What are the laws about quarantines?
We are not there yet, but this is a big question that many people have asked me. Can the government force me to stay indoors? Can they make it a crime to go outside? The answer is “yes” to both and, let me say it again, we are not there yet.
“Shelter in place,” an action that has been used in cities and states around the country, does not mean quarantine. Before we start seeing actual quarantines in the U.S., let’s consider what power governments have to force you to stay put. And when quarantines are useful.
Public health experts say quarantines could be effective tools for preventing the transmission of a disease that fits — at a minimum — two biological conditions:
- It is often infectious before symptoms appear, and;
- It is deadly or has other serious medical consequences.
Federal quarantine authority
Let’s start with the federal enforcement laws. Federal authority comes from section 361 of the Public Health Service Act. It says that 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.
While you may think of the Centers for Disease Control and Prevention as a research agency, federal law does give the CDC some enforcement power. Under 42 U.S. Code § 264 of federal regulations parts 70 and 71, the 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.
It’s the seclusion of a person potentially exposed to a disease for a period of time to see if they become infected. A person under quarantine typically stays in one place to avoid nearly all contact with the outside world. When such a quarantine is ordered by the government, it’s illegal to violate them: Breaking a federal quarantine is punishable by a fine or imprisonment, according to the Centers for Disease Control and Prevention. An individual found violating a federal quarantine order could face a fine of up to $100,000, a year in jail, or both, according to a report from the Congressional Research Service.
Many states also have their own punishments for violating quarantine, though they vary widely.
But many people talk about “quarantines” more broadly — referring to the city-wide lockdowns that force people to stay in their homes and cut off all travel to and from an impacted area. Legal experts often call this strategy of locking down an entire region “cordon sanitaire” — a term that dates back roughly 200 years when a French duke deployed troops along the Spanish border to contain the spread of infectious disease.
State quarantine authority
A quarantine would be hard to enact uniformly in the U.S. because we have 2,800 local health departments. And, as Stat.com pointed out, they have all kinds of different enforcement powers:
27% of states delegate this power solely to state authorities, 18% of states provide some power to local governments, and the remaining 55% delegate the powers to some combination of both, according to a recent study in the Journal of Public Health Management and Practice.
The National Conference of State Legislatures has a state-by-state list of quarantine and isolation laws. In some states, the governor has the power to declare a quarantine. In others, it is the state’s director of the department of health. Many states have the power to fine and/or arrest people who violate quarantine or isolation orders. It appears that Maryland has the highest allowable fine (up to $3,000) while Louisiana allows up to two years of jail time.
Massachusetts may want to consider updating its state law, which says: “When the board of health of a town shall deem it necessary, in the interest of the public health, to require a resident wage earner to remain within such house or place or otherwise to interfere with the following of his employment, he shall receive from such town during the period of his restraint compensation to the extent of three fourths of his regular wages; provided, that the amount so received shall not exceed two dollars for each working day.”
A study published by the National Institutes of Health points out that quarantines are important and “often misused.” The patchwork of state and local laws about quarantines creates all sorts of problems.
To be effective, the NIH study said, quarantine laws have to have incentives, measures that ensure job security if you are barred from going to work, and there should be a “tiered enforcement plan” so governments don’t go overboard. Right now, only about 20% of states have any kind of job protection provisions in times of quarantines.
Almost a third of states do not guarantee the rights of a person in quarantine to have a say in burial and cremation procedures, if it comes to that.
A brief history of quarantines in the U.S.
You can go way back in human history to find quarantines. The Bible includes instructions on how to quarantine people to control leprosy. Back then, if you even had a boil or a skin discoloration, you were supposed to go see a priest, who might put you away for a week or two.
In the mid-1600s, ships arriving in Boston Harbor were inspected for diseases and local laws allowed quarantines for people who might have yellow fever or smallpox.
The most significant change to U.S. quarantine laws may have been the federal Public Health Service Act (1944), which clearly established and regulated federal quarantines for the first time. States get their power to enact quarantines from the 10th Amendment to the U.S. Constitution, which says, “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”
The 1944 federal Public Health Services Act combined 150 years of health laws into one big opus of regulation. (By the way, and maybe this is inspiration for us all, this huge piece of legislation was approved without one single dissenting vote in Congress.) The first big test of the new act was to get tuberculosis under control.
