\n<\/p>\n
The Trump administration is employing \u201cauthoritarian\u201d and \u201cunconstitutional\u201d quarantine measures for at least one person who came into contact with a hantavirus patient, health law experts say.<\/p>\n
The mandatory quarantine, reimposed without an offering scientific evidence, reveals how the US might approach future cases of Ebola and other pathogens in the US \u2013 and sets a precedent for detaining Americans with no scientific rationale.<\/p>\n
\u201cCavalierly detaining somebody for no good reason, no crime and no significant public risk\u201d is \u201carbitrary, it\u2019s capricious and it\u2019s unjust\u201d, said Lawrence Gostin, health law professor at the Georgetown University law center.<\/p>\n
James Hodge, a professor and director of the Center for Public Health Law and Policy at Arizona State University\u2019s Sandra Day O\u2019Connor College of Law, said that health officials should never \u201cuse unconstitutional, ill-advised, unproven techniques to control infectious diseases\u201d.<\/p>\n
This incident could become \u201creally damaging\u201d for public health, particularly as the Ebola outbreak rages in the Democratic Republic of the Congo (DRC) and cases could arise in the US, said Hodge.<\/p>\n
\u201cWait and watch for it, because we\u2019re probably going to see that later this summer. CDC set a terrible precedent right now with the specific hantavirus cases, and I only hope that we\u2019ll see improvements for that to come,\u201d he said.<\/p>\n
Angela Perryman, an American passenger on the MV Hondius cruise ship, came into contact with another passenger who was sickened by Andes virus, a type of hantavirus. She has attempted to appeal a federal order to quarantine in a North Dakota facility, asking instead to self-quarantine in Florida.<\/p>\n
The US Centers for Disease Control and Prevention (CDC) has asked states to provide in-person symptom checks and round-the-clock guards for the passengers, an unusual move \u2013 especially for a pathogen like the Andes virus that is typically only transmitted between people in rare cases.<\/p>\n
\u201cIt just isn\u2019t the type of thing that you tend to have to quarantine for as tightly as what we\u2019re seeing here,\u201d Hodge said.<\/p>\n
Some states acquiesced to the requirement and 10 other passengers have returned home to self-quarantine. Florida refused these conditions.<\/p>\n
Michael Bell,deputy director of the division of healthcare quality promotion (DHQP) at the CDC, recently concluded that Perryman could effectively quarantine at home with daily remote symptom monitoring and access to public health support, according to a copy of his analysis obtained by Inside Medicine.<\/p>\n
But on 15 June, Robert F Kennedy Jr, secretary of the US Department of Health and Human Services (HHS), overrode that conclusion and continued the mandatory quarantine. He cited no scientific rationale for the decision in his order, which was also shared by Inside Medicine.<\/p>\n
Kennedy\u2019s decision to overrule the medical advice of the CDC is \u201cunprecedented\u201d, Hodge said, adding that it acts as \u201ca very bad precedent for just how Americans might expect to be treated if they\u2019re coming back to the United States with highly infectious or even semi-infectious conditions\u201d.<\/p>\n
Kennedy \u201cspecifically considered the medical recommendation before deciding to continue the current order\u201d, said HHS spokesperson Courtney Spencer.<\/p>\n
\u201cIn the absence of proper home monitoring by state authorities, the administration\u2019s quarantine order is necessary to ensure both Ms Perryman\u2019s and her community\u2019s wellbeing,\u201d she added.<\/p>\n
The agency did not answer the Guardian\u2019s questions about why Kennedy overruled the CDC and whether this sets an unconstitutional precedent for responding to other pathogens.<\/p>\n
Officials are meant to use the least restrictive option available to contain health threats in public health. That means that when there are multiple options that are effective in limiting spread, \u201cyou take the one that\u2019s less restrictive on civil liberties violations or infringements\u201d, Hodge said.<\/p>\n
The situation is \u201chighly atypical\u201d for the CDC, Hodge said. Usually, state and local officials set quarantine and isolation measures; the CDC may offer guidance on doing so. But now, \u201ceven when state and local governments have been willing to take over the mantle\u201d of managing some of these cases, \u201cCDC has been reluctant to let them out\u201d, Hodge said.<\/p>\n
Both Gostin and Hodge were closely involved in drafting the CDC\u2019s updated quarantine rules in 2017, and they opposed allowing the HHS secretary to overturn the agency\u2019s medical review. While the rules allow the secretary to take this step, \u201cit\u2019s just unconstitutional\u201d, Gostin said.<\/p>\n
\u201cI was assured that this would be very rare, and this was not supposed to happen. This wasn\u2019t supposed to work like this. There is a flagrant violation of her constitutional rights,\u201d Gostin added.<\/p>\n
Part of his objection is over the lack of accountability. \u201cSecretary Kennedy issued the order, and he\u2019s reviewing his own order, which is outrageous,\u201d Gostin said. \u201cYou\u2019ve got a political appointee reviewing his own order, providing no evidence or reasons \u2013 a person\u2019s liberty should not hinge on a political calculation, and that\u2019s exactly what this is.\u201d<\/p>\n
Officials are required to provide scientific justification for quarantine orders, Hodge said: \u201cThat\u2019s a constitutional requirement. This is exactly what Congress expects.\u201d<\/p>\n
Heavy-handed requirements \u2013 such as institutional quarantine for hantavirus or banning travelers from the DRC, Uganda and South Sudan, for instance \u2013 will likely lead to people evading the rules or not providing sufficient information about their activities, making it harder for public health officials to follow up on possible cases or contain outbreaks at the source, Hodge pointed out.<\/p>\n
\u201cThe threat is not knowing cases that are actually out there, because we created a climate to which people would not self-report for this. That would be the biggest threat,\u201d Hodge said.<\/p>\n
It also signals a dangerous \u201cauthoritarian\u201d approach from top health officials, Hodge said \u2013 despite previous opposition from those leaders to unspecified \u201clockdowns\u201d from the Covid pandemic.<\/p>\n
\u201cThe hypocrisy is almost unreal,\u201d Gostin said. \u201cThe whole raison d\u2019etre of Secretary Kennedy\u2019s tenure has been based upon medical freedom, \u2018the patient gets to choose\u2019, and yet here they\u2019re issuing immediately a compulsory deprivation of liberty.\u201d<\/p>\n
Officials in the Trump administration, like Kennedy and Jay Bhattacharya, director of the National Institutes of Health, have castigated the Biden administration and blue states for their handling of Covid, a much more transmissible and novel virus, Gostin said: \u201cYet their first response is not public health, it\u2019s not science, it\u2019s coercion.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
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