVID-19 should be considered a factor
    weighing in favor of release.”
    The record contains evidence that ICE reduced its
    detainee population under the guidance described above. As
    of April 10, 2020, ICE reported that it had released
    693 individuals from custody after evaluating their
    immigration histories and criminal records. Furthermore, in
    response to the virus, ICE sought to “limit[] the intake of
    new detainees being introduced into the ICE detention
    system.” As a result, ICE reported a decrease in “book-ins”
    of over 60 percent when comparing March 2020 to March
    2019. ICE also “arrested 1,982 fewer individuals in [the]
    Criminal Alien Program and 3,390 fewer at-large
    FRAIHAT V. USICE                            25
    individuals,” “comparing the period of 22 days before and
    after March 18, 2020.” All told, by “releas[ing] . . . highly
    vulnerable detainees, reducing [ICE’s] enforcement posture,
    and exercising discretion on certain lower risk arrests,” ICE
    reduced its detainee population from 37,662 single adults on
    February 13, 2020, to 35,980 on March 13, 2020, to 31,709
    on April 13, 2020.
    4
    On April 10, 2020, ICE ERO issued an 18-page
    document entitled “COVID-19 Pandemic Response
    Requirements.” “[I]ntended for use across ICE’s entire
    detention network,” the Pandemic Response Requirements
    “appl[ied] to all facilities housing ICE detainees” and
    provided detailed instructions for managing the detainee
    population in the face of COVID-19. ICE ERO explained
    that these measures were “necessary” given the “seriousness
    and pervasiveness of COVID-19.”              Thus, ICE was
    “providing guidance on the minimum measures required for
    facilities housing ICE detainees to implement to ensure
    consistent practices throughout its detention operations and
    the provision of medical care across the full spectrum of
    detention facilities to mitigate the spread of COVID-19.”
    The Pandemic Response Requirements, which were also
    developed in consultation with the CDC, imposed
    mandatory requirements on all facilities holding ICE
    detainees. 2 As the Requirements stated under “Objectives,”
    2
    The Pandemic Response Requirements imposed virtually identical
    requirements on both dedicated and non-dedicated ICE facilities. There
    were only two apparent distinctions. First, the Pandemic Response
    Requirements noted that the cross-referenced March 27, 2020 Action
    Plan was mandatory for dedicated facilities but not for non-dedicated
    26                      FRAIHAT V. USICE
    ICE’s purpose in issuing them was to “establish consistency
    across ICE detention facilities by establishing mandatory
    requirements and best practices all detention facilities
    housing ICE detainees are expected to follow during the
    COVID-19 pandemic.”
    The Pandemic Response Requirements began by
    mandating that all facilities “must . . . [c]omply with the
    CDC’s [Interim Guidance]” document, which we described
    above. Furthermore, each facility “must” have its Health
    Services Administrator notify the Field Office Director and
    Field Medical Coordinator responsible for the facility “as
    soon as practicable, but in no case more than 12 hours after
    identifying any detainee who meets the CDC’s identified
    populations potentially being at higher-risk for serious
    illness from COVID-19.”
    The Pandemic Response Requirements described those
    “higher-risk” populations as “including” “[p]eople aged 65
    and older” and “[p]eople of all ages with underlying medical
    conditions, particularly if not well controlled.” The
    specified medical conditions “includ[ed]” chronic lung
    disease, moderate to severe asthma, serious heart conditions,
    immunocompromising conditions, severe obesity (defined
    as “body mass index . . . of 40 or higher”), diabetes, chronic
    kidney disease undergoing dialysis, and liver disease.
    Furthermore, each facility “must” “[r]eport all confirmed
    and suspected COVID-19 cases to the local ERO Field
    facilities. And second, dedicated facilities were required to notify the
    local FOD and FMC by email within 12 hours of identifying a higher-
    risk detainee while non-dedicated facilities were authorized to make
    notifications within 12 hours either via email or some “[o]ther
    standardized means of communicati[on].”
    FRAIHAT V. USICE                      27
    Office Director (or designee), Field Medical Coordinator,
    and local health department immediately.”
    The Pandemic Response Requirements additionally
    “required” “all facilities housing ICE detainees” to establish
    a “COVID-19 mitigation plan” to protect detainees from the
    pandemic. The mitigation plan was “required” to “meet[]
    the following four objectives”:
    •   To protect employees, contractors,
    detainees, visitors to the facility, and
    stakeholders from exposure to the virus;
    •   To maintain essential functions and
    services at the facility throughout the
    pendency of the pandemic;
    •   To reduce movement and limit
    interaction of detainees with others
    outside their assigned housing units, as
    well as staff and others, and to promote
    social distancing within housing units;
    and
    •   To establish means to monitor, cohort,
    quarantine, and isolate the sick from the
    well.
    Consistent with these objectives, the Pandemic Response
    Requirements also imposed a wide range of additional
    operational requirements that “all detention facilities
    housing ICE detainees must also comply with.” These
    requirements were divided into three sections.
    First, under the heading “Preparedness,” the Pandemic
    Response Requirements provided detailed directives on
    28                  FRAIHAT V. USICE
    information-sharing with partner agencies, staffing, supplies
    (such as soap and facemasks), hygiene, and cleaning and
    disinfecting practices. In particular, the Pandemic Response
    Requirements mandated that facilities follow CDC guidance
    on optimizing the supply of personal protective equipment,
    such as facemasks and N95 respirators. The Pandemic
    Response Requirements also specified that when PPE such
    as N95 masks were limited in supply, “[c]loth face coverings
    should be worn by detainees and staff . . . to help slow the
    spread of COVID-19.”
    “Preparedness” also included requirements for ensuring
    personal and facility-wide hygiene. Among other things, all
    detainees and staff were to be provided “no-cost, unlimited
    access to supplies for hand cleansing, including liquid soap,
    running water, hand drying machines or disposable paper
    towels, and no-touch trash receptacles.” Facilities were also
    to “[p]rovide alcohol-based hand sanitizer with at least 60%
    alcohol where permissible based on security restrictions.”
    To educate detainees and staff, facilities were required to
    post signage (such as that provided by the CDC) about hand
    hygiene and cough etiquette in English, Spanish, and “any
    other common languages for the detainee population at the
    facility.”
    ICE detention facilities were also required to “[a]dhere
    to CDC recommendations for cleaning and disinfection,”
    and the Pandemic Response Requirements provided a link to
    the CDC guidance on the subject. The Pandemic Response
    Requirements       contain     a      lengthy     list    of
    “Cleaning/Disinfecting Practices” and recommendations for
    cleaning “Hard (Non-porous) Surfaces,” “Soft (Porous)
    Surfaces,” “Electronics,” and “Linens, Clothing, and Other
    Items That Go in the Laundry.”
    FRAIHAT V. USICE                       29
    Second, under the heading “Prevention,” the Pandemic
    Response Requirements provided directives for screening
    detainees and staff, visitation, and social distancing,
    emphasizing that “[b]oth good hygiene practices and social
    distancing are critical in preventing further transmission” of
    COVID-19. As to screening, for example, the Requirements
    detailed how facilities should screen for COVID-19
    symptoms and what facilities should do when they
    determined during the screening process that a detainee or
    staff member may have COVID-19 exposure. As to social
    distancing, the Pandemic Response Requirements discussed
    various measures for sleeping, dining, and recreation that
    could lead to greater physical distance between detainees
    during more hours of the day.
    While the Pandemic Response Requirements recognized
    that “strict social distancing may not be possible in
    congregate settings such as detention facilities,” it required
    facilities, “to the extent practicable,” to reduce detainee
    populations and population movement as part of creating
    greater social distancing. Facilities specifically were
    advised to “reduce the population to approximately 75% of
    capacity.” The Pandemic Response Requirements also
    required facilities, “[w]here possible, [to] restrict transfers
    of detained non-ICE populations to and from other
    jurisdictions and facilities unless necessary for medical
    evaluation, isolation/quarantine, clinical care, or
    extenuating security concerns.” Notwithstanding this new
    guidance, continued detention review, as specified in the
    April 4, 2020 “COVID-19 Detained Docket Review,”
    remained ongoing.
    Third, under the heading “Management,” the Pandemic
    Response Requirements provided detailed instructions on
    managing suspected or confirmed COVID-19 cases. All
    30                   FRAIHAT V. USICE
    such detainees were to be isolated “immediately” with their
    own individual “housing space[s] and bathroom[s] where
    possible,” and were to “always wear[] a face mask (if it does
    not restrict breathing) when outside of the isolation space,
    and whenever another individual enters the isolation room.”
    The Pandemic Response Requirements acknowledged
    cohorting as an option, but it “should only be practiced if
    there are no other available options.” Furthermore, “[i]f the
    number of confirmed cases exceeds the number of individual
    isolation spaces available in the facility, then ICE must be
    promptly notified so that transfer to other facilities, transfer
    to hospitals, or release can be coordinated immediately.”
    The Pandemic Response Requirements also reproduced
    the CDC’s list of medical isolation methods, ranging from
    the most preferred option (“[s]eparately, in single cells with
    solid walls (i.e., not bars) and solid doors that close fully”)
    to the option of last resort (“[a]s a cohort, in multi-person
    cells without solid walls or solid doors (i.e., cells enclosed
    entirely with bars), preferably with an empty cell between
    occupied cells”). Isolation was to be maintained, the
    Pandemic Response Requirements mandated, “until all the
    CDC criteria” for ending isolation have been met.
    With this important background in place, we now turn to
    the litigation at hand.
    C
    On August 19, 2019, several months before the COVID-
    19 outbreak began, a group of fifteen non-citizens in
    immigration detention and two non-profit organizations
    filed the underlying complaint in this case against DHS, ICE,
    and various DHS and ICE officials. Plaintiffs filed the case
    as a putative nationwide class action on behalf of “all people
    currently detained, or who in the future will be detained, in
    FRAIHAT V. USICE                      31
    ICE custody who are now, or will in the future be, subjected
    to” certain detention conditions. The complaint broadly
    alleged that the government had failed to “provide
    constitutionally adequate medical and mental health care” at
    ICE detention facilities, had unconstitutionally housed
    detainees in near-solitary confinement, and had
    discriminated against detainees with disabilities.
    Months into the litigation, COVID-19 began to grip the
    United States. The focus of this case then became ICE’s
    handling of the pandemic. On March 24 and 25, 2020, and
    before some of the ICE directives described above had been
    issued, plaintiffs filed emergency motions seeking a
    preliminary injunction and certification of two subclasses.
    Plaintiffs sought an injunction requiring ICE, inter alia, to
    identify all detainees at greater risk from COVID-19 because
    of certain medical conditions, and to release all such
    detainees “if medically necessary safeguards cannot be
    immediately (within 24 hours) provided to ensure [their]
    health and safety[] and absent an individualized finding of
    dangerousness to community.”
    On April 20, 2020, the district court entered a
    preliminary injunction and an accompanying provisional
    class certification order. Fraihat v. ICE, 
    445 F. Supp. 3d 709
    , 750–51 (C.D. Cal. 2020); Fraihat v. ICE, No. EDCV
    19-1546 JGB (SHKx), 
    2020 WL 1932393
    , at *1 (C.D. Cal.
    Apr. 20, 2020). The district court certified two subclasses.
    
    2020 WL 1932393
    , at *1. The first subclass consisted of
    “[a]ll people who are detained in ICE custody who have one
    or more of the Risk Factors placing them at heightened risk
    of severe illness and death upon contracting the COVID-19
    virus.” 
    Id.
     “Risk Factors” meant “being over the age of 55;
    being pregnant; or having chronic health conditions.” 
    Id.
    32                  FRAIHAT V. USICE
    The class certification order defined “chronic health
    conditions” as “including” the following list of conditions:
    cardiovascular disease (congestive heart
    failure, history of myocardial infarction,
    history of cardiac surgery); high blood
    pressure; chronic respiratory disease (asthma,
    chronic obstructive pulmonary disease
    including chronic bronchitis or emphysema,
    or other pulmonary diseases); diabetes;
    cancer; liver disease; kidney disease;
    autoimmune diseases (psoriasis, rheumatoid
    arthritis, systemic lupus erythematosus);
    severe psychiatric illness; history of
    transplantation; and HIV/AIDS.
    
    Id.
     The second subclass consisted of “[a]ll people who are
    detained in ICE custody whose disabilities place them at
    heightened risk of severe illness and death upon contacting
    the COVID-19 virus.” 
    Id.
     The list of “Covered disabilities”
    was identical to the list of “chronic health conditions.” 
    Id.
    The district court appointed five of the fifteen original
    individual plaintiffs as class representatives for the
    provisionally certified subclasses: Faour Abdallah Fraihat,
    Jimmy Sudney, Aristoteles Sanchez Martinez, Alex
    Hernandez, and Martín Muñoz. 
    Id.
     At the time, Sanchez
    Martinez was detained at the Stewart Detention Center in
    Georgia, and Hernandez was detained at the Etowah County
    Detention Center in Alabama. Fraihat, Sudney, and Muñoz
    previously had been detained at the Adelanto ICE Processing
    Center in California, but all three had been released by the
    time the district court issued the injunction and appointed
    them as class representatives.
    FRAIHAT V. USICE                      33
    With the exception of Sanchez Martinez, the class
    representatives had lengthy criminal histories, including
    convictions for manufacturing methamphetamine, robbery,
    and felony hit-and-run causing death or injury. At least two
    had previously been denied bond by Immigration Judges for
    presenting a danger to the community, and at least one
    previously had been found to be a flight risk.
    Simultaneously with its class certification order, the
    district court entered a preliminary injunction. 445 F. Supp.
    3d at 750–51. The court found that Plaintiffs were likely to
    succeed on the merits of three claims. First, ICE had likely
    acted with “medical indifference in violation of the Fifth
    Amendment” by failing to promulgate minimally adequate
    systemwide requirements in response to the pandemic. Id.
    at 742–46. The district court also noted deficiencies in
    hygiene, medical care, and social distancing at certain
    facilities. Id. at 728–734, 742–46.
    Second, the court held that ICE’s actions likely created
    “punitive conditions of confinement” in violation of the Fifth
    Amendment because the conditions in ICE detention
    facilities were worse than those in federal prisons. Id. at
    746–47. Third, the district court found that ICE likely
    violated section 504 of the Rehabilitation Act by failing to
    accord detainees with disabilities a “benefit,” which the
    court found was “best understood as participation in the
    removal process.” Id. at 747–48.
    Additionally, the district court found that plaintiffs
    showed a likelihood of irreparable harm based on an increase
    in COVID-19 cases among ICE detainees, a 15 percent
    mortality rate for “individuals vulnerable to COVID-19” and
    the possibility of “lasting consequences” for those who
    contract the virus and survive, and evidence that “detained
    populations tend to have worse health outcomes than the
    34                  FRAIHAT V. USICE
    population as a whole.” Id. at 749. The district court also
    found that the balance of the equities and public interest
    “sharply incline[d] in Plaintiffs’ favor.” Id.
    The district court entered a preliminary injunction that
    ordered ICE to undertake extensive measures in response to
    COVID-19. Id. at 750–51. Because it is important to
    appreciate the scope of the district court’s preliminary
    injunction, we quote its commands in full:
    •   Defendants shall provide ICE Field
    Office Directors with the Risk Factors
    identified in the Subclass definition;
    •   Defendants shall identify and track all
    ICE detainees with Risk Factors. Most
    should be identified within ten days of
    this Order or within five days of their
    detention, whichever is later;
    •   Defendants shall make timely custody
    determinations for detainees with Risk
    Factors, per the latest Docket Review
    Guidance.          In    making       their
    determinations,     Defendants     should
    consider the willingness of detainees with
    Risk Factors to be released, and offer
    information on post-release planning,
    which Plaintiffs may assist in providing;
    •   Defendants shall provide necessary
    training to any staff tasked with
    identifying detainees with Risk Factors,
    or delegate that task to trained medical
    personnel;
    FRAIHAT V. USICE                        35
    •   The above relief shall extend to detainees
    with Risk Factors regardless of whether
    they have submitted requests for bond or
    parole, have petitioned for habeas relief,
    have requested other relief, or have had
    such requests denied;
    •   Defendants shall promptly issue a
    performance standard or a supplement to
    their Pandemic Response Requirements
    (“Performance Standard”) defining the
    minimum         acceptable      detention
    conditions for detainees with the Risk
    Factors, regardless of the statutory
    authority for their detention, to reduce
    their risk of COVID-19 infection pending
    individualized determinations or the end
    of the pandemic;
    •   Defendants shall monitor and enforce
    facility-wide compliance with the
    Pandemic Response Requirements and
    the Performance Standard.
    Id. at 751. These measures, the district court ordered, were
    to “remain in place as long as COVID-19 poses a substantial
    threat of harm to members of the Subclasses.” Id. at 751.
    D
    On June 19, 2020, the government timely appealed the
    district court’s injunction and class certification order but did
    not seek a stay pending appeal. Briefing in this appeal was
    completed in early September 2020. Several weeks later, on
    October 7, 2020, the district court issued a further order
    granting in part plaintiffs’ motion to enforce the injunction.
    36                   FRAIHAT V. USICE
    Fraihat v. ICE, No. EDCV 19-1546 JGB (SHKx), 
    2020 WL 6541994
     (C.D. Cal. Oct. 7, 2020). In this order, the district
    court explained that there were “several areas” of the
    preliminary injunction “where clarification is warranted,”
    based on the government’s non-compliance with the original
    injunction. 
    Id. at *3
    . Although the district court’s October
    2020 order is the subject of a separate appeal, we discuss the
    order here because it demonstrates the district court’s
    understanding and interpretation of its earlier April 20, 2020
    injunction.
    In the October 7, 2020 order, the district court noted that
    the government had since revised its Pandemic Response
    Requirements, but the court concluded that those revisions
    were inadequate. While noting it was not “enlarging the
    preliminary injunction,” the district court issued substantial
    clarification in three areas. 
    Id.
     at *5–13.
    First, explaining that “the nature of the violation is a
    failure to adopt sufficiently comprehensive protocols to
    protect Subclass members,” the district court’s October 7,
    2020 order provided a detailed set of directives governing
    the manner in which ICE was to provide medical care. 
    Id. at *8
    . We quote those in full:
    •   Defendants shall issue a comprehensive
    Performance Standard directed to the
    Subclasses within twenty days.
    •   Defendants    shall   mandate     more
    widespread and regular testing of the
    Subclasses, consistent with CDC
    Guidelines and above the level provided
    by the [Bureau of Prisons] and state
    prisons.
    FRAIHAT V. USICE                    37
    •   Defendants shall develop minimum care
    and hospitalization protocols for Subclass
    Members who test positive.
    •   Defendants shall mandate that medical
    isolation and quarantine are distinct from
    solitary, segregated, or punitive housing,
    that extended lockdowns as a means of
    COVID-19 prevention are not allowed,
    and that access to diversion (books,
    television, recreation) and to telephones
    must be maintained to the fullest extent
    possible.
    •   Defendants shall mandate that safe
    cleaning products be utilized in safe
    quantities and in the manner intended for
    those products.        Defendants shall
    promptly investigate and redress reports
    of adverse reactions to harsh cleaning
    products or chemical sprays.
    •   Defendants     shall    provide      more
    protective, and more concrete, transfer
    protocols to protect the Subclasses,
    including a suspension of transfers with a
    narrow and well-defined list of
    exceptions consistent with CDC
    Guidance.
    •   Defendants shall mandate twice daily
    screening of the Subclass members for
    symptoms and temperature, consistent
    with CDC recommendations and utilizing
    a structured screening tool.
    38                     FRAIHAT V. USICE
    •   Defendants shall continue to update the
    Performance Standard, consistent with
    expert guidance and CDC Interim
    Guidance, with the goal of exceeding
    [Bureau of Prisons] and state prison
    system response levels.
    •   Defendants shall ensure subsequent
    iterations of the [Pandemic Response
    Requirements] do not dilute or distort
    CDC Interim Guidance, and shall ensure
    that facility operators are promptly
    notified of changes in CDC Interim
    Guidance.
    
