America’s defense against epidemics is divided among 2,684 state, local, and tribal public-health departments.
The federal government’s quarantine powers at U.S. borders are extensive. Travel ban on noncitizens who have been anywhere in China recently have been enacted, and the Secretary of Health and Human Services announced quarantine measures for returning citizens not long after the CDC issued its first federal quarantine order in more than 50 years.
But the average American may be surprised to learn who holds the authority to order such public-health measures. Except at the nation’s borders, the federal government, with the expertise of the Centers for Disease Control and Prevention, is not in charge. America’s defense against epidemics is divided among 2,684 state, local, and tribal public-health departments. Each one is responsible for monitoring people within its jurisdiction, imposing isolation or quarantine as needed. CDC officials are “ preparing as if [the new coronavirus] is the next pandemic,” but in reality, the laboring oar falls to state and local health departments.
State and local health departments provide the labor, set the rules, monitor people who might have been exposed to the virus, and trace the contacts of those who fall ill. The federal quarantine order for the 195 evacuees from Wuhan? That order was able to prevent them from leaving the plane they arrived in. The federal government could also order the quarantine of an entire cruise ship at one of the nation’s seaports—as Japan has done. But otherwise, federal quarantine orders have a pretty limited effect. When one of the Wuhan evacuees wanted to leave the military base in California where the group was under quarantine, a state-level quarantine order was necessary to prevent that from happening. This is because the quarantined group was no longer at a point of entry, or in an airplane, and was thus subject to the jurisdiction of the local health department where they were quarantined.
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