Infectious Disease / Law of the Land
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With the controversy surrounding a nurse who defies legal authority for her quarantine from possible Ebola virus exposure in her medical treatment of patients with the disease in Africa, here are a few federally enforceable laws derived from the U.S. Constitution:
Isolation and quarantine help protect the public by preventing exposure to people who have or may have a contagious disease.Isolation and Quarantine
- Isolation separates sick people with a contagious disease from people who are not sick.
- Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.
In
addition to serving as medical functions, isolation and quarantine also
are “police power” functions, derived from the right of the state to
take action affecting individuals for the benefit of society.
Federal Law
The federal government derives its authority for isolation and quarantine from the Commerce Clause of the U.S. Constitution.Federal isolation and quarantine are authorized for these communicable diseases:
- Cholera
- Diphtheria
- Infectious tuberculosis
- Plague
- Smallpox
- Yellow fever
- Viral hemorrhagic fevers
- Severe acute respiratory syndromes
- Flu that can cause a pandemic
Federal isolation and quarantine are authorized by Executive Order of
the President. The President can revise this list by Executive Order.
Under section 361 of
the Public Health Service Act (42 U.S. Code § 264), the U.S. Secretary
of Health and Human Services is authorized to take measures to prevent
the entry and spread of communicable diseases from foreign countries
into the United States and between states.
The authority for
carrying out these functions on a daily basis has been delegated to the
Centers for Disease Control and Prevention (CDC).
CDC’s Role
Under
42 Code of Federal Regulations parts 70 and 71, CDC is authorized to
detain, medically examine, and release persons arriving into the United
States and traveling between states who are suspected of carrying these
communicable diseases.
As part of its federal authority, CDC
routinely monitors persons arriving at U.S. land border crossings and
passengers and crew arriving at U.S. ports of entry for signs or
symptoms of communicable diseases.
When alerted about an ill passenger or crew member by the pilot of a plane or captain of a ship, CDC may detain passengers and crew as necessary to investigate whether the cause of the illness on board is a communicable disease.
State, Local, and Tribal Law
States
have police power functions to protect the health, safety, and welfare
of persons within their borders. To control the spread of disease within
their borders, states have laws to enforce the use of isolation and
quarantine.
These laws can vary from state to state and can be
specific or broad. In some states, local health authorities implement
state law. In most states, breaking a quarantine order is a criminal
misdemeanor.
Tribes also have police power authority to take actions that promote the health, safety, and welfare of their own tribal members. Tribal health authorities may enforce their own isolation and quarantine laws within tribal lands, if such laws exist.
Tribes also have police power authority to take actions that promote the health, safety, and welfare of their own tribal members. Tribal health authorities may enforce their own isolation and quarantine laws within tribal lands, if such laws exist.
Who Is in Charge
The federal government
- Acts to prevent the entry of communicable diseases into the United States. Quarantine and isolation may be used at U.S. ports of entry.
- Is authorized to take measures to prevent the spread of communicable diseases between states.
- May accept state and local assistance in enforcing federal quarantine.
- May assist state and local authorities in preventing the spread of communicable diseases.
State, local, and tribal authorities
- Enforce isolation and quarantine within their borders.
It
is possible for federal, state, local, and tribal health authorities to
have and use all at the same time separate but coexisting legal
quarantine power in certain events. In the event of a conflict, federal
law is supreme.
Enforcement
If a quarantinable disease is suspected or identified, CDC may issue a federal isolation or quarantine order.
Public
health authorities at the federal, state, local, and tribal levels may
sometimes seek help from police or other law enforcement officers to
enforce a public health order.
U.S. Customs and Border Protection and U.S. Coast Guard officers are authorized to help enforce federal quarantine orders.
Breaking a federal quarantine order is punishable by fines and imprisonment.
Federal law allows the conditional release of persons from quarantine if they comply with medical monitoring and surveillance.
For more information, please visit our source material.
The Federal Law:
Is it time for the CDC to issue quarantine orders for exposed individuals?
Also read VDP Gazette's A Crisis of Conscience.
Source: CDC, FDA