    Id.
     (footnotes omitted). 3
    Second, citing the government’s “weak monitoring of
    facility-wide compliance with the Performance Standard,”
    the district court in its October 7, 2020 order issued
    clarifications and directives on the issue of “monitoring and
    enforcement.” 
    Id. at *6
    , *8–9. We quote those in full:
    •   The Facility Survey shall be immediately
    and continuously updated to reflect the
    most current Performance Standard, shall
    include a section on Subclass member
    numbers and present conditions, and shall
    3
    According to the district court’s preliminary injunction, the
    referenced “Performance Standard” was to be a supplemented and more
    comprehensive version of ICE’s Pandemic Response Requirements that
    complied with the district court’s orders. 445 F. Supp. 3d at 751.
    FRAIHAT V. USICE                               39
    be corrected to address flaws noted by
    Plaintiffs’ expert.
    •    Defendants shall require [Detention
    Service Managers], [Detention Standards
    Compliance Officers] or other trained
    ICE compliance personnel to verify in
    person the facility self reports. These in-
    person checks should occur at least
    monthly.
    •    Defendants shall centrally track notices
    of non-compliance, action plans,
    corrective action plans, and notices of
    intent, and shall document their follow-
    up. These documents shall be included in
    the bi-weekly disclosures to Plaintiffs.
    Id. at *9 (citations omitted). 4
    Third, and most significantly, the district court found that
    ICE had not conducted sufficiently “meaningful” custody
    determinations. Id. at *9. The court was “especially
    distressed that about 70% of the detained Subclass members
    are not subject to mandatory detention yet have not benefited
    from the Docket Review Guidance, which instructs that the
    presence of a risk factor should be a significant discretionary
    factor in favor of release.” Id. at *6.
    4
    The referenced Facility Surveys were questionnaires completed by
    individual detention facility administrators that, according to the district
    court, allowed “self-report[ing] [of] conditions of confinement and
    degree of COVID-19 preparedness.” 
    2020 WL 6541994
    , at *4.
    40                   FRAIHAT V. USICE
    This, the district court explained, contravened its prior
    orders. The court characterized its initial injunction as
    “assum[ing]” that making the Docket Review guidance
    mandatory would, consistent with the court’s orders, “result
    in meaningful reviews and the release of significant numbers
    of Subclass members.” 
    Id. at *10
    . This meant that under the
    injunction, “only in rare cases would Defendants fail to
    release a Subclass member not subject to mandatory
    detention.” 
    Id.
     But the court also indicated it had “expected
    that some individuals subject to mandatory detention would
    be released under the Docket Review Guidance and
    Preliminary Injunction.” 
    Id. at *11
    . The district court
    faulted the government for failing to release more detainees,
    finding that its “expect[ation]” of an “increase in releases”
    since the injunction had not been fulfilled. 
    Id.
    To remedy this issue, the district court issued further
    “clarifications” that it described as “necessary to achieve the
    original purposes” of the injunction. 
    Id. at *12
    . The court
    first clarified that under the original injunction, ICE was
    required to follow a two-step process for custody
    determinations. 
    Id. at *12
    . The district court provided this
    further direction, as follows:
    •   The Preliminary Injunction requires
    Defendants to identify and track
    detainees with risk factors within five
    days of their detention (step one) then to
    make a “timely” custody determination
    (step two).
    o At step one, Defendants must
    affirmatively identify and track
    detainees with Risk Factors.
    However, detainee medical files
    might be incomplete. To account for
    FRAIHAT V. USICE                     41
    this likelihood, a detainee or their
    counsel may promptly obtain a copy
    of the medical file and may
    supplement medical records at any
    time. Defendants shall streamline
    and clarify procedures for such
    requests.      Defendants’ medical
    personnel shall review newly
    submitted records within five days
    and inform the detainee and his or her
    counsel of the result.
    o At step two, Defendants must
    complete a “timely” custody
    determination. Only in rare cases
    should the determination take longer
    than a week.
    o Defendants shall provide notice of the
    result of the custody determination to
    the Subclass member and his or her
    counsel. The notice shall mention the
    Risk Factor(s) identified, and in cases
    of non-release shall reference a basis
    for continued detention in the Docket
    Review Guidance.
    
    Id.
     (citation omitted).
    The district court then specified the manner in which ICE
    was to make custody determinations, as well as the
    frequency with which ICE was to release detainees. We
    quote the district court’s clarifications in full:
    •   In order to increase compliance and
    reduce detainee and attorney confusion,
    42           FRAIHAT V. USICE
    Defendants     shall    advertise   and
    implement consistent procedures across
    field offices, for both steps outlined
    above. Defendants shall ensure that the
    presence of a Risk Factor is given
    significant weight and that the custody
    reviews are meaningful.
    o Blanket or cursory denials do not
    comply with the Preliminary
    Injunction or with the Docket Review
    Guidance’s instruction to make
    individualized determinations.
    o Only in rare cases should a Subclass
    member not subject to mandatory
    detention remain detained, and
    pursuant to the Docket Review
    Guidance, a justification is required.
    o Subclass members subject to
    mandatory detention shall also
    receive custody determinations.
    Defendants shall not apply the Docket
    Review Guidance rule against release
    of Section 1226(c) detainees so
    inflexibly that none of these Subclass
    members are released.          Section
    1226(c) Subclass members should
    only continue to be detained after
    individualized consideration of the
    risk of severe illness or death, with
    due regard to the public health
    emergency.
    FRAIHAT V. USICE                      43
    o Defendants shall centrally track and
    report in their biweekly productions
    the results of the Risk Factor and
    custody determinations.
    o To the extent Fraihat conflicts with
    another injunction regarding custody
    determination practices or procedures
    at particular field offices or facilities,
    the other court orders take
    precedence.
    •   The Risk Factor “Severe psychiatric
    illness” includes psychiatric illnesses that
    make it difficult for the individual to
    participate in their own care, that make it
    unlikely the individual will express
    symptoms, or that increase the risk of
    complications from the virus.
    
    Id.
     (citation and footnote omitted).
    The district court reiterated, however, that “[t]he
    Preliminary Injunction and subsequent orders address only
    Defendants’ systemwide response to the pandemic.” 
    Id. at *13
    . As a result, the district court went on, “[t]he case
    does not opine on the lawfulness of conditions faced by any
    individual detainee, nor does it determine the lawfulness of
    conditions at any particular facility.” 
    Id.
    The government then filed a separate notice of appeal
    from the district court’s October 7, 2020 clarification order.
    After we heard oral argument in the original appeal of the
    preliminary injunction and class certification orders, we
    ordered that the second appeal be held in abeyance pending
    the resolution of the first appeal. In the meantime, the
    44                   FRAIHAT V. USICE
    district court has issued a further order granting plaintiffs’
    motion to appoint a special master to “monitor and oversee”
    ICE’s compliance with the injunction. The government has
    since filed a third notice of appeal of a further order of the
    district court accepting the special master’s May 21, 2021
    recommendations on additional oversight of ICE relating to
    the release and transfer of detainees and vaccinations.
    In the meantime, and following the change in
    presidential administrations, the government reiterated its
    opposition to the district court’s April 20, 2020 injunction.
    In a February 26, 2021 letter to this Court, the government
    maintained that “individual findings of likely deliberate
    indifference are not enough to show systemic harm or
    enough to warrant certification of sweeping nationwide
    classes or class-wide relief.” Citing “ICE’s extensive
    nationwide approach and response to COVID-19,” the
    government renewed its position that “ICE’s policies in
    response to COVID-19” did not “violate[] due process on a
    nationwide basis.”
    On September 9, 2021, nine months after this case was
    argued and submitted and nearly fifteen months after the
    government had filed its notice of appeal, the parties asked
    us to refer this case to our Court’s mediation program. This
    request comes much too late, and we deny it. This matter
    has long been poised for resolution on appeal. The parties
    were free to resolve their dispute at any time and remain free
    to reach any private agreement. But given the substantial
    judicial and court resources that the parties already required
    be expended on their behalf, we decline their request to now
    use further court resources in the form of the Court’s
    mediation program—itself a not unlimited resource. See
    Ninth Circuit General Order 7.1 (“The goals of the [Circuit
    mediation] program are to facilitate the voluntary resolution
    FRAIHAT V. USICE                            45
    of appeals in order to reduce the Court’s workload and to
    offer parties an alternative to litigation to resolve their
    disputes.”). Mediation is also not a sound use of court
    resources when the court has already fully evaluated and
    reached a decision on the merits, and when there are obvious
    reasons to question whether a circuit mediator could
    efficiently resolve this sprawling dispute, itself but one part
    of a much larger litigation. 5
    II
    The government argues on appeal that the district court
    erred both in issuing a preliminary injunction and in granting
    provisional class certification.        Although we have
    jurisdiction to reach the latter issue, see Paige v. State of
    California, 
    102 F.3d 1035
    , 1039 (9th Cir. 1996), we need not
    do so here. The district court’s class certification ruling
    depended on, and was in service of, its preliminary
    injunction. If the preliminary injunction is infirm, the class
    certification order necessarily falls as well, regardless of
    whether class certification was otherwise proper under
    Federal Rule of Civil Procedure 23.
    We thus turn our attention to the district court’s
    preliminary injunction.     We have jurisdiction under
    
    28 U.S.C. § 1292
    (a)(1) to “review for an abuse of discretion
    the district court’s decision to grant a preliminary
    injunction.” Ramos v. Wolf, 
    975 F.3d 872
    , 888 (9th Cir.
    2020). “Within this inquiry, we review the district court’s
    legal conclusions de novo and its factual findings for clear
    error.” 
    Id.
     In addition, “[a]n overbroad injunction is an
    5
    The parties’ request to refer this case to the Court’s mediation
    program is thus denied. For the reasons set forth in Judge Berzon’s
    dissenting opinion, Judge Berzon would grant the mediation request.
    46                   FRAIHAT V. USICE
    abuse of discretion.” Stormans, Inc. v. Selecky, 
    586 F.3d 1109
    , 1119 (9th Cir. 2009) (quotations and alteration
    omitted); see also McCormack v. Hiedeman, 
    694 F.3d 1004
    ,
    1019 (9th Cir. 2012); E. & J. Gallo Winery v. Gallo Cattle
    Co., 
    967 F.2d 1280
    , 1297 (9th Cir. 1992).
    A preliminary injunction is “an extraordinary and drastic
    remedy, one that should not be granted unless the movant,
    by a clear showing, carries the burden of persuasion.” Lopez
    v. Brewer, 
    680 F.3d 1068
    , 1072 (9th Cir. 2012) (quoting
    Mazurek v. Armstrong, 
    520 U.S. 968
    , 972 (1997) (per
    curiam)); accord Winter v. Nat. Res. Def. Council, Inc.,
    
    555 U.S. 7
    , 22 (2008); California ex rel. Becerra v. Azar,
    
    950 F.3d 1067
    , 1105 (9th Cir. 2020) (en banc); City &
    County of San Francisco v. USCIS, 
    944 F.3d 773
    , 789 (9th
    Cir. 2019)).
    To obtain this relief, a plaintiff “must establish [1] that
    he is likely to succeed on the merits, [2] that he is likely to
    suffer irreparable harm in the absence of preliminary relief,
    [3] that the balance of equities tips in his favor, and [4] that
    an injunction is in the public interest.” USCIS, 944 F.3d at
    788–89 (quoting Winter, 
    555 U.S. at 20
    ) (alterations in
    original). “Likelihood of success on the merits is the most
    important factor.” California v. Azar, 
    911 F.3d 558
    , 575 (9th
    Cir. 2018) (quotations omitted). In this Circuit, we also
    “employ[] an alternative ‘serious questions’ standard, also
    known as the ‘sliding scale’ variant of the Winter standard.”
    Ramos, 975 F.3d at 887 (quoting All. for the Wild Rockies v.
    Cottrell, 
    632 F.3d 1127
    , 1134 (9th Cir. 2011)). Under that
    formulation, “‘serious questions going to the merits’ and a
    balance of hardships that tips sharply towards the plaintiff[s]
    can support issuance of a preliminary injunction, so long as
    the plaintiff[s] also show[] that there is a likelihood of
    FRAIHAT V. USICE                      47
    irreparable injury and that the injunction is in the public
    interest.” All. for the Wild Rockies, 632 F.3d at 1135.
    The district court found that plaintiffs had established a
    likelihood of success on three claims: (1) deliberate
    indifference to the medical needs of detainees, in violation
    of the Fifth Amendment; (2) punitive conditions of
    confinement, also in violation of the Fifth Amendment; and
    (3) a violation of section 504 of the Rehabilitation Act,
    
    29 U.S.C. § 794
    . 445 F. Supp. 3d at 741–48. We hold,
    however, that plaintiffs failed to demonstrate a likelihood of
    success or serious questions on the merits of any of these
    claims. We address each in turn.
    III
    We begin with plaintiffs’ primary claim that ICE “failed
    to promulgate and implement medically necessary protocols
    and practices to protect medically vulnerable people” from
    COVID-19, and that this failure amounted to deliberate
    indifference in violation of the Fifth Amendment. We
    conclude that plaintiffs have not shown a likelihood of
    success or serious questions on the merits of this claim, and
    that the district court’s determination otherwise turned on a
    misapprehension of the governing legal standards.
    A
    Demonstrating deliberate indifference requires a
    substantial showing. Plaintiffs must establish the following:
    (i) the defendant made an intentional decision
    with respect to the conditions under which
    the plaintiff was confined; (ii) those
    conditions put the plaintiff at substantial risk
    of suffering serious harm; (iii) the defendant
    48                  FRAIHAT V. USICE
    did not take reasonable available measures to
    abate that risk, even though a reasonable
    official in the circumstances would have
    appreciated the high degree of risk
    involved—making the consequences of the
    defendant’s conduct obvious; and (iv) by not
    taking such measures, the defendant caused
    the plaintiff’s injuries.
    Gordon v. County of Orange, 
    888 F.3d 1118
    , 1125 (9th Cir.
    2018).
    In substance, the government focuses on the third
    element, which requires plaintiffs to show that defendants’
    conduct was “objectively unreasonable.” 
    Id.
     To establish
    objective unreasonableness, a plaintiff must “prove more
    than negligence but less than subjective intent—something
    akin to reckless disregard.” 
    Id.
     (quoting Castro v. County of
    Los Angeles, 
    833 F.3d 1060
    , 1071 (9th Cir. 2016) (en banc));
    see also, e.g., Roman v. Wolf, 
    977 F.3d 935
    , 943 (9th Cir.
    2020) (per curiam).
    The “reckless disregard” standard is a formidable one.
    See, e.g., Roman, 977 F.3d at 947 (Miller, J., concurring in
    part and concurring in the judgment) (describing “reckless
    disregard” as a “high standard”). Neither “mere lack of due
    care,” nor “an inadvertent failure to provide adequate
    medical care,” nor even “[m]edical malpractice,” without
    more, is sufficient to meet this standard. Estelle v. Gamble,
    
