The Legal Mess of Coronavirus Quarantine Across America’s 2,500+ Public Health Departments

U.S. Air Force Staff Sgt. Robert McCauley, right, 60th Medical Operations Squadron medical technician, attends to Airman 1st Class Stanley Dinkins, left, 60th Force Support Squadron force management technician, who plays the role of an agitated quarantined influenza patient during a base exercise Nov. 6, 2019, at Travis Air Force Base, California. The exercise tested Team Travis’ ability to respond to a public health emergency in the event of an actual health crisis. (U.S. Air Force photo by Heide Couch)

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.

Read the full story at The Atlantic


Legal Authorities for Isolation and Quarantine CDC

Practical Steps for Legal Preparedness NCBI

Health Officer Practice Guide for Communicable Disease Control in California CDPH

Isolation and Quarantine Response Plan King County

Public Health Legal Authority Briefing Georgia DPH

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