Once Policies are Established, Costs for Quarantines Should be Considered
By CHHS Law and Policy Analyst Christine Gentry
While public opinion favors mandatory quarantines of asymptomatic individuals with possible exposure to Ebola and several states are establishing quarantine policies, little discussion has been given to the cost of quarantine. Naturally, overall cost will depend on the level of quarantine in place, from mandatory quarantine enforced by state order to voluntary isolation and monitoring. Regardless of the level and method of enforcement, however, most quarantine practices will involve health care services, security or enforcement, and ancillary support services. While the public health infrastructure is in place to respond to Ebola and other infectious diseases, use of this infrastructure costs.
While some states will establish designated facilities as quarantine centers, others, including Maryland, plan to impose home quarantines. Home quarantines may save overhead costs on housing, but as seen with New Jersey’s temporary quarantine of Kaci Hickox, quarantine of out-of-state individuals then creates additional complications.
A final category of cost is compensation of lost wages for those in quarantine. New York Governor Andrew Cuomo has said that those under mandatory quarantine whose employers will not provide paid leave may seek assistance from the state. What this assistance entails and how it is claimed is unclear at this point. Ohio House Bill 647, on the other hand, would require employers to compensate mandatory quarantined employees.
Not much public disclosure has been made in the way of what quarantines have cost. A recent Wall Street Journal article, however, outlined the quarantine measures and costs taken for a West African family that served a mandatory quarantine in West Haven, Connecticut. The family of six spent over a week under a home quarantine order. The municipality provided security, transportation, active monitoring, and food delivery. Even though some of the costs of care were supplemented by the family’s relatives, West Haven’s mayor, Edward O’Brien, estimates that the municipality’s costs ran around $1,000 or more per day. Mayor O’Brien stated that he would seek compensation from the state to help defray costs.
One question state and local authorities should consider is in the event federal aid is made available to reimburse jurisdictions’ Ebola preparation, response, and recovery efforts, will that compensation be made contingent on following federal guidelines, such as the Centers for Disease Control and Prevention’s (CDC) quarantine guidelines?
Maryland state officials estimate that 10 to 20 people from Guinea, Liberia, or Sierra Leone arrive in Maryland every day. Even though under Maryland’s policy, which closely mirrors the CDC guidelines, only those in the highest-risk category will be subject to home quarantine, state and local authorities, and especially hospitals and health departments, should factor in these expenses when planning for the possibility of Ebola-related costs.