    429 U.S. 97
    , 105–06 (1976); Gordon, 888 F.3d at 1125;
    Castro, 833 F.3d at 1071; see also Roman, 977 F.3d at 947
    (Miller, J., concurring in part and concurring in the
    judgment) (“Although the word ‘reasonable’ might be taken
    to suggest something akin to the duty of reasonable care
    applied in negligence cases, the standard is more demanding
    than that . . . .”). Instead, a plaintiff must show that the
    FRAIHAT V. USICE                       49
    defendant “disregard[ed] an excessive risk” to the plaintiff’s
    health and safety by failing to take “reasonable and available
    measures” that could have eliminated that risk. Castro,
    833 F.3d at 1070–71 (quoting Estate of Ford v. Ramirez-
    Palmer, 
    301 F.3d 1043
    , 1050 (9th Cir. 2002)).
    The scope of the plaintiffs’ allegations and the nature of
    their requested relief also necessarily inform our analysis.
    See Gordon, 888 F.3d at 1125 (explaining that whether the
    government’s conduct was “objectively unreasonable” “will
    necessarily turn on the facts and circumstances of each
    particular case” (quotations omitted and alteration
    accepted)).     In many cases alleging unconstitutional
    deliberate indifference to medical needs, the plaintiff seeks
    relief as to himself, based on his own medical circumstances.
    See, e.g., Gamble, 
    429 U.S. at
    99–106; Mendiola-Martinez
    v. Arpaio, 
    836 F.3d 1239
    , 1243–46 (9th Cir. 2016); Long v.
    County of Los Angeles, 
    442 F.3d 1178
    , 1181–86 (9th Cir.
    2006); Toguchi v. Chung, 
    391 F.3d 1051
    , 1055–56 (9th Cir.
    2004). In some cases, the plaintiffs seek relief on behalf of
    a larger group, but one nonetheless bounded by a more
    narrowly drawn common experience, such as conditions at a
    particular facility. See, e.g., Roman, 977 F.3d at 939
    (conditions at the Adelanto ICE Processing Center);
    Disability Rights Mont., Inc. v. Batista, 
    930 F.3d 1090
    ,
    1093–96 (9th Cir. 2019) (conditions at the Montana State
    Prison).
    More unusually here, in contrast, the basis for plaintiffs’
    request and the district court’s injunction was not the
    individual circumstances of any detainee or the conditions at
    any ICE facility. Given the inevitable differences in the
    medical vulnerabilities of individual detainees and the
    material differences across the approximately 250 detention
    facilities nationwide, plaintiffs’ premising their requested
    50                   FRAIHAT V. USICE
    injunctive relief on these grounds would have created
    understandable problems in justifying a nationwide
    injunction and nationwide classes.
    Instead, and in an effort to match the broad relief they
    sought, plaintiffs focused on the asserted unconstitutionality
    of ICE’s nationwide directives, issued through the policy
    documents we chronicled above at length. See Brown v.
    Plata, 
    563 U.S. 493
    , 499–506, 505 n.3 (2011) (exposure of
    prisoners to substantial risk of serious harm through
    statewide policies and practices); Parsons v. Ryan, 
    754 F.3d 657
    , 662–68, 676–78 (9th Cir. 2014) (same). The district
    court’s order granting a preliminary injunction thus focused
    on these same ICE policy documents, as well as “several
    additional global failures” that also were premised on the
    documents. 445 F. Supp. 3d at 743–45. As the district court
    thus made clear in its October 2020 order enforcing the
    injunction, “the nature of the violation is a failure to adopt
    sufficiently comprehensive protocols to protect Subclass
    members.” 
    2020 WL 6541994
    , at *8. In this sense,
    plaintiffs’ constitutional challenge is necessarily more
    abstract, yet more far-reaching, than a challenge to
    individual or facility-specific conditions of confinement.
    Based on our careful review of ICE’s March and April
    2020 directives, we conclude that plaintiffs have not made
    “a clear showing” that in responding to the evolving and
    unprecedented COVID-19 pandemic, ICE acted with
    “deliberate indifference” to medical needs or in “reckless
    disregard” of health risks. California v. Azar, 911 F.3d at
    575; Gordon, 888 F.3d at 1125. We chronicled the various
    ICE mandates and guidance documents at some length above
    because they show why plaintiffs cannot establish a
    likelihood of success on the merits.
    FRAIHAT V. USICE                       51
    Those documents demonstrate that far from recklessly
    disregarding the threat of COVID-19, ICE in the spring of
    2020 (and earlier) took steps to address COVID-19. In
    particular, the March 6, 2020 IHSC Interim Reference Sheet,
    March 27, 2020 ICE Action Plan, April 4, 2020 Docket
    Review guidance, and April 10, 2020 ICE ERO Pandemic
    Response Requirements collectively provided a detailed set
    of directives on a host of topics relevant to mitigating the
    risks of COVID-19. These topics included: screening of
    detainees and staff for COVID-19 symptoms and exposure
    risk; monitoring, tracking, and reporting of detainees who
    had possible viral exposure; housing, cohorting,
    quarantining, and testing of detainees who may have
    developed COVID-19; hygiene practices, such as mask-
    wearing and sanitization; social distancing policies for
    sleeping, mealtimes, recreation periods, and otherwise;
    health education of detainees and staff; adherence to
    additional CDC Interim Guidance; release of detainees, with
    priority for those who had greater susceptibility to COVID-
    19 infection; limits on outside visits to detention facilities;
    development of facility-specific mitigation plans; and so on.
    The April 10, 2020 ICE ERO Pandemic Response
    Requirements—which was ICE’s most recent directive prior
    to the district court’s injunction and which ICE issued after
    plaintiffs had already sought preliminary injunctive relief—
    bears particular mention.          The Pandemic Response
    Requirements made compliance with the CDC Interim
    Guidance mandatory for all ICE detention facilities and
    instituted a system for reporting at-risk detainees or
    suspected or confirmed COVID-19 cases on an expedited
    timeframe.       It also contained mandatory, detailed
    requirements for provision of hygiene supplies, PPE, and
    signage; procedures for cleaning various surfaces and
    common items; screening detainees and staff; and detainee
    52                   FRAIHAT V. USICE
    housing protocols, including social distancing, cohorting,
    and medical isolation methods. It further required each
    facility to establish a mitigation plan dedicated to protecting
    detainees.
    The Supreme Court long ago reminded us that “[a]ny
    rule of constitutional law that would inhibit the flexibility of
    the political branches of government to respond to changing
    world conditions should be adopted only with the greatest
    caution.” Mathews v. Diaz, 
    426 U.S. 67
    , 81 (1976).
    Particularly in the face of scientific uncertainty about
    COVID-19—and with due consideration for the Executive
    Branch’s preeminent role in managing immigration
    detention facilities and its greater institutional competence
    in this area, see Bell v. Wolfish, 
    441 U.S. 520
    , 548 (1979);
    Roman, 977 F.3d at 947 (Miller, J., concurring in part and
    concurring in the judgment)—we cannot conclude that
    ICE’s directives are the stuff of deliberate indifference.
    Updated over time to account for improved understandings
    of an unprecedented global pandemic, ICE’s documents
    reflect a mobilized effort to address what ICE acknowledged
    was the “seriousness and pervasiveness of COVID-19.”
    As a result, whether one would characterize ICE’s spring
    2020 policy response to COVID-19 as strong, fair, needing
    improvement, or something else, it simply cannot be
    described in the way that matters here: as a reckless
    disregard of the very health risks it forthrightly identified
    and directly sought to mitigate. The district court’s
    determination that ICE’s national directives reflected a
    “callous indifference to the safety and wellbeing of the
    FRAIHAT V. USICE                             53
    Subclass members,” 445 F. Supp. 3d at 745, is therefore not
    supported. 6
    B
    Plaintiffs’ contrary arguments, which the district court
    accepted, do not demonstrate otherwise. To the extent
    plaintiffs have come forward with evidence suggesting that
    ICE might have approached the pandemic more effectively
    in the spring of 2020, plaintiffs have not shown that ICE’s
    national policies reflected deliberate indifference or reckless
    disregard of COVID-19.
    First, plaintiffs argued, and the district court agreed, that
    ICE had unreasonably delayed in issuing nationwide
    directives to detention facilities. 445 F. Supp. 3d at 744–45.
    For example, the district court faulted the government for
    “promulgat[ing] only non-binding guidance for the first
    month of the pandemic” and for “unreasonably delay[ing]
    taking steps that would allow higher levels of social
    distancing in detention.” Id. at 743–44. But this does not
    demonstrate deliberate indifference.
    It may be that ICE could have moved more expeditiously
    in engaging the threat that COVID-19 posed. But ICE began
    addressing that issue in January 2020, and was addressing it
    in earnest by March 2020, when it issued the IHSC Interim
    Reference Sheet and ICE Action Plan. COVID-19 presented
    a public health crisis unlike any that we have encountered in
    our time. See, e.g., Hope v. Warden York Cnty. Prison,
    6
    Our fine dissenting colleague maintains we have applied a
    subjective intent standard. That is not correct. The standard, as we have
    indicated, is an objective one, and we have considered ICE’s policies
    through that lens.
    54                   FRAIHAT V. USICE
    
    972 F.3d 310
    , 330 (3d Cir. 2020) (“COVID-19 presents
    highly unusual and unique circumstances that have radically
    transformed our everyday lives in ways previously
    inconceivable and have altered our world with lightning
    speed and unprecedented results.” (quotations and citations
    omitted and alterations accepted)). Plaintiffs have not
    demonstrated that ICE’s response to the pandemic in the
    spring of 2020 materially trailed that of the many other areas
    of government that were confronting this challenging new
    problem at the same time.
    Regardless, ICE’s earlier delays in addressing COVID-
    19 did not demonstrate deliberate indifference on an ongoing
    basis.     “[T]o establish eligibility for an injunction,
    [plaintiffs] must demonstrate the continuance of
    [defendants’] disregard during the remainder of the litigation
    and into the future.” Farmer v. Brennan, 
    511 U.S. 825
    , 846
    (1994). If ICE’s prior delays had led to harm, that injury
    might be redressable in court. But the relief sought here is
    injunctive in nature. And plaintiffs have not explained how
    ICE’s allegedly being slow out of the gate could justify
    preliminary injunctive relief if ICE’s national policies at the
    time of the injunction did not reflect deliberate indifference.
    See 
    id.
     at 846 n.9 (observing that defendants “could prevent
    issuance of an injunction by proving, during the litigation,
    that they were no longer unreasonably disregarding an
    objectively intolerable risk of harm and that they would not
    revert to their obduracy upon cessation of the litigation”).
    Second, the district court found special fault with ICE’s
    March 6, 2020 IHSC Interim Reference Sheet. 445 F. Supp.
    3d at 743, 745. The district court explained that “Plaintiffs
    raise serious questions about the reasonableness of the IHSC
    guidance at the time it was promulgated and updated”
    because, among other things, “[t]he IHSC guidance omits
    FRAIHAT V. USICE                      55
    aspects of the CDC recommendations” and “did not more
    strongly recommend social distancing.” Id. at 745. These
    observations, however, did not support a finding of
    deliberate indifference.
    We discussed the IHSC Interim Reference Sheet in detail
    above. That document provided extensive recommended
    protocols for intake medical screening, monitoring of
    detainees with exposure risk (both those with symptoms and
    those who presently lacked them), quarantining, and
    cohorting of detainees. Once again, whatever limitations
    might be detected in this “interim” set of policies does not
    demonstrate a reckless disregard of COVID-19. The Interim
    Reference Sheet instead reflects an effort, ongoing in nature,
    to address viral exposure through recommended
    implementation of concrete procedures.
    Several weeks later, moreover, ICE would issue the
    April 10, 2020 ICE ERO Pandemic Response Requirements,
    which directed that all ICE facilities “must” comply with the
    CDC’s Interim Guidance on COVID-19 and which
    contained a section detailing “Additional Measures to
    Facilitate Social Distancing.” While the district court
    questioned “whether the issuance of non-binding
    recommendations is an objectively ‘reasonable’ response to
    a pandemic,” it acknowledged that the Pandemic Response
    Requirements “set forth ‘mandatory requirements’ for all
    facilities housing ICE detainees.” Id. at 724, 744. That ICE
    was updating its policies during the preliminary injunction
    proceedings and mid-pandemic also underscores the
    difficulty plaintiffs face in showing that ICE’s policies
    reflected deliberate indifference on a nationwide level. The
    reckless disregard standard did not permit the district court
    56                       FRAIHAT V. USICE
    to scrutinize ICE’s national policies at the level that it did.
    See Wolfish, 
    441 U.S. at 539
    , 547–48. 7
    Third, the district court agreed with plaintiffs that ICE
    had “fail[ed] to take measures within ICE’s power to
    increase the distance between detainees.” Id. at 745. But
    plaintiffs did not thereby demonstrate ICE’s deliberate
    indifference to the risks of COVID-19.
    There are understandable constraints in imposing social
    distancing measures in a detention facility consistent with
    other necessary governmental objectives, such as security
    and the need to place certain persons in custody. See, e.g.,
    Wolfish, 
    441 U.S. at 540
     (“The Government . . . has
    legitimate interests that stem from its need to manage the
    facility in which the individual is detained.”). Even so, as
    detailed in the various ICE directives from March and April
    2020, ICE recommended and ordered extensive social
    distancing measures, which included releasing some persons
    from detention altogether.
    Most notably, the April 10, 2020 Pandemic Response
    Requirements mandated that ICE facilities “must” adopt the
    CDC Guidelines, which included the requirement to
    “[i]mplement social distancing strategies to increase the
    physical space between incarcerated/detained persons.”
    Moreover, the Pandemic Response Requirements directed
    7
    Like the district court, the dissent flyspecks ICE’s policies to the
    point of criticizing its use of particular words or phrases, like “please,”
    “ideally,” and “efforts should be made,” while chastising ICE for
    acknowledging the realistic difficulties associated with achieving
    complete social distancing in custodial settings. These critiques are
    inconsistent with the reckless disregard standard and the deference owed
    to the government in its operation of immigration detention centers mid-
    pandemic.
    FRAIHAT V. USICE                       57
    that “all facilities housing ICE detainees should implement
    . . . to the extent practicable” a detailed list of “Additional
    Measures to Facilitate Social Distancing.” These measures,
    which reiterated many of the CDC’s recommended social
    distancing strategies, consisted of the following required
    actions, which we quote in full:
    •   Efforts should be made to reduce the
    population to approximately 75% of
    capacity.
    •   Where detainee populations are such that
    such cells are available, to the extent
    possible, house detainees in individual
    rooms.
    •   Recommend that detainees sharing
    sleeping quarters sleep “head-to-foot.”
    •   Extend recreation, law library, and meal
    hours and stagger detainee access to the
    same in order to limit the number of
    interactions between detainees from other
    housing units.
    •   Staff and detainees should be directed to
    avoid congregating in groups of 10 or
    more, employing social distancing
    strategies at all times.
    •   Whenever possible, all staff and
    detainees should maintain a distance of
    six feet from one another.
    •   If practicable, beds in housing units
    should be rearranged to allow for
    58                       FRAIHAT V. USICE
    sufficient separation during sleeping
    hours.
    Taken together, ICE’s national policies in the spring of 2020,
    including adoption of CDC Guidelines, did not reflect
    reckless disregard of the very social distancing approaches
    they sought to implement. 8 While we do not suggest these
    policies are impervious to criticism, they did not
    demonstrate deliberate indifference to medical needs.
    Fourth, the district court found plaintiffs had met their
    burden because “Defendants have not provided even
    nonbinding guidance to detention facilities specifically
    regarding medically vulnerable detainees, pending
    individualized determinations of release or denial of
    release.” 445 F. Supp. 3d at 744. This finding appears to
    have been the root of that portion of the district court’s
    injunction requiring ICE to undertake various actions as to
    those detainees with certain “Risk Factors” that the district
    court specified. Id. at 750–51.
    We conclude, however, that plaintiffs did not meet their
    burden of demonstrating deliberate indifference on this front
    either because the district court’s determination otherwise
    8
    The dissent claims that in Roman, we held that the CDC Guidelines
    “do not provide a workable standard.” 977 F.3d at 946. But the dissent
    leaves out the rest of the quoted sentence in that case, which states that
    the CDC Guidelines “do not provide a workable standard for a
    preliminary injunction.” Id. (emphasis added). In Roman, we vacated a
    district court’s COVID-19–related preliminary injunction that applied to
    just a single immigration detention facility. Id. at 945. And in the course
    of doing so, we advised the district court not to base any renewed
    injunction for that particular facility on the CDC Guidelines. Id. We
    certainly did not say in Roman that the CDC Guidelines were
    unworkable as national policy, which is how ICE is using them here.
    FRAIHAT V. USICE                      59
    was premised on legal error and a misapprehension of ICE’s
    policies. As an initial matter, and contrary to suggestions in
    the district court’s decision, ICE’s mandatory Pandemic
    Response Requirements did consider whether certain
    detainees were at higher risk of developing serious illness
    from COVID-19 based on certain identified factors, such as
    age and preexisting health conditions. ICE made this the
    focus of its determinations whether to release certain
    detainees from custody, as well as various internal reporting
    requirements. ICE also directed, for example, that if
    facilities lacked adequate capacity to house confirmed
    COVID-19 cases individually, “the facility must be
    especially mindful of cases that are at higher risk of severe
    illness from COVID-19” to “prevent transmission” to the
    “higher-risk individual.”
    To the extent the district court believed it was necessary
    for ICE to develop hygiene and other practices specific to
    persons with greater vulnerability to COVID-19, the
    government responds that the guidance ICE issued applied
    to all detainees, which included those at greater risk from
    COVID-19. The government’s chosen approach does not
    reflect deliberate indifference.
    ICE developed its policies based on its knowledge of
    how immigration detention facilities functioned and in
    consultation with the CDC. It may be that plaintiffs, their
    experts, and the district court have identified an alternative
    strategy that ICE could have pursued and that would have
    been more effective. But “a mere difference of medical
    opinion is insufficient, as a matter of law, to establish
    deliberate indifference.” Toguchi, 
    391 F.3d at 1058
    (quotations omitted and alterations accepted). Nor can the
    constitutional line be drawn based on “a court’s idea of how
    best to operate a detention facility.” Wolfish, 
    441 U.S. at
    60                        FRAIHAT V. USICE
    539. The deliberate indifference standard recognizes that the
    Executive must have some discretion in addressing a
    complex problem like the one before us; plaintiffs’ and the
    district court’s approach do not account for that. Cf. Swain
    v. Junior, 
    961 F.3d 1276
    , 1289 (11th Cir. 2020) (“We simply
    cannot conclude that, when faced with a perfect storm of a
    contagious virus and the space constraints inherent in a
    correctional facility, the defendants here acted unreasonably
    . . . .”). 9
    Finally, and for similar reasons, the district court erred
    in determining that ICE’s policies for releasing detainees
    were “objectively unreasonable,” and in finding that ICE
    acted with deliberate indifference in not adhering to
    9
    The dissent attempts to suggest that the district court’s injunction
    was “limited” because it only applied to “medically vulnerable
    detainees.” But the certified classes comprised persons with the Risk
    Factors that the district court identified, which consisted of anyone over
    age 55 or who had a wide range of different health issues, including
    conditions such as high blood pressure and asthma. The district court
    itself explained that “general knowledge and common sense indicate that
    the class is large.” Fraihat, 445 F. Supp. 3d at 736 (quotations and
    brackets omitted). And by the district court’s determination, the classes
    consist of persons “at immigration detention facilities across the
    country,” so that any injunction would operate “across all facilities.” Id.
    at 719, 738. These statements belie the dissent’s effort to minimize the
    import of the district court’s injunction, while confirming that in ordering
    ICE to follow certain directives for those detainees with “Risk Factors,”
    the district court’s disagreement with ICE’s approach to the pandemic
    was not somehow a limited one.
    The dissent similarly maintains that “[t]he district court’s injunction
    did not create a nationwide policy,” but “mandated only that ICE change
    its own nationwide policies.” But that is a distinction without a
    difference. It is obvious that the preliminary injunction imposed on ICE
    extensive directives that the district court devised, subject to the district
    court’s continuing oversight.
    FRAIHAT V. USICE                      61
    procedures that would result in the release of more detainees.
    445 F. Supp. 3d at 745. The district court concluded that
    ICE’s Docket Review guidance improperly failed to contain
    “a strong presumption of release.” Id. In its later October 7,
    2020 order, the district court elaborated that its initial
    injunction was intended to “result in meaningful reviews and
    the release of significant numbers of Subclass members,” so
    that “only in rare cases would Defendants fail to release a
    Subclass member not subject to mandatory detention.” 
    2020 WL 6541994
    , at *10 (emphasis added). The district court
    further clarified that it had “expected that some individuals
    subject to mandatory detention would be released.” 
    Id. at *11
    .
    Plaintiffs have not demonstrated a likelihood of success
    in obtaining such extraordinary relief on a system-wide
    basis. While “the district court’s power to grant injunctive
    relief included the authority to order a reduction in
    population, if necessary to remedy a constitutional
    violation,” Roman, 977 F.3d at 942, compelled release of
    detainees is surely a remedy of last resort, see, e.g., Hope,
    972 F.3d at 333 (characterizing release of immigration
    detainees as “the most extreme” remedy); see also Plata,
    
