Sunday, October 26, 2014

As States Look to Halt Ebola, Restrictions Prompt a Debate
Illustration of the Ebola virus.
New York Times
OCT. 26, 2014

It was nearly 100 years ago that an influenza pandemic led to sweeping quarantines in American cities, and it was more than two decades ago when patients in New York were forced into isolation after an outbreak of tuberculosis.

In modern America, public health actions of such gravity are remarkably rare, and the decisions by New York and New Jersey on Friday to quarantine some travelers returning from the Ebola zone in West Africa are taking public officials into unfamiliar legal and medical territory.

From public health advocates and civil liberties lawyers has come sharp criticism, and the first person to be detained under the new protocol, a nurse who was quarantined in New Jersey upon returning from Sierra Leone, lashed out on Sunday at Gov. Chris Christie as her lawyer said he would mount a legal challenge to her confinement.

Mr. Christie on Sunday defended his policy, and Florida and Illinois have ordered similar restrictions. In Connecticut, nine people who may have been exposed to Ebola have been confined to their homes under an order signed by Gov. Dannel P. Malloy on Oct. 7.

But on Sunday night, barely two days after his joint announcement with Mr. Christie, Gov. Andrew M. Cuomo of New York announced his state would not go as far as New Jersey has.

The nurse, Kaci Hickox, said on Sunday in an interview with CNN that she felt her “basic human rights have been violated.”

Donna E. Lieberman, the executive director of the New York Civil Liberties Union, said the most restrictive protocols are far too broad.

“The current order is sweeping in individuals who are asymptomatic and who may never develop symptoms,” Ms. Lieberman said. “I think there is a serious question as to whether the governor has the authority to impose the broad quarantine that he has imposed,” she added.

The quarantine by New Jersey of medical workers returning from Ebola-afflicted areas of West Africa is virtually without precedent in the modern history of the United States, public health and legal experts said on Sunday.

“This is, I think, pushing the envelope quite a bit and is highly counterproductive,” Lawrence Gostin said, a professor of global health law at Georgetown University who has studied the legal issues around quarantining Americans. “I can’t think of a situation where any jurisdiction in the United States in modern times has simply quarantined a whole class of people.”

In a new era of mass travel and global pandemics, public health officials have seen the utility of quarantines to rein in outbreaks that appear to be spiraling out of control. But the approach, experts said, is an extreme one.

“It doesn’t seem like we’re to that stage yet,” said Steven D. Gravely, who helped Virginia rewrite its laws on quarantine to make it easier for the state to respond quickly to disease outbreaks. Instead, he said, “there’s so much anxiety right now, that’s become the problem.”

Government officials, he added, need to explain “why are you doing this, what do you hope to accomplish. Because otherwise people read into it things that are not there.”

The power to impose quarantine derives from the general police power granted to states in the Constitution. But over the last century, state and federal authorities have moved away from blanket applications of categories of people, said Dr. Gostin, adding that one would have to reach back to the influenza pandemic of 1918 to find a parallel for the sort of blanket approach being employed in response to Ebola in New Jersey.

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