Arsenal of Legal Tools Available to Combat Ebola in the U.S.

October 17th, 2014

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This week, 132 passengers who had traveled on a Frontier Airlines flight from Cleveland to Dallas-Fort Worth received word that a passenger on the plane, Amber Vinson, had tested positive for Ebola. Vinson, a nurse who had helped care for Thomas Eric Duncan while he was being treated at Texas Health Presbyterian Hospital, says she received the Centers for Disease Control and Prevention’s (CDC) permission to board the flight after calling to report that she was running a low-grade fever of 99.5 degrees, which is below the CDC’s fever threshold of 100.4 degrees.

While Americans have understandably responded to this news with concern for their own safety and questions, the public should find some reassurance in knowing that the current framework of federal and state laws provides a variety of tools which can be used to help prevent the further spread of Ebola within the United States (US). While public health and emergency management laws vary from state to state and among local jurisdictions, all fifty states have the authority to isolate individuals known to be infected with a communicable disease and to quarantine those individuals who are believed to have been exposed to such a disease. Several individuals have already been placed under quarantine in both Dallas and New Jersey to limit their exposure to others as they monitor their own health for symptoms of Ebola following known contact with individuals diagnosed with the disease.

Additionally, the federal government has authority to isolate and quarantine individuals at ports of entry, including airports, and when there is danger of interstate transmission of a communicable disease, such as Ebola. The CDC is currently conducting temperature checks at five U.S. airports with substantial international traffic and will be able to isolate any individuals who arrive in the US and are found to be infected with Ebola. Federal quarantine authority could also be used for passengers arriving from international destinations who appear to have been at a high risk for exposure to the virus. If necessary, the CDC, in coordination with state and local public health authorities, could also limit the movement of individuals with known exposure to Ebola between states to help mitigate the spread of the virus nationally.

Although isolation and quarantine may be the most frequently discussed options for preventing the spread of Ebola within the US, federal and state governments also possess other powers that may help to limit further exposure to the disease. Under their police powers, state and local governments have varying degrees of authority to take specific non-clinical measures if they are deemed necessary to help prevent the spread of disease. For example, most state and local governments have the authority to decontaminate, and, if necessary, seize and/or destroy personal property that may have been contaminated by a virus or bacteria. Such measures have already been used in the US as additional cases of Ebola have been confirmed. Similarly, most states’ emergency laws also provide authority to a state’s executive branch (i.e. the Governor and other state officials) to limit the movement of individuals. This can include imposing curfews, closing businesses, and canceling events that would result in large public gatherings. All of these strategies would provide for enforced social distancing at the state and local level. While these measures would not likely be used unless a large scale outbreak was occurring, the authority to implement such tactics is one tool available to state and local governments to help protect public health or enhance response efforts during a disaster.

If response to the current Ebola outbreak required it, the federal government could also institute similar measures to limit foreign and interstate travel. Federal efforts currently appear to be focused on preventing individuals with known Ebola infection or exposure from further spreading the disease. The CDC is now considering placing the healthcare workers who treated Duncan on a TSA no-fly list while they monitor their symptoms during the 21-day incubation period as one way of limiting the potential interstate spread of the disease. Many Congressional representatives are also calling for travel bans from West African countries known to be dealing with Ebola outbreaks to limit further transport of the disease into the US. The CDC is not currently recommending that the federal government pursue this measure, however. They state that it will actually make identification of potentially-infected individuals more difficult and that the use of travel bans ignores the reality of how Ebola is actually spread.

Successfully battling the spread of Ebola in the US will require an organized, collaborative effort at the federal, state, and local levels. While there is no easy answer to this problem, the legal framework is in place to help government officials do their job and protect the public health of the American public.

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