    563 U.S. at
    500–01. The same is true of a judicial decree
    ordering the government to adhere to procedures with the
    expectation and understanding that they will result in greater
    release of detainees. And, in all events, the availability of
    any of this relief necessarily turns on “the antecedent
    question whether the government has acted with ‘reckless
    disregard.’” Roman, 977 F.3d at 947 (Miller, J., concurring
    in part and concurring in the judgment).
    In this case, plaintiffs did not demonstrate that the mere
    fact of their detention amounted to deliberate indifference.
    It is undisputed that the government has the authority to
    62                    FRAIHAT V. USICE
    detain those in the plaintiff class. See 
    8 U.S.C. §§ 1225
    (b),
    1226(a), (c), 1231(a).         Nor did the conditions of
    confinement, as reflected in ICE’s nationwide policy
    directives, provide a basis for the district court effectively to
    order the release of substantial numbers of immigration
    detainees.
    The same was true of the district court’s directives
    requiring ICE to adhere to more stringent custody review
    determinations that reflected a “strong presumption of
    release.” Fraihat, 445 F. Supp. 3d at 745. Cross-referencing
    the April 4, 2020 Docket Review guidance, the mandatory
    Pandemic Response Requirements stated that ICE ERO
    “will review” detainees at higher risk of illness “to determine
    whether continued detention is appropriate.” That the
    plaintiffs and district court may have desired more detainees
    be released, and on a potentially quicker basis, does not
    mean that the government’s approach—which involved
    early release determinations—reflected reckless disregard
    on a national basis.
    The Supreme Court has recognized that “judicial
    deference to the Executive Branch is especially appropriate
    in the immigration context.” INS v. Aguirre-Aguirre,
    
    526 U.S. 415
    , 425 (1999). And “the operation of our
    correctional facilities is peculiarly the province of the
    Legislative and Executive Branches of our Government, not
    the Judicial.” Wolfish, 
    441 U.S. at 548
    ; see also Mirmehdi
    v. United States, 
    689 F.3d 975
    , 984 (9th Cir. 2012) (“[T]he
    decision to detain an alien pending resolution of immigration
    proceedings is explicitly committed to the discretion of the
    Attorney General . . . .”), as amended (June 7, 2012). When
    combined with the exigencies of a global pandemic, these
    core principles, grounded in the Constitution’s separation of
    powers, must in this context necessarily inform the
    FRAIHAT V. USICE                        63
    deliberate indifference standard and the scope of appropriate
    injunctive relief.
    For the reasons we have explained, plaintiffs have not
    demonstrated a likelihood of success or serious questions
    going to the antecedent constitutional violation that would
    justify any of the relief they were seeking, much less a
    judicial decree effectively directing the United States to
    release persons whom it was lawfully detaining. That is
    especially the case in view of ICE policies that already
    enabled the discretionary release of detainees with greater
    susceptibility to COVID-19—policies which, at the time of
    the injunction, had already led to the release of many
    detainees. On this record, there is no basis to conclude that
    to avoid acting with deliberate indifference, the Executive
    Branch was required to release large numbers of detainees
    held under proper authority.
    The dissent for its part attempts to save the district
    court’s nationwide injunction by downplaying its
    significance, calling the injunction “limited, modest, and
    deferential.” Suffice it to say, that is not an apt description
    of the injunction before us, which imposed far-ranging
    court-ordered directives on the Executive Branch during a
    pandemic. That is why the district court itself (accurately)
    viewed plaintiffs as “claim[ing] entitlement to a
    comprehensive response to the pandemic,” and why the
    district court viewed the issue in this case as whether ICE’s
    “global response” to the pandemic was “adequate.” Fraihat,
    445 F. Supp. at 738–39; see also id. at 742 n.25 (district court
    “reject[ing] the implication that it lacks authority to enter
    class-wide relief to require a constitutionally adequate
    response to COVID-19 from ICE”).
    Nor can the import of the district court’s injunction be
    minimized on the theory that the injunction operated on
    64                   FRAIHAT V. USICE
    ICE’s policies and not the detention centers themselves. The
    policies govern the detention centers. There is no dispute
    that plaintiffs “claim Defendants have failed to ensure
    minimum lawful conditions of confinement at immigration
    detention facilities across the country,” and that the district
    court’s injunction therefore operates “across all facilities.”
    Fraihat, 445 F. Supp. 3d at 719, 738. To say that the
    injunction bears upon the policies in the first instance is only
    to underscore the magnitude of both the relief plaintiffs
    sought and the district court’s error in concluding that
    plaintiffs had shown that ICE acted with reckless disregard
    to COVID-19 on a national level.
    C
    Perhaps recognizing that the district court’s injunction
    cannot be maintained based on ICE’s policy directives,
    plaintiffs devote extensive effort to detailing the conditions
    at certain ICE facilities. In this regard, plaintiffs have
    pointed to potential shortcomings in the on-the-ground
    COVID-19 response at individual detention facilities in
    spring 2020.
    Whether those shortcomings would rise to the level of a
    constitutional violation, however, is a different question.
    See Gordon, 888 F.3d at 1125. And whether those
    conditions persist today, over a year after plaintiffs first
    sought injunctive relief, is yet another question,
    underscoring the difficulties with issuing injunctive relief
    about detention conditions in the midst of a fast-moving
    pandemic, where improved scientific knowledge leads to
    updated approaches over time. See Roman, 977 F.3d at 945–
    46 (vacating provisions of a preliminary injunction ordering
    specific COVID-19 measures at Adelanto where
    “circumstances have changed dramatically” since the time
    of the injunction). In this case, moreover, most of the named
    FRAIHAT V. USICE                             65
    plaintiffs who sought the injunction are no longer in custody
    at all and were not detained at least as of July 2020. 10
    The more fundamental point, however, is that conditions
    at individual detention facilities cannot support the
    injunction that plaintiffs sought. While the district court
    discussed conditions at certain ICE facilities, as described by
    detainees and other visitors to detention facilities, 445 F.
    Supp. 3d at 728–34, the district court did not base its
    injunction on this evidence, some of which it characterized
    as “anecdotal,” id. at 728. Instead, the district court was
    clear that it was the claimed deficiencies in ICE’s nationwide
    directives that justified a nationwide injunction and
    nationwide classes.
    “[T]he common question driving this case,” the district
    court explained, is the adequacy of “Defendants’ system-
    wide response” to the pandemic. Id. at 737. Accordingly,
    the district court’s analysis focused on ICE’s “decision to
    promulgate . . . guidance” and its purported “systemwide
    inaction.” Id. at 743. In its later order enforcing the
    injunction, the district court reiterated that “[t]he Preliminary
    Injunction and subsequent orders address only Defendants’
    systemwide response to the pandemic.” 
    2020 WL 6541994
    ,
    at *13. The district court thus was clear that its preliminary
    injunction order “does not opine on the lawfulness of
    conditions faced by any individual detainee, nor does it
    10
    Although we do not reach the question of irreparable harm, we
    note that the dissent’s perception of that issue turns on its unsupported
    determination that ICE’s national policies reflected reckless disregard,
    and that the district court’s solution to the situation was more likely to
    ameliorate harm than ICE’s own policies. The dissent also questions the
    accuracy of the central statistic on which it relies.
    66                    FRAIHAT V. USICE
    determine the lawfulness of conditions at any particular
    facility.” 
    Id.
    The district court’s disclaimer was understandable
    because the circumstances at individual detention facilities
    could not justify the broad, nationwide relief that plaintiffs
    pursued. By seeking an injunction based on ICE’s allegedly
    unconstitutional    “systemwide”       response,    plaintiffs
    necessarily attacked ICE’s detention policies at every one of
    its more than 250 facilities across the country. Yet the five
    class representatives had been detained at only three
    facilities.
    The government persuasively argues that given the
    material differences across ICE facilities—including their
    size, layout, health care capabilities, whether they also
    housed non-ICE detainees, and so on—the nature of the
    injunctive relief plaintiffs sought could not be justified based
    on evidence about conditions at individual facilities. On this
    record, that position is well-taken.
    A federal court must “tailor[] a remedy commensurate
    with the . . . specific violations” at issue in a case, and it errs
    where it “impose[s] a systemwide remedy going beyond
    [the] scope” of those violations. Lewis v. Casey, 
    518 U.S. 343
    , 359 (1996) (quoting Dayton Bd. of Educ. v. Brinkman,
    
    433 U.S. 406
    , 417 (1977)); accord California v. Azar,
    911 F.3d at 584 (“The scope of an injunction . . . must [be]
    tailor[ed] . . . ‘to meet the exigencies of the particular case.’”
    (quoting Trump v. Int’l Refugee Assistance Project, 
    137 S. Ct. 2080
    , 2087 (2017) (per curiam))). “[O]nly if there has
    been a systemwide impact may there be a systemwide
    remedy.” Flores v. Huppenthal, 
    789 F.3d 994
    , 1005–06 (9th
    Cir. 2015) (alteration in original) (quoting Casey, 
    518 U.S. at
    359–60).
    FRAIHAT V. USICE                        67
    Plaintiffs have not demonstrated that the conditions at
    their individual facilities support a showing that ICE has
    acted with deliberate indifference or reckless disregard as to
    the approximately 250 immigration detention facilities
    nationwide. In this case, moreover, the declarations upon
    which the district court relied to support the preliminary
    injunction all were dated in March 2020, which was prior to
    the April 10, 2020 Pandemic Response Requirements, ICE’s
    most significant operative guidance at the time the district
    court entered its injunction. See 445 F. Supp. 3d at 728–34.
    And while plaintiffs attempted to submit additional
    declarations in a filing that the district court denied as moot,
    those facility-specific declarations—which were prepared
    only several days after the mandatory Pandemic Response
    Requirements were issued and included discussion of events
    prior to that time—do not show deliberate indifference on a
    system-wide basis either. Indeed, the CDC’s own guidance
    acknowledged differences in “facility types . . . and sizes”
    and specified that “[a]dministrators and agencies should
    adapt these guiding principles to the specific needs of their
    facility.”
    For these reasons, plaintiffs’ reliance on our decisions in
    Roman v. Wolf, 
    977 F.3d 935
     (9th Cir. 2020) (per curiam),
    and Zepeda Rivas v. Jennings, 845 F. App’x 530 (9th Cir.
    2021), is misplaced. In Roman, plaintiffs challenged only
    the conditions of confinement at one immigration detention
    facility, Adelanto, and they sought an injunction only with
    respect to that facility’s handling of COVID-19. 977 F.3d
    at 939. The district court there had before it detailed
    information about the conditions at Adelanto, such as the
    population levels, screening procedures, cleaning routines,
    and physical layout of the facility, down to the precise
    distance between bunk beds in feet and inches. Roman v.
    Wolf, 
    2020 WL 1952656
    , at *1–9 (C.D. Cal. Apr. 23, 2020),
    68                   FRAIHAT V. USICE
    aff’d in part and vacated in part by 977 F.3d at 946–47.
    Even then, we “vacate[d] the provisions of the preliminary
    injunction that ordered specific measures to be implemented
    at Adelanto,” including reductions of the detainee
    population. 977 F.3d at 939, 945. And we cautioned that
    “the district court should, to the extent possible, avoid
    imposing provisions that micromanage the Government’s
    administration of conditions at Adelanto.” Id. at 946.
    Similarly, in Zepeda Rivas, plaintiffs challenged the
    conditions at two detention facilities. As in Roman, in
    entering a preliminary injunction the district court
    considered detailed evidence about those facilities’ approach
    to COVID-19. Zepeda Rivas v. Jennings, 
    465 F. Supp. 3d 1028
    , 1034 (N.D. Cal. 2020), aff’d in part, 845 F. App’x
    at 534. There were also notable similarities between the two
    facilities: they were both located in California’s Central
    Valley, were operated under the same ICE field office, and
    received detainees convicted of similar crimes transferred
    from the same county jail. See Zepeda Rivas v. Jennings,
    
