The CDC issued a new rule on Jan. 19, expanding the agency's authority to quarantine Americans amid public health responses for either emerging or re-emerging infectious disease.
The new rule empowers the CDC to restrict domestic travel amid a health crisis for the first time. It also grants the agency the ability to self-regulate when deciding to quarantine an individual, but does not provide a clear path for challenging the isolation order in federal court. Previously, the task of quarantine largely fell under state law. The new rule is set to take effect Feb. 21.
According to an op-ed published in The New York Times, this expansion of power should be greeted with concern.
Here are three reasons the CDC's enhanced quarantine authority should be cause for alarm, according to Times op-ed contributors Kyle Edwards, a law student at Yale in New Haven, Conn.; Wendy Parmet, the program director for health policy and law at Northeastern University in Boston; and Scott Burris, the director of the public health research program at Temple University in Philadelphia.
1. History: Quarantines in the past have been driven by politics, not science. For instance, during the bubonic plague outbreak of 1900, a quarantine of the entire Chinatown neighborhood in San Francisco was authorized by government officials. It applied only to Chinese residents, lacked scientific merit and was primarily fueled by fear and racism. It happened again during the Ebola epidemic: Kaci Hickox, a nurse caring for Ebola patients in Sierra Leone, was quarantined by New Jersey Gov. Chris Christie even though, according to the CDC's guidelines, she should have been allowed to monitor her symptoms from home. After three days in isolation at a tent hospital in Newark, she was released
"Given this history, we want to ensure that federal officials applying the new regulations will act on the basis of science and evidence and not on politics and public fear," wrote the authors.
2. Legal implications: The majority of quarantines related to public health crises, until now, have been issued and enforced by state and local governments. With exception of New Jersey and Connecticut — states facing litigation for their handling of the Ebola crisis — many state legislatures have protections for citizens built into their quarantine laws. Isolated individuals are able to quickly challenge a state's order to push back against the possibility of an undue quarantine. However, the new rules give the CDC in-house oversight of the decision to quarantine and even the legal authority for the CDC to take over the quarantine role from states, which the op-ed authors found troublesome.
3. A new administration: In the Times op-ed, authors expressed concern over the previously expressed views of President Donald Trump and the possible actions his administration could take.
"During the 2014 Ebola outbreak, Mr. Trump tweeted, contrary to the judgment of Ebola experts, that West Africans and American healthcare workers returning from 'Ebola-infected countries' should be barred from entering the United States. During his campaign, he said that Mexican immigrants bring 'tremendous infectious disease' across the border, which is a lie. Given this history, we cannot dismiss the possibility that his administration would respond to an epidemic (real or feared) in a way that is sensational, discriminatory or ignorant of science," wrote the op-ed contributors.
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