Sunday, February 16, 2020

Will future community-acquired COVID-19 infection in the US require mandatory isolation? Yes, if state health departments say so. And it's a legal mess


Can the government order quarantine of persons in the United States who have no symptoms of the coronavirus of COVID-19, on the basic of contact tracing indicating the likelihood of exposure?

Yes.  Polly J. Price of Emory University in Atlanta offers some analysis in The Atlantic .  Essentially, only state and local health departments can quarantine individuals once they have entered the country;  the CDC alone cannot, although state health departments would follow CDC (and NIH) guidance. There were a few questions in Texas and New York City in 2014 regarding one or two persons exposed to Ebola. 

 It appears that CDC can quarantine people at international airports upon arrival (which is what happens now with the evacuations). 


There is no constitutional protection of the individual from involuntary confinement even if they have done nothing wrong.  There is no provision to reimburse financial, job losses or other possibilities.  You can imagine the gofundme’s on social media in the future if this became widespread, or the “social justice” implications down the road.  However, there are some due process concerns.  The orders must be reasonable and based on evidence.

The Virginia health department notes some persons under monitoring, none of whom have tested positive.  I am surprised that persons with recent travel to China (that’s most of them) would be in the group given travel bans.

California also has a statement here.
   
I would be concerned about domestic travel to another state and being detained because you were reported to be in proximity of someone else who had tested positive, even if you had not traveled abroad.  I don’t know yet if this is a realistic concern.  You would presumably be responsible for your own housing expenses if you did not have symptoms and were not held at a federal or state quarantine center.  This needs attention.

Update: NPR says that the CDC did get increased federal quarantine authority at the start of the Trump administration in this article about the Diamond Princess. 

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