    445 F. Supp. 3d 36
    , 38–40, 39 n.4 (N.D. Cal. 2020).
    Roman and Zepeda Rivas are of no assistance to
    plaintiffs here and put in perspective the immensity of the
    relief sought in this case. In contrast to the comparatively
    focused, facility-specific relief in those two prior cases,
    plaintiffs here challenged conditions of confinement at every
    ICE detention facility nationwide. The relief they seek is far
    greater than what was at issue in Roman and Zepeda Rivas.
    Plaintiffs’ request demanded proof that would meet it. And
    given the nature of their challenge, that proof was not to be
    found in the form of particular conditions at individual
    detention facilities.
    Plaintiffs also argue that the injunction could be justified
    by the district court’s reference to “ICE’s apparent failure to
    FRAIHAT V. USICE                       69
    enforce compliance with its policy documents.” 445 F.
    Supp. 3d at 743. But the district court here was referring to
    the fact that “from March 11, 2020 to April 10, 2020,” ICE’s
    policies “seem[] to have been voluntary.” Id. As the district
    court acknowledged, and as we have explained, the April 10,
    2020 Pandemic Response Requirements were mandatory.
    See id. at 724 (district court quoting the Pandemic Response
    Requirements and stating that “[t]he Pandemic Response
    Requirements set forth ‘mandatory requirements’ for all
    facilities housing ICE detainees as well as best practices”).
    The district court still faulted those Requirements for lacking
    “enforcement mechanisms.” Id. But the district court did
    not here elaborate on the “enforcement mechanisms” that
    were supposedly lacking. And plaintiffs have cited no
    authority requiring such additional mechanisms as a matter
    of constitutional law in the face of mandatory policies that
    were to be implemented through a chain of command.
    To the extent plaintiffs instead argue that ICE has failed
    adequately to implement its policies at individual facilities,
    this encounters the same problem we have discussed above
    about the difficulties of invoking facility-specific conditions
    to justify a “clear showing” of nationwide deliberate
    indifference. Noncompliance at individual facilities could
    provide evidence of a lack of adequate oversight at those
    specific facilities. See, e.g., Roman, 977 F.3d at 939–940.
    But on this record, that evidence is insufficient to support a
    finding as to ICE’s allegedly deliberately indifferent
    “system-wide response.” 445 F. Supp. 3d at 737. There is
    considerable distance between imperfect implementation of
    a policy, or even knowledge of the imperfect implementation
    of a policy, and deliberate indifference in the constitutional
    sense. See, e.g., Mortimer v. Baca, 
    594 F.3d 714
    , 722–23
    (9th Cir. 2010); see also, e.g., Gamble, 
    429 U.S. at
    105–06;
    Gordon, 888 F.3d at 1125; Castro, 833 F.3d at 1071.
    70                   FRAIHAT V. USICE
    We therefore hold that plaintiffs failed to make a “clear
    showing” of entitlement to relief commensurate with the
    scope of their request. USCIS, 944 F.3d at 789 (quoting
    Winter, 
    555 U.S. at 22
    ). Plaintiffs have not established a
    likelihood of success or serious questions on the merits of
    their claim that ICE’s nationwide approach to COVID-19 in
    spring 2020 reflected deliberate indifference or reckless
    disregard of health risks. The district court’s injunction
    therefore cannot stand on this basis.
    IV
    Given our holding on plaintiffs’ deliberate indifference
    claim, it all but follows that plaintiffs have not demonstrated
    a likelihood of success on their closely related theory that
    ICE’s COVID-19 policies reflected unconstitutional
    “punishment” under the Fifth Amendment.
    “[U]nder the Due Process Clause, a detainee may not be
    punished prior to an adjudication of guilt in accordance with
    due process of law.” Wolfish, 
    441 U.S. at 535
    . We have thus
    held that “a civil detainee awaiting adjudication is entitled to
    conditions of confinement that are not punitive.” Jones v.
    Blanas, 
    393 F.3d 918
    , 933 (9th Cir. 2004). “[A] restriction
    is ‘punitive’ where it is intended to punish, or where it is
    ‘excessive in relation to its non-punitive purpose,’ or is
    ‘employed to achieve objectives that could be accomplished
    in so many alternative and less harsh methods.’” 
    Id.
     at 933–
    34 (alteration accepted) (first quoting Demery v. Arpaio,
    
    378 F.3d 1020
    , 1028 (9th Cir. 2004); and then quoting
    Hallstrom v. City of Garden City, 
    991 F.2d 1473
    , 1484 (9th
    Cir. 1993)). But “if a particular condition or restriction of
    pretrial detention is reasonably related to a legitimate
    governmental objective, it does not, without more, amount
    to ‘punishment.’” Wolfish, 
    441 U.S. at 539
    .
    FRAIHAT V. USICE                        71
    In this case, we easily conclude that there is a “legitimate
    governmental objective” in detaining plaintiffs. 
    Id.
     ICE is
    holding them because they are suspected of having violated
    the immigration laws or are otherwise removable from the
    United States. See 
    8 U.S.C. §§ 1182
    (a), 1225(b), 1226(a),
    (c), 1227(a), 1231(a).          The government has an
    understandable interest in detaining such persons to ensure
    attendance at immigration proceedings, improve public
    safety, and promote compliance with the immigration laws.
    See, e.g., Demore v. Kim, 
    538 U.S. 510
    , 521 (2003); see also
    Jennings v. Rodriguez, 
    138 S. Ct. 830
    , 836 (2018)
    (explaining that “Congress has authorized immigration
    officials to detain some classes of aliens during the course of
    certain immigration proceedings” to allow “immigration
    officials time to determine an alien’s status without running
    the risk of the alien’s either absconding or engaging in
    criminal activity before a final decision can be made”).
    The district court concluded that “[d]uring a pandemic
    such as this, it is likely punitive for a civil detention
    administrator to fail to mandate compliance with widely
    accepted hygiene, protective equipment, and distancing
    measures until the peak of the pandemic.” 445 F. Supp. 3d
    at 746. But regardless of ICE’s earlier actions, by April 10,
    2020, the Pandemic Response Requirements imposed a host
    of mandatory obligations on all ICE detention facilities,
    including mandatory compliance with the CDC Guidelines.
    Just as ICE’s national directives as of that time did not reflect
    deliberate indifference to COVID-19, they did not create
    excessive conditions of “punishment” either.
    The district court concluded otherwise in part on the
    ground that ICE had “fail[ed] to take similar systemwide
    actions as jails and prisons.” Id. at 746–47. But plaintiffs
    cannot demonstrate a likelihood of success on that theory
    72                   FRAIHAT V. USICE
    either. Under case law that the district court referenced, “a
    presumption of punitive conditions arises where the
    individual is detained under conditions identical to, similar
    to, or more restrictive than those under which pretrial
    criminal detainees are held.” Jones, 494 F.3d at 934. If a
    plaintiff establishes that this presumption applies, “the
    burden shifts to the defendant to show (1) ‘legitimate, non-
    punitive interests justifying the conditions of the detainee’s
    confinement’ and (2) ‘that the restrictions imposed are not
    “excessive” in relation to these interests.’” King v. County
    of Los Angeles, 
    885 F.3d 548
    , 557 (9th Cir. 2018)
    (alterations accepted) (quoting Jones, 494 F.3d at 935).
    Jones announced the foregoing comparative
    presumption in the context of a California state prisoner who
    was civilly detained and awaiting proceedings under
    California’s Sexually Violent Predator Act. See 
    393 F.3d at
    922–23. King involved a plaintiff in substantially the
    same situation. See 885 F.3d at 552–53. Plaintiffs have not
    identified authority from this Court extending Jones’s
    presumption to the context of federal immigration detainees.
    But assuming without deciding that it would be appropriate
    to invoke that presumption in the immigration context—in
    which different government interests are at stake—the
    presumption provides no aid to plaintiffs here.
    As an initial matter, to the extent plaintiffs seek
    application of this presumption to their confinement itself,
    as opposed to their “conditions of confinement,” Jones,
    494 F.3d at 934 (emphasis added), we have not previously
    invoked the presumption in that manner. Nor do we see how
    we could do so in this context, when the Supreme Court “has
    recognized detention during deportation proceedings as a
    constitutionally valid aspect of the deportation process.”
    Demore, 
    538 U.S. at 523
    . Insofar as plaintiffs argue that
    FRAIHAT V. USICE                       73
    they should be released in greater numbers because more
    criminal detainees have been released due to concerns about
    COVID-19 at their prisons, we are aware of no authority
    requiring such parity as a matter of federal constitutional
    law.
    To the extent plaintiffs’ intended comparison is instead
    between the conditions at different facilities—ICE facilities
    versus those housing criminal detainees—plaintiffs have not
    demonstrated a likelihood of success on that theory. In
    Jones, where we invoked the presumption plaintiffs seek, we
    were considering a suit for damages by a single state
    detainee who was civilly committed pending a trial to
    determine whether he qualified as a sexual predator under
    California law. Jones, 494 F.3d at 922–23. We compared
    that detainee’s conditions of confinement to those of the
    general jail population at the same facility in which the
    plaintiff was housed. Id. at 934–35.
    Here, in sharp contrast, plaintiffs’ argument in favor of a
    presumption of “punitive” conditions depends on a far more
    monumental comparison: all ICE detention facilities against
    (presumably) all prisons housing criminal detainees. Once
    again, the scope of plaintiffs’ desired relief demands a
    commensurately high showing, which plaintiffs have not
    made here.
    The record lacks evidence from which to draw any
    relevant comparisons between the overall conditions of
    confinement of ICE detainees as compared to those in
    criminal custody. The only basis for comparison that the
    district court identified related to a Department of Justice
    memorandum from the Attorney General to the Federal
    Bureau of Prisons (BOP) concerning the release of criminal
    detainees due to COVID-19 concerns. 445 F. Supp. 3d
    at 747.
    74                   FRAIHAT V. USICE
    That comparison is unavailing. There is, as we have
    already explained, no support in our cases for applying
    Jones’s presumption about comparative “conditions” of
    confinement to the government’s continued ability to
    confine persons pursuant to lawful authority, as here. But
    even setting that threshold issue aside, plaintiffs have not
    demonstrated that any “presumption” about punitive
    conditions should arise from the BOP memorandum.
    When we have applied the presumption announced in
    Jones, we have done so after comparing the relevant
    conditions of confinement as a whole. Thus in Jones, for
    example, we compared the plaintiff’s overall conditions of
    confinement—including recreational activities, phone calls,
    time out of cell, and so on—with those of persons in the jail’s
    general population. See 
    393 F.3d at
    934–35; see also King,
    885 F.3d at 557 (similar).         Even assuming release
    determinations qualify as “conditions” of confinement (they
    do not), plaintiffs have not explained how we can evaluate
    this one “condition” in isolation, without comparing the
    various other “conditions” at ICE and criminal detention
    facilities that also bear on COVID-19 mitigation efforts.
    And on that point, and beyond custody release
    determinations, plaintiffs have not identified how the
    relevant “conditions” generally differ across the two types of
    facilities. Under these circumstances, we do not think the
    Jones presumption could apply, or that it could apply with
    any meaningful force, when plaintiffs’ focus is limited to one
    “condition” of confinement among many.
    Regardless, plaintiffs have not demonstrated there is any
    material difference between the BOP’s approach to COVID-
    19-based custody release determinations and that which ICE
    set forth in its Docket Review guidance. The April 10, 2020
    Pandemic Response Requirements provides that all
    FRAIHAT V. USICE                      75
    detention facilities housing ICE detainees “must” “[n]otify
    both the local ERO Field Office Director (or designee) and
    the Field Medical Coordinator as soon as practicable, but in
    no case more than 12 hours after identifying any detainee
    who meets the CDC’s identified populations potentially
    being at higher-risk for serious illness from COVID-19.”
    The Pandemic Response Requirements then instruct that
    “[u]pon being informed of” such a detainee, “ERO will
    review the case to determine whether continued detention is
    appropriate.”
    At this point, the Pandemic Response Requirements
    cross-reference the April 4, 2020 Docket Review guidance,
    which provides detailed instructions for higher-risk “cases
    that should be reviewed to re-assess custody.” After setting
    forth an “[e]xpand[ed]” list of health conditions that would
    warrant this review, the Docket Review guidance instructs
    relevant personnel to “review the case to determine whether
    continued detention remains appropriate in light of the
    COVID-19 pandemic.” The Guidance further makes clear
    that “[t]he fact that an alien is potentially higher-risk for
    serious illness from COVID-19 should be considered a
    factor weighing in favor of release.”
    Notwithstanding this, the district court concluded that
    the BOP memorandum reflected “a more decisive and urgent
    call to action,” whereas ICE’s Docket Review guidance
    “arguably fails to communicate the same sense of urgency
    or concern.” 445 F. Supp. 3d at 747. When considering the
    Docket Review guidance in conjunction with the later
    Pandemic Response Requirements, we do not think they
    promote a materially discrepant message from that of the
    BOP memorandum. But even if there were a difference in
    emphasis, any such perceived tonal difference does not
    demonstrate a sufficiently material divide between ICE’s
    76                    FRAIHAT V. USICE
    approach and that of the BOP. That perceived disparity thus
    could not be the basis for any “presumption” of punitiveness.
    Nor, as we have explained, have plaintiffs otherwise shown
    a likelihood of success on this Fifth Amendment
    “punishment” claim.
    V
    We turn lastly to plaintiffs’ statutory claim under the
    Rehabilitation Act. That Act prohibits a program receiving
    federal financial assistance from discriminating based on
    disability. 
    29 U.S.C. § 794
    ; see generally Fleming v. Yuma
    Reg’l Med. Ctr., 
    587 F.3d 938
    , 940 (9th Cir. 2009). We hold
    that plaintiffs have not met their burden of establishing a
    likelihood of success on the merits of this claim.
    Section 504 of the Rehabilitation Act states in relevant
    part that “[n]o otherwise qualified individual with a
    disability . . . shall, solely by reason of her or his disability,
    be excluded from the participation in, be denied the benefits
    of, or be subjected to discrimination under any program or
    activity receiving Federal financial assistance.” 
    29 U.S.C. § 794
    (a). A plaintiff bringing a section 504 claim thus “must
    show that ‘(1) he is an individual with a disability; (2) he is
    otherwise qualified to receive the benefit; (3) he was denied
    the benefits of the program solely by reason of his disability;
    and (4) the program receives federal financial assistance.’”
    Updike v. Multnomah County, 
    870 F.3d 939
    , 949 (9th Cir.
    2017) (quoting Duvall v. County of Kitsap, 
    260 F.3d 1124
    ,
    1135 (9th Cir. 2001)).
    Plaintiffs have at the very least not established a
    likelihood of success on the third element. Plaintiffs have
    not identified any “benefit” that they have been denied. The
    district court held otherwise after concluding that the
    “programmatic ‘benefit’ in this context . . . is best
    FRAIHAT V. USICE                       77
    understood as participation in the removal process.” 445 F.
    Supp. 3d at 748. But even assuming “participation in the
    removal process” could fit within the statutory term
    “benefit,” plaintiffs have not shown they were deprived of
    the ability to participate in their immigration proceedings.
    Plaintiffs in their answering brief respond only that “a person
    cannot participate in challenging her removal from this
    country—by communicating with counsel, witnesses, or the
    immigration judge—if she is on a ventilator.” But this bare
    allegation is insufficient.
    In addition, plaintiffs did not establish a further
    requirement of section 504’s third element, which is that the
    denial of benefits be “solely by reason” of plaintiffs’ alleged
    disabilities. 
    29 U.S.C. § 794
    (a). Plaintiffs at most
    demonstrated that they were subjected to inadequate national
    policies that they claimed reflected deliberate indifference to
    COVID-19; they did not show they were treated differently
    from other detainees “solely by reason” of their disabilities.
    See K.M. ex rel. Bright v. Tustin Unified Sch. Dist., 
    725 F.3d 1088
    , 1099 (9th Cir. 2013).
    We have no occasion to reach the Rehabilitation Act’s
    other elements because we conclude that plaintiffs have not
    shown a likelihood of success that they were denied a benefit
    solely by reason of their claimed disabilities. Their statutory
    claim, like their constitutional claims, thus cannot support
    preliminary injunctive relief. And because plaintiffs have
    not demonstrated a likelihood of success on any claim, we
    need not address the other preliminary injunction factors that
    plaintiffs also would have needed to establish. See
    California ex rel. Becerra, 950 F.3d at 1083 (“If a movant
    fails to establish likelihood of success on the merits, we need
    not consider the other factors.”).
    *   *    *
    78                   FRAIHAT V. USICE
    COVID-19 presents inherent challenges in institutional
    settings, and it has without question imposed greater risks on
    persons in custody. But plaintiffs had to demonstrate
    considerably more than that to warrant the extraordinary,
    system-wide relief that they sought. The demanding legal
    standards that govern plaintiffs’ request reflect the
    separation of powers implications underlying any effort to
    place presumptively Executive responsibilities in judicial
    hands. That COVID-19 is an unprecedented public health
    issue could not thereby sustain a preliminary injunction that,
    without sufficient basis, effectively placed a federal court at
    the center of the Executive’s nationwide effort safely to
    manage immigration detention facilities in the middle of an
    evolving pandemic.
    We therefore reverse the preliminary injunction and
    direct that all orders premised on it be vacated.
    REVERSED            AND        REMANDED             WITH
    INSTRUCTIONS.
    BERZON, Circuit Judge, dissenting:
    I dissent from both the majority’s opinion vacating the
    district court’s preliminary injunction and its order denying
    the parties’ joint request for mediation.
    Today, the majority vacates the district court’s April
    2020 preliminary injunction. To arrive at its holding, the
    majority applies incorrect standards three times: The
    majority recites but does not engage with our sliding scale
    approach for reviewing a preliminary injunction. See All. for
    the Wild Rockies v. Cottrell, 
    632 F.3d 1127
    , 1131–32 (9th
    Cir. 2011); Opinion at 46. It correctly identifies but then
    FRAIHAT V. USICE                             79
    flouts our mandate to review the grant of a preliminary
    injunction for abuse of discretion, not de novo. See, e.g., 
    id.
    at 58–59 (reaching its own “conclu[sion]” as to whether the
    plaintiffs met their factual burden). And, functionally, it
    evaluates Plaintiffs’ Fifth Amendment reckless disregard
    claim under a subjective, instead of the proper, objective,
    standard. 
    Id.
     at 48–53. The majority also repeatedly
    characterizes as “sweeping,” “far-reaching” and of great
    “magnitude,” 
    id. at 9
    , 11–12, an injunction that is actually
    limited, modest, and deferential to the government’s primary
    role in crafting policy and administering the detention
    facilities that house immigration detainees. Beyond these
    analytical errors, the majority does precisely what it
    chastises the district court for: by declining the parties’ joint
    request for mediation, the majority imposes its own will on
    the parties.
    I.
    This appeal is more easily summarized than the
    majority’s lengthy opinion suggests. The federal
    government is authorized, and sometimes required, by
    statute to hold people in civil detention pending federal
    immigration proceedings. See generally Jennings v.
    Rodriguez, 
    138 S. Ct. 830
    , 836–38 (2018). But “[t]he Fifth
    Amendment requires the government to provide conditions
    of reasonable health and safety to people in its custody.”
    Roman v. Wolf, 
    977 F.3d 935
    , 943 (9th Cir. 2020) (citing
    DeShaney v. Winnebago Cnty. Dep’t of Soc. Servs., 
    489 U.S. 189
    , 199–200 (9th Cir. 2017)). 1 People in custody can
    1
    People in custody may also argue that conditions are
    unconstitutionally punitive under a related Fifth Amendment due process
    theory. See Roman v. Wolf, 
    977 F.3d 935
    , 943 n.4 (citing Bell v. Wolfish,
    
