Lately, there has been no shortage of news surrounding Coronavirus and its potential impact on the United States. When it comes to responding to a public health crisis, who is responsible for spearheading the response here in the United States? Like many legal questions, the answer is complicated.
A common response to a public health outbreak like the Coronavirus is to isolate and quarantine those affected in an effort to minimize the spread of the disease. The federal government has the power to isolate and quarantine under the Commerce Clause in the Constitution. More specifically, Congress has passed the Public Health Service Act that authorizes the Secretary of Health and Human Services to take measures to prevent the entry of spread of diseases from foreign countries into the United States. This authority has been legally delegated to the Centers for Disease Control (“CDC”).
This means, however, that the federal government’s power is strongest at the borders. In the case of Coronavirus, the CDC put in place a two-week quarantine for U.S. citizens seeking to return to the U.S. after travelling to certain areas of China where the spread of the disease began. Under federal regulations, CDC is authorized to detain, medically examine, and release those suspected of carrying the disease. This extends as far as detaining entire planes or ships coming in to the U.S.
Most of the isolation and quarantine work, however, is carried about by state and local governments that have the power to establish their own quarantine orders and enforce federal orders within their borders. This can lead to a varying degree of responses and compliance with decrees which make a uniform response to Coronavirus difficult.
This dynamic played out in California where Coronavirus patients who were taken off of a cruise ship were being held at an Air Force base. Federal and state officials wanted to move the patients to a hospital in Costa Mesa, California for quarantine, but Costa Mesa pursued a temporary restraining order to prevent any Coronavirus patients from coming to the city. The matter was left to a U.S. District Court judge in California for decision to resolve the conflict of competing interests.
The Constitutional question that remains is to what extent the federal government and CDC can step in to deal with the spread of disease between states within the U.S. Luckily, serious communicable diseases are not frequent problems, but, because of that fact, the law on proper authority is unsettled. While much is yet to be seen on how Coronavirus will affect the United States, how governments and courts wield their power will be something to watch.
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