In the last decade, talk of quarantines rose again during the Ebola outbreak. The American Civil Liberties Union argued that Ebola quarantines were unconstitutional:
Because the Ebola quarantines of 2014–2015 were not medically necessary, they violated the U.S. Constitution. A quarantine is a form of imprisonment and therefore a very significant incursion on an individual’s freedom. Under the Constitution, quarantines are permitted only when the state has a compelling interest in imposing one and when such interventions are the least restrictive measures available to prevent the spread of disease. Because the Ebola quarantines were not medically necessary, they did not satisfy those criteria. Furthermore, quarantined individuals are legally entitled to due process of law, including a timely hearing before a judge or other neutral arbiter. Few of the states that imposed quarantines did this. States are also required to quarantine under humane conditions, and not all states did so.
The terms to know to report this story
The ACLU provides a glossary of quarantine-related terms:
Self-monitoring: A monitoring regime under which those potentially exposed to an infectious disease assume responsibility for assessing and reporting their own health status.
Active monitoring: A regime under which public health officials regularly check in with potentially exposed individuals. Individuals, for example, are asked to take their temperature twice daily, monitor themselves for symptoms, and report their health status regularly to a public health authority. No explicit movement restrictions are imposed.
Direct active monitoring: Direct observation of potentially exposed individuals by a public health authority, which visits the potentially exposed individual at least once daily to check for fever and other symptoms. The monitored individual must discuss any plans for travel, work, and use of public spaces.
Controlled movement: Restrictions on the movement of potentially exposed individuals, such as screenings, travel limitations and restrictions, and social-distancing measures.
Isolation: The separation of an individual who is showing symptoms of an infectious disease. Isolation is a precaution typically taken in hospitals to prevent disease transmission.
Do you REALLY need a gun?
Lots of you have reported stories about the increase in gun sales related to COVID-19. But Jacob Margolis at KPCC – Southern California Public Radio took a different angle.
Margolis looked at the claims that society comes unraveled, and even violent, after disasters. As it turns out, the opposite happens. We pull together more than we attack each other. The story included this passage:
And even if things do get tougher, as they very well could, people often forget that those around them are generally pretty good.
That people don’t react to disasters like in the movies.
“We tend to come together as humans and work together and help each other and try to work towards the collective good,” said Joseph Trainor, sociologist at the Disaster Research Center at the University of Delaware.
A good example can be found in a paper Trainor co-wrote about people’s responses following Hurricane Katrina, about guests stuck in a hotel as things went from bad to worse:
“While they heard many of the rumors about widespread antisocial behavior all around them, in most hotels the guests helped one another and later reported feeling very positive about the hotel staff.”
Your mind might be going to what happened after Hurricane Katrina, which has been held up again and again, as a moment when civilized society collapsed under the weight of the stress from a natural disaster and government ineptitude. Over time, many of the stories of unchecked violence there were debunked — often, myths rooted in racism.
A fabric store is providing DIY masks for medical workers
Joann Fabrics is providing materials and instruction for people who want to make face masks. I have seen some conversations on our NextDoor feed from neighbors who are making masks to donate. This video shows how to use materials like menstrual pads and home air filters to create masks in ways that would make MacGyver jealous. KIRO-TV in Seattle found people at home with sewing machines who are stitching together masks to send to hospital workers. Those workers know the homemade masks are not as reliable as commercial masks but that they are better than nothing. I saw another big outpouring from a sewing group in Cincinnati.
Let’s be clear, the World Health Organization is not recommending that healthy people wear face masks to protect themselves from COVID-19. But some countries have been aggressive. A report in the medical journal Lancet summarized responses around the world and found that since people can be infected without showing symptoms, it might make more sense for everyone to wear a mask before they show symptoms.