    441 U.S. 520
    , 535–37 (1979)). I agree with the majority that the
    80                       FRAIHAT V. USICE
    demonstrate unconstitutional conditions by pointing to
    systemwide policies insufficient for protecting their health
    and safety. See generally Brown v. Plata, 
    563 U.S. 493
    , 505
    n.3 (2011); Parsons v. Ryan, 
    754 F.3d 657
    , 676–79 (9th Cir.
    2014).
    In March 2020, a group of people in federal immigration
    detention sought, in an already pending case, emergency
    subclass certification for, and a preliminary injunction on
    behalf of, all detainees who for medical reasons were “at
    heightened risk of severe illness and death upon contracting
    the COVID-19 virus.” Fraihat v. U.S. Immigr. & Customs
    Enf’t, 
    445 F. Supp. 3d 709
    , 726, 736–41 (C.D. Cal. 2020)
    (Preliminary Injunction). The district court provisionally
    certified both subclasses, using a set of medical risk factors
    substantially similar to those put forth by U.S. Immigration
    and Customs Enforcement (ICE), based on guidance from
    the Centers for Disease Control and Prevention (CDC). Id.;
    see also Fraihat v. U.S. Immigr. & Customs Enf’t, No. 19-
    1546, 
    2020 WL 1932393
     (C.D. Cal. Apr. 20, 2020) (Class
    Certification Order). So—and this point is critical, although
    the majority opinion repeatedly loses track of it—this case
    concerns ICE COVID-19 policy only as it relates to
    medically vulnerable detainees.
    The majority opinion, disregarding that this case focuses
    on the lack of specific provisions in ICE’s policy statements
    regarding vulnerable detainees, recites at length the
    provisions in ICE documents governing the treatment of all
    detainees during the early days of the pandemic. That ICE
    produced a fair amount of paper addressing the COVID-19
    Plaintiffs have not raised serious questions on the merits of their punitive
    conditions claim or their Rehabilitation Act claim.
    FRAIHAT V. USICE                       81
    problem in its facilities should not obscure the critical facts
    as found by the district court and here relevant:
    During the period of time the district court considered
    when issuing the injunction under review, ICE had issued a
    national policy guidance, known as the “Detained Docket
    Review Guidance,” advising its agents to reassess the
    continued custody of some medically vulnerable detainees.
    But, the district court found, the policy was discretionary, as
    it did not “mandate action” and lacked “any requirement”
    that ICE field agents conduct such custody reviews.
    Preliminary Injunction, 445 F. Supp. 3d at 743, 750. The
    district court recounted that the guidance only “ask[ed] Field
    Office Directors to ‘please’ make individualized
    determinations of the necessity of ongoing detention, and
    only as to some detainees.” Preliminary Injunction, 445 F.
    Supp. 3d at 743 (emphasis added) (quoting Detained Docket
    Review Guidance). Moreover, the district court found, ICE
    did not have a centralized tracking mechanism enabling
    affirmative and quick identification of such detainees, nor
    did ICE “enforce compliance.” Id. at 726–28, 745, 747, 743.
    “To the extent COVID-19 risk was addressed by individual
    facilities from March 11, 2020 to April 10, 2020,” the district
    court concluded, “it seems to have been voluntary.” Id. at
    743. And, the district court further found, ICE had no
    specific policy mandating minimum acceptable detention
    conditions for medically vulnerable subclass members in
    particular, directed at reducing their chance of contracting
    COVID-19 while they remained detained. Id. at 744.
    ICE’s April 10, 2020, COVID-19 policy, known as the
    “Pandemic Response Requirements,” or “PRR,” did not cure
    these defects. It sought implementation of the measures it
    laid out to prevent the spread of COVID-19 only “to the
    extent practicable,” specified that “[e]fforts should be made
    82                   FRAIHAT V. USICE
    to reduce the population to approximately 75% of capacity,”
    and recognized that “strict social distancing may not be
    possible in congregate settings such as detention facilities.”
    Finally, the PRR included “no mention of enforcement
    mechanisms.” Preliminary Injunction, 445 F. Supp. 3d
    at 743. For all its verbosity, the majority opinion does not
    identify as clear error—and therefore as an abuse of
    discretion—any of the district court’s findings about ICE’s
    inadequate focus on the particular needs of medically
    vulnerable detainees or ICE’s failure to mandate and assure
    compliance with directives to protect such detainees.
    Because ICE’s initial policy guidance was discretionary
    and its updated guidances required only “[e]fforts” that the
    guidance itself recognized as perhaps futile, high-risk
    detainees faced dangerous, deteriorating conditions at the
    time the injunction under review issued. Plaintiff subclass
    members detained in ICE facilities reported “little change in
    protocols or procedures in place in light of COVID-19.” One
    man, detained at the Etowah County Detention Center in
    Alabama, detailed his living conditions thus: he had received
    no formal education about COVID-19; he ate three meals a
    day in a crowded setting, side-by-side with approximately
    seventy other people; he spent four hours every day in a
    group area where “there [wa]s no room for social distancing”
    and the maximum distance between people was
    approximately two feet; he shared a cell with another person
    in which social distancing was not possible; he was given
    soap once every one-to-two weeks; he was given one
    facemask to reuse; and there was no hand sanitizer available.
    Another man, detained at the Stewart Detention Center in
    Georgia, declared, “[s]ince the COVID-19 crisis started, ICE
    has not made any changes to the cleaning schedule for our
    dorm. Nor have we been provided with additional cleaning
    FRAIHAT V. USICE                       83
    supplies to keep our dorm disinfected and sufficiently
    clean.”
    An employee at a faith-based organization that works
    with people in ICE detention facilities reported that people
    in detention “ha[d] not experienced any material changes
    that protect them from the virus. To the contrary, I have daily
    conversations with our detained community members and
    with each passing day the conditions get worse.” The
    testimony of another man, detained at the Adelanto
    Detention Center in California, highlighted the ways in
    which conditions were deteriorating. Hand sanitizer in a
    dispenser in a common area had been empty for more than
    two weeks. More than that, the man worked as a janitor in
    the facility, earning one dollar per day, and although “[t]here
    [we]re bottles of disinfectant in the janitor’s closet that
    [they] [we]re supposed to add to the bucket,” the bottles
    were “empty.” “We are,” he told the district court, “just
    cleaning with water.”
    The district court’s findings reflected this disturbing
    evidence and that of medical experts. After a hearing, the
    district court found that 15% of subclass members would die
    if they contracted COVID-19, which was considerably more
    likely while they remained detained. Preliminary Injunction,
    445 F. Supp. 3d at 722, 744. Subclass members who contract
    COVID-19 and survive would be likely to experience “life-
    altering complications” such as “permanent loss of
    respiratory capacity, heart conditions, [and] kidney
    damage.” Id. The district court also found that “a surge in
    preventable cases would further strain local hospital and
    healthcare resources.” Based on the record before it and its
    findings, the district court issued a preliminary injunction in
    April 2020 to protect the medically vulnerable detainee
    subclass members from COVID-19.
    84                    FRAIHAT V. USICE
    According to the majority, the “sweeping injunction”
    “was extraordinary beyond measure” and “effectively
    place[d] this country’s network of immigration detention
    facilities under the direction of a single federal district
    court.” Opinion at 9, 11–12. That characterization, to put it
    mildly, is not accurate.
    The Plaintiffs did not contend, as the majority suggests,
    that “all of the approximately 250 immigration detention
    facilities nationwide” were violating the Fifth Amendment.
    Id. at 9. Instead, Plaintiffs claimed ICE’s nationwide
    policies, or lack thereof, for protecting high-risk detainees
    from COVID-19 exposed them to an unconstitutional risk of
    harm given their medical vulnerabilities. So it was not the
    preliminary injunction that put the hundreds of immigration
    facilities under the control of the district court. Instead each
    of those facilities is part of the federal government’s
    immigration detention system and must comply with ICE’s
    national policies. For that reason, systemic changes in the
    policies will affect individual facilities, but the injunction is
    directed at the promulgation of the policies, not at evaluating
    the conditions at individual facilities. And, as the district
    court noted, “[D]efendants do not dispute that they have the
    authority to mandate compliance [with national policies].”
    Preliminary Injunction, 445 F. Supp. 3d at 746.
    Although one would not know this from reading the
    majority’s hyperbolic language about the separation of
    powers and appropriate judicial reticence, the April 2020
    injunction ultimately required ICE to devise appropriate
    policies; the injunction did not dictate those policies or usurp
    the agencies’ role in running the detention facilities. It left
    the definition of specific policies to the defendants, and
    appropriately so. Cf. Brown v. Plata, 
    563 U.S. 493
    , 500
    (2011) (upholding a district court’s order that le[ft] the
    FRAIHAT V. USICE                        85
    choice of means to reduce overcrowding to the discretion of
    . . . officials”). Injunctions regarding conditions in detention
    facilities are suitable when they lay out “general areas . . .
    that [the agency] need[s] to address,” and “direct the
    [agency] to develop specific policies and procedures for
    complying with” federal law. Armstrong v. Davis, 
    275 F.3d 849
    , 883 (9th Cir. 2001) (Berzon, J., concurring). That is
    precisely what the district court’s original injunction did.
    Specifically, the preliminary injunction mandated, at a
    high level of generality, the following:
    •   Defendants shall provide ICE Field
    Office Directors with the Risk Factors
    identified in the Subclass definition;
    •   Defendants shall identify and track all
    ICE detainees with Risk Factors. Most
    should be identified within ten days of
    this Order or within five days of their
    detention, whichever is later;
    •   Defendants shall make timely custody
    determinations for detainees with Risk
    Factors, per the latest Docket Review
    Guidance.       In      making        their
    determinations,     Defendants     should
    consider the willingness of detainees with
    Risk Factors to be released, and offer
    information on post-release planning,
    which Plaintiffs may assist in providing;
    •   Defendants shall provide necessary
    training to any staff tasked with
    identifying detainees with Risk Factors,
    86                   FRAIHAT V. USICE
    or delegate that task to trained medical
    personnel;
    •   The above relief shall extend to detainees
    with Risk Factors regardless of whether
    they have submitted requests for bond or
    parole, have petitioned for habeas relief,
    have requested other relief, or have had
    such requests denied;
    •   Defendants shall promptly issue a
    performance standard or a supplement to
    their Pandemic Response Requirements
    (‘Performance Standard’) defining the
    minimum         acceptable      detention
    conditions for detainees with the Risk
    Factors, regardless of the statutory
    authority for their detention, to reduce
    their risk of COVID-19 infection pending
    individualized determinations or the end
    of the pandemic;
    •   Defendants shall monitor and enforce
    facility-wide compliance with the
    Pandemic Response Requirements and
    the Performance Standard.
    Preliminary Injunction, 445 F. Supp. 3d at 750–51. The
    injunction, then, specified areas that needed to be addressed,
    leaving to ICE the development of specific policies and
    procedures. Pursuant to the injunction, ICE, not the court,
    was to decide how to identify and track detainees, the
    standards governing custody determinations, the “minimal
    acceptable detention conditions,” and the way in which
    compliance would be monitored and enforced.
    FRAIHAT V. USICE                        87
    The government never moved to stay the injunction,
    modify it, or vacate it, despite the district court’s invitation
    to do so, see id. at 750, and waited two months to file an
    appeal.
    According to the district court, after the injunction
    issued, custody reviews of subclass members remained “a
    disorganized patchwork of non-responses or perfunctory
    denials.” Fraihat v. U.S. Immigr. & Customs Enf’t, No.
    EDCV191546JGBSHKX, 
    2020 WL 6541994
    , at *6, *10
    (C.D. Cal. Oct. 7, 2020) (Supervisory Order). There was still
    no minimum detention standard “to address the substantial
    risk of death to subclass members during the pandemic.” 
    Id. at *6
    . And “monitoring efforts rel[ied] on a meager survey
    that allow[ed] facilities to self-report their level of
    compliance.” 
    Id.
     To address these gaps, the district court
    issued a further order in October 2020, from which
    defendants also appealed. See generally id.; Notice of
    Appeal, Fraihat v. U.S. Immigr. & Customs Enf’t, No. 5:19-
    cv-01546-JGB-SHK (C.D. Cal. Dec. 7, 2020), ECF No. 250.
    Most recently, a special master appointed by the district
    court reported that immigration detention facilities “are in
    the midst of an unprecedented surge in cases.” Report and
    Recommendation of Special Master, Fraihat v. U.S. Immigr.
    & Customs Enf’t, No. 5:19-cv-01546-JGB-SHK (C.D. Cal.
    May 21, 2021), ECF No. 304; see also Opinion at 43–44
    (referencing the special master). The majority opinion
    devotes considerable attention to the details of the October
    2020 order, even though it is the subject of a separate appeal.
    II.
    It is true that this case has an artificial quality, as the
    development of the coronavirus crisis has taken many twists
    and turns, both terrifying and at times heartening, and both
    inside and outside detention institutions, since April 2020.
    88                     FRAIHAT V. USICE
    As a result of both changes in the pandemic’s course and
    concerns about ICE’s implementation of the bare-bones
    provisions of the April injunction, the district court has acted
    within its power in considering new facts on the ground and
    revisiting the terms of the order it originally issued. See Fed.
    R. Civ. P. 62(d) (“While an appeal is pending from an
    interlocutory order . . . that grants . . . an injunction, the court
    may . . . modify . . . [the] injunction.”). But the majority’s
    approach to this fluid situation—relying on the district
    court’s October order to demonstrate that the April order was
    too intrusive, while refusing to recount or consider any of the
    facts underlying it—cannot be justified. See, e.g., Opinion
    at 61.
    Either we consider—as did this court in Roman v. Wolf,
    
    977 F.3d 935
     (9th Cir. 2020), and Zepeda Rivas v. Jennings,
    Nos. 20-16276 & 20-16690 (9th Cir. 2021)—what actually
    happened after the April 2020 injunction issued, or we do
    not. Were we to consider it, we might note that what
    happened, according to the district court, was that ICE did
    little to carry out the broad, deferential directives issued in
    April, and the coronavirus spread exponentially among the
    medically vulnerable members of the Plaintiff subclasses. It
    might well have made more sense to consolidate this appeal
    with the appeal of the October order and the appeal of the
    district court’s June 23, 2021, order that adopted the special
    master’s report and recommendation regarding compliance
    with the April 2020 injunction—but we did not do that.
    What we cannot do is what the majority does: treat the
    April injunction here under review as if it included all the
    FRAIHAT V. USICE                             89
    terms of the October order while refusing to consider the
    factual and legal circumstances that led to that second order. 2
    In the end, we have to deal with the appeal before us,
    from the April injunction, not with the appeals not before us,
    from the October 2020 and June 2021 orders. I therefore
    focus this dissent on the April record and the April
    injunction.
    III.
    As to the question actually before us—the propriety of
    the April, 2020, preliminary injunction—the majority begins
    by applying a misleading standard when considering
    whether the issuance of the injunction was proper. The
    majority first lays out the familiar preliminary injunction test
    in Winter v. Nat. Res. Def. Council, Inc., 
    555 U.S. 7
     (2008),
    under which “[a] plaintiff . . . must establish that he is likely
    to succeed on the merits, that he is likely to suffer irreparable
    harm in the absence of preliminary relief, that the balance of
    equities tips in his favor, and that an injunction is in the
    public interest.” 
    Id. at 20
    . The majority then acknowledges
    in passing that in this court we apply Winter through a
    sliding scale approach, adjusting the level of likelihood of
    success on the merits to the degree and imminence of
    irreparable harm demonstrated. Opinion at 46; All. for the
    Wild Rockies, 632 F.3d at 1131–32. But its recitation of the
    standard from Alliance for the Wild Rockies is the beginning
    2
    It is critical in this regard that we are reviewing a preliminary
    injunction. The case remains pending, so the majority’s rejection of a
    preliminary injunction based on the April 2020 record with regard to the
    deliberate indifference issue does not preclude the Plaintiffs from
    moving for, nor the district court from considering, a renewed motion for
    a preliminary injunction or permanent relief.
    90                        FRAIHAT V. USICE
    and end of its consideration and appreciation of the sliding
    scale standard.
    I would actually apply the sliding scale analysis under
    Alliance for the Wild Rockies with regard to Plaintiffs’
    reckless disregard due process claim, rather than reciting and
    then ignoring it. Doing so, I would affirm the district court’s
    preliminary injunction. 3
    A.
    Contrary to the majority’s suggestion, our standard of
    review is not whether “[w]e conclude” “that plaintiffs did
    not meet their burden of demonstrating deliberate
    indifference.” Opinion at 58–59 (emphasis added); see also
    id. at 61. Rather, “[a]s long as the district court got the law
    right, it will not be reversed simply because the appellate
    court would have arrived at a different result if it had applied
    the law to the facts of the case.” A&M Records, Inc. v.
    Napster, Inc., 
    239 F.3d 1004
    , 1013 (9th Cir. 2001) (internal
    quotation marks omitted). “A preliminary injunction should
    be set aside only if the district court ‘abused its discretion or
    based its decision on an erroneous legal standard or on
    clearly erroneous findings of fact.’” Doe v. Kelly, 
    878 F.3d 710
    , 719 (9th Cir. 2017) (internal quotation marks omitted).
    The majority opinion is bereft of any recognition of our
    3
    Alternatively, I would leave the injunction in place and suspend
    consideration of this case while the parties mediate towards a solution,
    as they have requested. On June 1, 2021, the parties informed us that they
    were considering requesting a referral to the court’s mediators, and on
    September 9, 2021, they jointly did so. The majority today refuses to
    grant the parties’ joint request. I note that this court has an excellent in-
    house mediation service, and during my time on the court, a panel has
    denied a joint request for referral to that service rarely if ever.
    FRAIHAT V. USICE                       91
    limited role in reviewing a district court’s issuance of a
    preliminary injunction.
    B.
    Again, under Alliance for the Wild Rockies, the proper
    preliminary injunction inquiry takes into account whether
    the balance of hardship tips sharply in Plaintiffs’ favor, and,
    if so, whether they have raised serious questions going to the
    merits of their Fifth Amendment reckless disregard claim.
    “That is, ‘serious questions going to the merits’ and a
    balance of hardships that tips sharply towards the plaintiff[s]
    can support issuance of a preliminary injunction, so long as
    the plaintiff[s] also show[] that there is a likelihood of
    irreparable injury and that the injunction is in the public
    interest.” 
    Id. at 1135
    . Here, in my view, the equity balance
    does strongly favor the Plaintiffs. And there are, at a
    minimum, serious questions as to whether ICE’s supervision
    of detention facilities recklessly disregarded the medical
    needs of the high risk detainees who make up the Plaintiff
    subclasses. The district court did not abuse its discretion in
    so concluding.
    (i) First, the balance of equities does tip sharply in
    Plaintiffs’ favor.
    When the government is a party, the balance of equities
    factor merges with the public interest consideration. Drakes
    Bay Oyster Co. v. Jewell, 
    747 F.3d 1073
    , 1092 (9th Cir.
    2014). On the balance of equities/public interest point,
    Roman is instructive. Roman held that “[t]he district court
    rightly concluded that the equities and public interest tipped
    in [the] [p]laintiffs’ favor,” because the “[p]laintiffs were
    likely to suffer irreparable harm absent relief given COVID-
    19’s high mortality rate,” and the government’s interests
    were unlikely to be harmed by the issuance of an injunction:
    92                    FRAIHAT V. USICE
    many of the plaintiffs did not have criminal records and there
    was little risk the plaintiffs would “abscond if they were
    released” especially given the availability of electronic
    monitoring tools.” 977 F.3d at 944.
    The same is true here. As the district court explained,
    defendants “do not dispute that 15% of [subclass members]
    who ultimately contract COVID-19 will die, or that those
    who survive are likely to suffer life-altering complications,”
    such as “permanent loss of respiratory capacity, heart
    conditions, [and] kidney damage.” Preliminary Injunction,
    445 F. Supp. 3d. at 744, 722. Death and life-altering medical
    conditions are surely irreparable injuries. In fact, a
    comparison with Roman suggests that the balance of
    hardships tips more “sharply towards the plaintiff[s],” All.
    for the Wild Rockies, 632 F.3d at 1135, than in Roman,
    because, as to the irreparable harm to the class, Fraihat
    subclass members are particularly vulnerable to COVID-19,
    while the Roman class included all detainees.
    Also as in Roman, the government’s interests here were
    not likely to be injured. The latest statistics available suggest
    that 70% of detained subclass members were not
    mandatorily detained, Supervisory Order, 
    2020 WL 6541994
    , at *5, and thus not “inadmissible or deportable
    because of [their] criminal history,” 
    8 U.S.C. § 1226
    (c).
    There is no reason to think that Fraihat subclass members
    are more likely to have criminal records than Roman class
    members. And there is no presumption that Fraihat subclass
    members with criminal records would be routinely released
    under the April order, which specified that ICE should apply
    FRAIHAT V. USICE                                93
    its own Detained Docket Review Guidance, not one
    provided by the court. 4
    The heightened risk of a COVID-19 outbreak in
    detention centers was apparent in April 2020. 5 A “remedy
    for unsafe conditions need not await a tragic event.” Helling
    v. McKinney, 
    509 U.S. 25
    , 33–34 (1993). Also, the district
    court’s preliminary injunction opinion explained that “[a]n
    immigration facility outbreak would also menace the non-
    detained: a surge in preventable cases would further strain
    local hospital and healthcare resources.” Preliminary
    Injunction, 445 F. Supp. 3d. at 722.
    “Faced with . . . preventable human suffering,” as we are
    here, “we have little difficulty concluding that the balance of
    hardships tips decidedly in plaintiffs’ favor.” Hernandez v.
    Sessions, 
    872 F.3d 976
    , 996 (9th Cir. 2017); see Preliminary
    Injunction, 445 F. Supp. 3d at 749 (quoting Hernandez).
    4
    I note that in the October enforcement order, the district court
    retained the Detained Docket Review Guidance as providing the
    governing standards and specified only that, “Defendants shall not apply
    the Docket Review Guidance rule against release of Section 1226(c)
    detainees so inflexibly that none of these subclass members are
    released.” Supervisory Order, 
    2020 WL 6541994
    , at *12 (emphasis
    added).
    5
    It is no surprise that the pandemic’s eventual course bore this
    prediction out. In a July 2020 filing, an expert relayed to the district court
    that “detention centers are closed environments that increase the risk of
    COVID-19 outbreaks and are institutional amplifiers of the virus, not
    unlike factories or nursing homes.” Supervisory Order, 
    2020 WL 6541994
    , at *3. And in October 2020 the district court observed,
    “[d]etention centers with lax social distancing or other COVID-19
    prevention measures continue to pose a grave threat of harm to
    individuals residing and working in them, as well as to the community as
    a whole.” 
    Id.
     (emphasis added).
    94                   FRAIHAT V. USICE
    Because the district court appropriately concluded that an
    injunction was needed to safeguard the health of both
    detainees and the communities surrounding detention
    centers, its issuance of a preliminary injunction was in the
    public interest. The district court so found and did not abuse
    its discretion in doing so.
    (ii) Next, Plaintiffs have raised serious questions going
    to the merits of their reckless disregard claim. The district
    court “identified the correct legal rule” governing this claim.
    United States v. Hinkson, 
    585 F.3d 1247
    , 1262 (9th Cir.
    2009) (en banc). Under Gordon v. County of Orange,
    
    888 F.3d 1118
     (9th Cir. 2018), Plaintiffs must show
    “(i) the defendant[s] made an intentional
    decision with respect to the conditions under
    which . . . plaintiff[s] w[ere] confined;
    (ii) those conditions put the plaintiff[s] at
    substantial risk of suffering serious harm;
    (iii) the defendant[s] did not take reasonable
    available measures to abate that risk, even
    though a reasonable official in the
    circumstances would have appreciated the
    high degree of risk involved—making the
    consequences of the defendant[s’] conduct
    obvious; and (iv) by not taking such
    measures, the defendant[s] caused the
    plaintiff[s’] injuries.”
    FRAIHAT V. USICE                             95
    
    Id. at 1125
    . The majority focuses only on the third element,
    as there is no dispute that the others are met. 6 See Opinion
    at 48–53.
    Critically, “[w]ith respect to the third element, the
    defendant[s’] conduct must be objectively unreasonable.”
    Gordon, 888 F.3d at 1125 (quoting Castro v. Cnty. of L.A.,
    
    833 F.3d 1060
    , 1071 (9th Cir. 2016) (en banc) (emphasis
    added)). “[T]he plaintiff[s] must ‘prove more than
    negligence but less than subjective intent—something akin
    to reckless disregard.’” 
    Id.
     (quoting Castro, 833 F.3d at
    1071) (footnote omitted). The majority recognizes this point
    but then repeatedly elides it.
    Even though the proper standard “is one of objective
    indifference, not subjective indifference,” id. at 1120
    (emphasis added), the majority substantiates its analysis
    with cases that additionally require subjective indifference.
    It does so primarily by relying on cases that predate Kingsley
    v. Hendrickson, 
    576 U.S. 389
     (2015). Opinion at 48–49, 59–
    6
    Defendants do not dispute that they made a series of intentional
    decisions with respect to COVID-19—in fact, the premise of their
    defense, and the majority’s reversal, is that ICE “forthrightly identified
    and directly sought to mitigate,” Opinion at 52–53. the threat of COVID-
    19. There is also no dispute that Plaintiffs were at “substantial risk of
    suffering serious harm,” Gordon, 888 F.3d at 1125, in the midst of a
    global pandemic. As the district court explained, “[i]t is undisputed that
    COVID-19 finds its way into almost every . . . communal setting.”
    Preliminary Injunction, 445 F. Supp. 3d at 744. Further, defendants “do
    not dispute that 15% of [subclass members] who ultimately contract
    COVID-19 will die, or that those who survive are likely to suffer life-
    altering complications.” Id. Similarly, there is no dispute that the
    causation element is met too, as, to prove causation, “a plaintiff need
    only prove a ‘sufficiently imminent danger,’ because a ‘remedy for
    unsafe conditions need not await a tragic event.’” Roman, 977 F.3d
    at 943–44 (quoting Helling, 
    509 U.S. at
    33–34 (cleaned up).
    96                   FRAIHAT V. USICE
    60. Kingsley held the proper standard for evaluating a
    detainee’s excessive force claim is purely objective.
    576 U.S. at 395–97. Applying Kingsley, Gordon
    “conclude[d] that the proper standard of review” for “right
    to adequate medical care” claims “is one of objective
    indifference, not subjective indifference.” 888 F.3d at 1120.
    The majority relies, for example, on Toguchi v. Chung,
    
    391 F.3d 1051
    , 1058 (2004) for the proposition that “a mere
    difference of medical opinion is insufficient, as a matter of
    law, to establish deliberate indifference.” But Toguchi,
    decided before Gordon, applied “both the objective and
    subjective” test. 
    Id. at 1057
     (quoting Hallett v. Morgan,
    