But, and this is important, the Lancet study said misuse of masks can make things worse:
People in some regions (eg, Thailand, China, and Japan) opted for makeshift alternatives or repeated usage of disposable surgical masks. Notably, improper use of face masks, such as not changing disposable masks, could jeopardize the protective effect and even increase the risk of infection.
The Lancet study also said if everyone wore masks, then there might be less discrimination against people who do.
Consideration should also be given to variations in societal and cultural paradigms of mask usage. The contrast between face mask use as hygienic practice (ie, in many Asian countries) or as something only people who are unwell do (ie, in European and North American countries) has induced stigmatization and racial aggravations, for which further public education is needed. One advantage of universal use of face masks is that it prevents discrimination of individuals who wear masks when unwell because everybody is wearing a mask.
Firefighters and EMTs plead for more supplies
There are shortages at hospitals. And firefighters and EMTs are pleading for supplies, too. The International Association of Firefighters produced a video with information and advice for those who may call them. Make sure you are checking in with your local first responders. Just look at this video to see all of the steps they are supposed to take with every patient.
COVID-19 ransomware is on the loose
The old saying in the stock market is “there is opportunity in confusion.” Ransomware thieves know that. There are some new bugs to be aware of.
The newest one, according to Forbes, “tricks the user into changing the phone’s password and locks the device, before demanding a $100 Bitcoin payment inside 48 hours for a return to normal. The penalty for non-compliance is a total erase of the device’s data. Fortunately, if you’re on Android 7.0 or newer, you should be protected — as long as you have set a password. But we all know that many devices are stuck on older versions of the OS.”
This is the sort of thing you might try to keep a running list of for the public.
Where to find COVID-19 data
This constantly updated COVID-19 Tracking Project is another one of my favorite resources. Be sure to look at the raw spreadsheet for notes about where the data is coming from because, as the project says, information is patchy. Github also offers a repository for constantly updated datasets.
OpenHealth produces a crowdsourced interactive map of private COVID-19 testing sites that may be useful.
How jails and prisons are handling COVID-19 cases
Poynter partners with The Marshall Project on our Covering Jails workshops. The Marshall Project is doing a terrific job reporting on how jails and prisons are handling the coronavirus’ spread.
Some jails and prisons have suspended all visits, some still allow visits from lawyers and some are still working out their plans. The spreading virus will create all sorts of challenges for jails and prisons, including:
- Will guards show up for work?
- How can jails and prisons encourage sanitation when cleaning supplies are considered contraband?
- How will jails and prisons implement “social distancing,” especially when local jails are packed?
The Marshall Project published an essay written by a man in prison in Washington State. He said prison guards were telling inmates to put a sock over the phone receiver when making calls.
A TV station produced a coronavirus special for the whole family
News directors are telling me that ratings for local news are way up right now. That alone is enough to tell you that you are doing important work and people believe in what you are reporting.
WCCO-TV in Minneapolis is stretched like all of you are, but last week the station produced a 9 a.m. special aimed at family viewing. Here is a preview version for a quick look, and here is a link to the whole program. In addition to updating viewers on the latest, the program helped parents talk with their kids about the virus and showed how to exercise at home.
“We set out to break down COVID-19-speak in a way that was honest but not scary,” Kari Patey, WCCO’s news director, told me. “Our goal was to help kids understand something that adults are having a hard time processing. It’s a heavy lift on a normal day let alone with more than half of your team working remotely and practicing good social distancing.”
WFSB in Hartford, Connecticut, produced a three-hour primetime special last week.
I am seeing so much remarkable work from local newsrooms, where reporters are working out of cars and kitchens. We may just look back on all of this, years from now, and see that it was your finest hour.
These are tough times for traffic reporters
Traffic and transit reporter Jamie Stelter at NY1 in New York City said every day is a slow news day on her beat these days.
At the same time, the light traffic is a great opportunity for road construction projects to move fast. The Florida Department of Transportation said it will allow workers to finish projects ahead of schedule.
We’ll be back tomorrow with a new edition of Covering COVID-19. Sign up here to get it delivered right to your inbox.
Al Tompkins is senior faculty at Poynter. He can be reached at email@example.com or on Twitter, @atompkins.