    296 F.3d 732
    , 744 (9th Cir. 2002). Similarly, the majority
    quotes Swain v. Junior, 
    961 F.3d 1276
    , 1289 (11th Cir.
    2020), as support for its conclusion that the government did
    not act with deliberate indifference. Opinion at 59–60. But,
    as Swain explicitly noted, the Eleventh Circuit “require[s]
    detainees to prove subjective deliberate indifference.”
    961 F.3d at 1285 n.4 (emphasis added); see Dang ex rel.
    Dang v. Sheriff, Seminole Cnty. Fla., 
    871 F.3d 1272
    , 1279
    n.2 (11th Cir. 2017) (holding Kingsley did not abrogate
    Eleventh Circuit precedent of using a subjective standard for
    claims of inadequate medical treatment). Thus, Swain held
    the government had not “acted with a deliberately indifferent
    mental state” because its mental state was not “equivalent to
    ‘subjective recklessness.’” 961 F.3d at 1289. Our court
    applies a different standard, so Swain’s reasoning offers little
    guidance.
    The majority’s importation of subjective elements into
    its analysis is not simply a matter of erroneously citing cases
    applying a subjective standard. The majority’s analysis of
    whether ICE’s policies regarding the protection of medically
    FRAIHAT V. USICE                        97
    vulnerable detainees from serious illness and possible death
    is replete with consideration of subjective factors.
    To the majority, ICE’s April 2020 policy response was
    reasonable because it “reflect[ed] a mobilized effort” which
    “forthrightly identified and directly sought to mitigate” the
    health risks posed by COVID-19. Opinion at 52–53
    (emphasis added); see also id. at 4. Indeed—and
    thankfully—some federal immigration officials did
    recognize the threat of COVID-19 in detention facilities. For
    example, ICE’s March 2020 “Action Plan” recognized “[t]he
    combination of a dense and highly transient detained
    population presents unique challenges for ICE efforts to
    mitigate the risk of infection and transmission.”
    But the Kingsley/Gordon reckless disregard standard is
    not satisfied by simply recognizing a risk to health and
    safety, expressing concern, and taking some measures to
    decrease the risk. Instead, the officials responsible for the
    conditions must take “reasonable available measures to
    abate that risk”; the degree of risk presented necessarily
    informs which “reasonable available measures” are needed
    “to abate” them. Gordon, 888 F.3d at 1125. Plaintiffs have
    presented evidence which, viewed through an objective
    standard, strongly suggesting the government did not
    prescribe such measures, whether it meant to do so or not.
    Distracted, I submit, by its evaluation of whether ICE
    was acting in good faith, the majority holds that ICE’s policy
    about detention conditions is not “objectively
    unreasonable,” Opinion at 48–53; Gordon, 888 F.3d at 1125
    (quoting Castro, 833 F.3d at 1071). I disagree. Given the
    degree of irreparable harm to which the Plaintiff subclasses
    of medically vulnerable detainees were exposed, Roman
    makes clear that the district court did not abuse its discretion
    in concluding that the Plaintiffs at least demonstrated a
    98                      FRAIHAT V. USICE
    serious legal question on the merits of their claim, sufficient
    to support the grant of a preliminary injunction.
    The majority holds, for example, that “[P]laintiffs did not
    demonstrate that the mere fact of their detention amounted
    to deliberate indifference,” 7 Opinion at 61, such that the
    government’s custody review policy at the time could be
    considered unconstitutional reckless disregard of potential
    medical injury. But the district court did not hold that
    continued detention itself demonstrated reckless disregard of
    the safety of medically vulnerable detainees during the
    pandemic. Instead, the district court’s findings—and
    order—focused on the failure to articulate a mandatory
    individual review requirement for each member of the
    limited, medically vulnerable Plaintiff subclasses to
    determine whether temporary release was appropriate under
    ICE’s own release standards.
    With regard to the underlying finding regarding the level
    of risk—again, an essential aspect of determining whether
    any failure to cabin that risk was “reckless”—the district
    court found that 15% of subclass members would die if they
    contracted COVID-19, Preliminary Injunction, 
    445 F. Supp. 7
    The post-Kingsley case law continues to use the term “deliberate
    indifference,” see, e.g., Gordon, 
    888 F.3d 1118
    , 1124–25 (9th Cir. 2018);
    Castro v. Cnty. of Los Angeles, 
    833 F.3d 1060
    , 1069–70 (9th Cir. 2016),
    despite its origination in the Eighth Amendment subjective standard
    cases, e.g., Whitley v. Albers, 
    475 U.S. 312
    , 320 (1986); Hudson v.
    McMillian, 
    503 U.S. 1
    , 6 (1992), and even though the term seems to
    incorporate the subjective component (that the “indifference” was
    “deliberate”). I use “reckless disregard” here and suggest that we stop
    using the misleading “deliberate indifference” rubric in cases involving
    pretrial or civil detention Fifth or Fourteenth Amendment challenges.
    FRAIHAT V. USICE                             99
    3d at 722, 744, which was significantly more likely while
    they remained detained. 8
    Notably, the government does not contend that the
    district court’s factfinding as to the level of risk to which
    medically vulnerable detainees are exposed was clearly
    erroneous. Given that level of risk, the government was
    required to take “reasonable available measures to abate
    th[e] risk,” Gordon, 888 F.3d at 1125, which stemmed
    directly from the congregate nature of detention. Issuing an
    advisory policy for field agents with regard to reviewing the
    continued detention of medically vulnerable people, see
    pp. 101–104, infra, does amount to reckless disregard for
    subclass members’ health and safety—or at least the district
    court did not abuse its discretion in so concluding.
    The majority’s dismissal of Roman as not pertinent here
    notwithstanding, Opinion at 67–69, Roman strongly
    supports this conclusion. In Roman, we agreed with the
    district court, see 977 F.3d at 943, that detaining people in a
    too-crowded detention facility without proper sanitation
    exposed them to a “substantial risk of suffering serious
    harm” from COVID-19, Gordon, 888 F.3d at 1125. For
    support, Roman pointed to Helling, 
    509 U.S. at 35
    , which it
    described as “holding that the health risk posed by a prison
    inmate’s involuntary exposure to second-hand smoke could
    form the basis of a claim that the government was violating
    his right to reasonable safety.” Roman, 977 F.3d at 943–44.
    8
    It is possible that since April 2020, developments such as a more
    sophisticated understanding of COVID-19 and the availability of a
    vaccine mean that this estimated fatality rate is no longer accurate. The
    shifting nature of the pandemic is precisely why I strongly disagree with
    the majority’s insistence on deciding a case that the parties would now
    prefer to mediate. See note 4, supra.
    100                     FRAIHAT V. USICE
    And again the Fraihat subclass members—compared to the
    Roman plaintiffs—faced a heightened risk of harm because
    the Fraihat subclass included only those who were already
    medically vulnerable to COVID-19—not, as in Roman, all
    detainees. 9
    In addition to holding that the risk of harm to all
    detainees from COVID-19 exposure during immigration
    detention was serious, Roman held it was not an abuse of
    discretion for the district court in that case to conclude that
    ICE’s conduct at the time the injunction issued was
    “objectively unreasonable,” Gordon, 888 F.3d at 1125
    (quoting Castro, 833 F.3d at 1071), such that ICE “violated
    detainees’ due process right to reasonable safety,” Roman,
    977 F.3d at 943. The majority holds that because “the
    guidance ICE issued [concerning detention conditions]
    applied to all detainees, which included those at greater risk
    from COVID-19,” “[t]he government’s chosen approach
    does not reflect deliberate indifference.” Opinion at 59. But
    the undisputed record shows subclass members are not
    similarly situated to all other persons detained. In fact,
    subclass members are uniquely vulnerable to COVID-19,
    and the government must take “reasonable available
    measures to abate that risk.” Gordon, 888 F.3d at 1125
    (emphasis added).
    *     *    *
    In sum, the rubric that is the appropriate one here, is
    whether the “balance of hardships . . . tips sharply towards
    the plaintiff[s].” All. for the Wild Rockies, 632 F.3d at 1135.
    The district court did not abuse its discretion in concluding
    9
    One of Plaintiffs’ experts declared that a person aged 50–59 years
    without underlying medical conditions had a 1% “case fatality rate.”
    FRAIHAT V. USICE                      101
    that it does. As in Roman, the district court appropriately
    concluded that the Plaintiffs “were likely to suffer
    irreparable harm absent relief given COVID-19’s high
    mortality rate,” 977 F.3d at 944. And, for the reasons I have
    explained, the issuance of an injunction accorded with the
    public interest, and there were at least “serious questions”
    going to the merits of the plaintiff’s reckless disregard Fifth
    Amendment claim.
    IV.
    So the district court did not err in concluding it could
    properly issue some preliminary injunction. The question
    that remains is whether the district court abused its discretion
    by ordering the specific terms of the April 2020 injunction.
    I am convinced that it did not.
    The majority maintains that the district court abused its
    discretion in issuing a preliminary injunction in April 2020
    because, according to the majority, even if ICE was “slow
    out of the gate” in addressing COVID-19, “ICE’s national
    policies at the time of the injunction did not reflect deliberate
    indifference.” Opinion at 54. More specifically, the majority
    suggests that, by April 2020, ICE had already “take[n]
    reasonable available measures to abate th[e] risk” of
    COVID-19 to subclass members, Gordon, 888 F.3d at 1125,
    pointing out that, by then, “ICE policies . . . had already led
    to the release of many detainees.” Opinion at 63.
    What the district court actually found was that ICE had
    released 693 individuals since March 2020 based on medical
    vulnerabilities. Preliminary Injunction, 445 F. Supp. 3d
    at 727. At the time, ICE had more than thirty thousand
    people in custody. Id. at 725. That 693 individuals were
    released is no measure of whether ICE’s release review
    policy had reached and was going to reach all endangered
    102                       FRAIHAT V. USICE
    members of the Plaintiff subclasses. The district court’s
    order that ICE affirmatively require prompt detention
    reviews of the particularly vulnerable subset of detainees in
    the Plaintiff subclasses, and that it enforce the requirement,
    was designed to assure that the number of medically
    vulnerable individuals released reflected the application of
    ICE’s own standards for release to the high risk presented,
    not local intransigence or foot-dragging. 10
    The majority considers that the district court’s injunction
    might have been justified if the Pandemic Response
    Requirements had not been mandatory. Opinion at 69. But it
    rejects this justification because, in its view, “the April 10,
    2020 Pandemic Response Requirements were mandatory.”
    Id. (emphasis added). The majority inaccurately asserts that
    “the district court acknowledged” that the PRRs were
    mandatory. Id. But the majority points to the district court’s
    statement, in quotation marks, that the April 10, 2020
    Pandemic Response Requirements purported to “set forth
    ‘mandatory requirements’ for all facilities housing ICE
    detainees.” 445 F. Supp. at 724 (quoting PRR). In fact, the
    PRR’s concrete terms regarding custody reviews, and the
    specific language it uses to convey those terms to ICE
    facilities, belie the majority’s suggestion that the terms were
    likely to be understood as mandatory.
    The processes the PRR laid out regarding custody
    reviews afforded ICE broad discretion. The PRR does not
    10
    As it turned out, six months later the district court found “a pattern
    of noncompliance or exceedingly slow compliance,” Supervisory Order,
    
    2020 WL 6541994
    , at *13, vindicating the district court’s earlier
    apprehension about “Defendants’ halting start to pandemic response”
    and its conclusion that “Defendants have not . . . shown that delays or
    non-enforcement of ICE facility-wide policies will cease.” Preliminary
    Injunction, 445 F. Supp. 3d at 750.
    FRAIHAT V. USICE                      103
    impose a time limit by which custody reviews of medically
    vulnerable detainees must take place. It advises facilities to
    notify Enforcement and Removal Operations (“ERO”) “in
    no case more than 12 hours after identifying any detainee”
    who is “potentially . . . at higher-risk for serious illness from
    COVID-19.” But there is no requirement that the review
    itself take place expeditiously; it specifies no time period at
    all. Upon notification, the PRR specifies, “ERO will review
    the case to determine whether continued detention is
    appropriate.” That description is followed by a citation to the
    April 4, 2020 Detained Docket Review Guidance. The
    custody review the PRR specifies is thus the same as the
    review laid out in the previous guidance, the Detained
    Docket Review Guidance.
    That guidance is replete with advisory language no one
    contends is mandatory. And in fact, the language the
    Detained Docket Review Guidance uses to describe the
    custody review process is unlikely to be understood by
    readers as conveying an imperative; the language amounts,
    at most, to exhortations that ICE facilities take specified
    action. In the section regarding custody reviews, for
    example, the Detained Docket Review Guidance uses
    encouraging, advisory language such as “should,” not
    directive terms such as “must” and “shall.”
    Elsewhere, with regard to other conditions both guidance
    documents refer to what “must,” be done, what facilities are
    “directed” to do, and what branch offices are “required” to
    do—regarding. See, e.g., Pandemic Response Requirements
    at 8, 12 (staff member obligations), 9 (signage
    requirements), 15 (notifying ICE of case rates), 16 (food
    safety hygiene requirements), 9 (hand hygiene
    requirements). The contrast is evident. Where guidance does
    not state “‘must’ or ‘shall’ . . . but merely that [an actor]
    104                      FRAIHAT V. USICE
    ‘should’” take some action, such language affords
    discretion. United States v. Navarro-Vargas, 
    408 F.3d 1184
    ,
    1205, (9th Cir. 2005) (en banc). Just so here.
    Given the language used regarding custody review and
    the internal contrasting language, the district court did not
    abuse its discretion in concluding the Pandemic Response
    Requirements would not be understood as mandatory with
    regard to reviewing custody, and in issuing an injunction to
    compel ICE to issue actual directives requiring timely
    custody reviews of members of the Plaintiff subclass, and to
    enforce them.
    The majority similarly explains that it vacates the
    preliminary injunction’s requirement to articulate minimum
    detention standards for subclass members in part because
    “ICE was updating its policies during the [April 2020]
    preliminary injunction proceedings and mid-pandemic,”
    including the April 10th “Pandemic Response
    Requirements.” Opinion at 55. 11 But the result of this
    “updating,” at the time the injunction issued, was a moving
    target of enunciated policies strewn about with precatory
    language. Those documents advised: detention facilities
    should implement measures to facilitate social distancing “to
    the extent practicable”; detention “facilities should consider
    cohorting daily intakes”; “[e]fforts should be made” to
    reduce capacity of people detained; people should be
    detained in individual rooms “to the extent possible”; “strict
    11
    Despite the preliminary injunction, it was still the case six months
    later that “[u]nder each PRR iteration, a 70-year-old with multiple Risk
    Factors w[ould] be held in essentially the same conditions as a 20-year-
    old, ‘ideally’ with further accommodations once they bec[a]me infected
    or [had] been in close contact with COVID-19.” Supervisory Order,
    
    2020 WL 6541994
    , at *7.
    FRAIHAT V. USICE                       105
    social distancing may not be possible in congregate settings
    such as detention facilities”; and “[i]deally, ill detainees
    should not be cohorted with other infected individuals.” The
    injunction did not override or disregard ICE’s efforts or
    impose the district court’s own pandemic detention
    protections. Instead, it afforded discretion and control to
    ICE, requiring that ICE “supplement” its existing guidance
    with a carefully considered set of standards that could be
    clearly communicated to each detention center and enforced
    by ICE. Preliminary Injunction, 445 F. Supp. 3d at 751.
    Additionally, the majority makes much of the fact that
    the PRR mandated ICE facilities adopt the CDC guidelines
    for detention facilities, deeming that overlap “[m]ost
    notabl[e].” Opinion at 56. But Roman subsequently held the
    CDC guidelines “do not provide a workable standard”
    because of a “lack of specificity” and “key” “vague[]”
    “caveats, such as that its recommendations ‘may need to be
    adapted based on individual facilities’ physical space,
    staffing, population, operations, and other resources and
    conditions.’” 977 F.3d at 946. Given these features, Roman
    remarked, “it is no surprise that the parties . . . disagree about
    what the CDC guidance means.” Id. The majority strains to
    minimize Roman’s conclusion, reminding us that Roman
    concluded only that the CDC Guidelines were unworkable
    for a preliminary injunction, not “unworkable as national
    policy, which is how ICE is using them here.” Opinion at 58
    n.7. True. But this observation does not impede my own
    conclusion, which naturally follows. The reasons the CDC
    Guidelines were “a poor guidepost for mandatory injunctive
    relief” are precisely the same reasons the guidelines cannot
    save the PRR: the guidelines were vague and nonmandatory,
    admitting of “adapt[ation] based on individual facilities’”
    needs. Roman, 977 F.3d at 946. Finally, the majority harps
    on what it characterizes as the “sweeping” “nationwide
    106                   FRAIHAT V. USICE
    relief” the district court ordered that “effectively place[d]
    this country’s network of immigration detention facilities
    under the direction of a single federal district court.” Opinion
    at 11–12, 66, 9. COVID-19 was and is a nationwide problem.
    ICE’s control of detention centers is nationwide. ICE’s
    policies thus apply nationwide. Plaintiffs could not have
    challenged an ICE policy specific to the detention centers
    that housed them because ICE’s policies are not detention-
    center specific. The district court’s injunction did not create
    a nationwide policy; it mandated only that ICE change its
    own nationwide policies. The injunction did not specify any
    particular standards for any particular facilities—or, indeed,
    any standards at all, as it only required ICE to have and
    enforce its own standards.
    One measure of the reasonableness of the injunction the
    district court issued in April is a comparison with the advice
    provided in Roman regarding ordering detainees released.
    The district court in Roman had “imposed a moratorium on
    [the] receipt of new detainees . . . [and] ordered the facility’s
    detainee population to be reduced to a level that would
    enable social distancing,” among other things. 977 F.3d
    at 939. Roman explained,
    If the district court determines, based on
    current facts, that particular measures are
    necessary to ensure that conditions . . . do not
    put detainees at unreasonable risk of serious
    illness and death, it may require such
    measures. The district court may, for
    example, require . . . a reduction in the
    population to a level that would allow for six-
    foot social distancing, if it concludes th[at]
    action[] [is] necessary to bring the conditions
    to a constitutionally adequate level.
    FRAIHAT V. USICE                     107
    Id. at 945–46.
    Here, the district court did not order the mass release of
    the particularly vulnerable subclass members in April 2020.
    Although the majority characterizes the district court as
    “compell[ing] release of detainees,” Opinion at 61, in fact
    the April injunction required only that ICE assure the review
    of subclass members’ continued custody according to its
    own standards for release; there was no compelled release
    here. Instead, the district court ordered a prompt,
    comprehensive, enforceable review of whether each subclass
    member should remain in custody, based on ICE’s own
    standards for release (its Detained Docket Review
    Guidance). Preliminary Injunction, 445 F. Supp. 3d. at 751.
    So the majority is just wrong when it says that the relief
    provided in this case was “far greater” than the relief
    approved in Roman; in fact, it was considerably narrower.
    Opinion at 68. The district court did not abuse its discretion
    with regard to requiring individualized custody reviews.
    At oral argument, the government pointed to the
    requirement that it adopt detention and release standards
    specifically for subclass members—that is, the medically
    vulnerable detainees—as a particular burden. It is hard to
    see why it is more burdensome to review a subgroup of
    detainees for release than to review all of them, or more
    burdensome to promulgate isolation and quarantine
    provisions for a subgroup of detainees than for all detainees.
    It may, for example, prove difficult to prescribe individual
    rooms, not cohorting, for isolating or quarantining all
    detainees, but practical to do so for medically vulnerable
    individuals. Moreover, the specific release and detention
    condition standards were left to Defendants. The district
    court provided the government the very flexibility the
    majority emphasizes is important, and limited even the
    108                      FRAIHAT V. USICE
    flexible requirements to the Plaintiff subclasses, not all
    detainees. See Opinion at 52, 61. It was up to the government
    to determine which preventative measures were most
    appropriate for medically vulnerable detainees.
    V.
    The majority nonetheless “reverse[s] the preliminary
    injunction.” Opinion at 78. It also “direct[s] that all orders
    premised on it be vacated.” Id.
    As to this latter edict, according to the majority, “[t]he
    district court’s class certification ruling depended on, and
    was in service of, its preliminary injunction.” Id. at 45. Thus,
    “the class certification order necessarily falls . . . regardless
    of whether class certification was otherwise proper.” 12 Id.
    I do not see why that is so. Although it is true that, under
    Paige v. California, 
    102 F.3d 1035
     (9th Cir. 1996), “we
    could not uphold [the preliminary injunction] without also
    upholding the certification of the class,” 
    id. at 1039
    (emphasis added), and thus, if the class certification order
    was infirm, then the preliminary injunction might be as well,
    the majority does not uphold the preliminary injunction.
    Further, Roman vacated provisions of a preliminary
    injunction related to COVID-19 in federal immigration
    detention, just as the majority does here, while upholding the
    12
    I agree with the majority that “we have jurisdiction” to review the
    district court’s provisional class certification order, Opinion at 45, even
    though the government did not seek permission to appeal that under
    Federal Rule of Civil Procedure 23(f), because the class certification
    order “is inextricably bound up with the grant of the interim injunction,”
    Paige v. California, 
    102 F.3d 1035
    , 1039 (9th Cir. 1996).
    FRAIHAT V. USICE                       109
    district court’s provisional class certification order. 977 F.3d
    at 944–45.
    Whether the Fraihat subclass certification is proper
    depends on Federal Rule of Civil Procedure 23. Roman
    provides strong evidence that such certification was proper.
    See id. at 944. As the majority does not provide a contrary
    Rule 23 analysis, there is no reason the district court must
    repeat its own, and the majority opinion should not be read
    to suggest otherwise.
    VI.
    I am convinced that the district court did not err in
    determining that circumstances were potentially life-
    threatening for subclass members; that issuing an injunction
    would be in the public interest; and that Plaintiffs raised
    serious questions on the merits of their reckless disregard
    claim in light of these facts. The majority is nonetheless
    alarmed by the modest, deferential, preliminary injunction.
    Contrary to the majority’s suggestion, the district court’s
    remedy does not place all federal detention facilities under
    its control nor purport to set policy. The injunction directs
    ICE to craft, implement, and enforce its own policies,
    adequate to meet the needs of the medically vulnerable
    members of the Plaintiff subclasses. As neither issuance of a
    preliminary injunction to address a developing dire situation
    nor the terms of the deferential injunction issued were an
    abuse of the district court’s discretion, I respectfully, but
    vigorously, dissent.