EbolaLegality of mandatory quarantine of asymptomatic individuals questioned

Roughly three decades ago, patients in New York were forced into isolation after an outbreak of tuberculosis, and about seventy years before that, an influenza pandemic led to mass quarantine in major American cities. Today, fear of an Ebola outbreak in the United States has led some states to mandate quarantine of individuals suspected of having the Ebola virus, but legal analysts question the legality of such measures. “Coercive measures like mandatory quarantine of people exhibiting no symptoms of Ebola and when not medically necessary raise serious constitutional concerns about the state abusing its powers,” said Udi Ofer, executive director of the ACLU of New Jersey.

New Jersey governor Chris Christie and New York governor Andrew Cuomo recently announced that individuals returning from an Ebola-infected country would be quarantined at home for three weeks. “The protocol is clear that a New Jersey resident with no symptoms, but who has come into contact with someone with Ebola, such as a health care provider, would be subject to a mandatory quarantine order and quarantined at home,” said Christie spokesman Kevin Roberts. “Nonresidents would be transported to their homes if feasible and, if not, quarantined in New Jersey.” Some federal health officials and the White House have said that such measures could discourage potentially sick patients from coming forward.

On Saturday, Cuomo responded to questions on the legal challenges of forced quarantine. “Could you have a hostile person who doesn’t want to be quarantined?” He said during a campaign appearance in Queens. “I suppose you could. But that hasn’t been the case yet.” On whether those refusing to be quarantined could face arrest or prosecution, “It’s nothing that we’ve discussed, no,” Cuomo said.

Nurse Kaci Hickox, who was quarantined in New Jersey upon returning from Sierra Leone, but now released after showing no symptoms of Ebola, said she is considering a legal challenge to her confinement. “My human rights have been violated, and we must react in order to ensure that other health care workers do not endure such injustice,” she wrote in an e-mail to theNew York Times.

Donna E. Lieberman, the executive director of the New York Civil Liberties Union, said forced quarantine measures are too broad. “The current order is sweeping in individuals who are asymptomatic and who may never develop symptoms,” 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.

Forced quarantine of a whole class of people is unprecedented in modern American history. Lawrence O. Gostin, a professor of global health law at Georgetown University, said the 1918 influenza pandemic would be the most recent example of the blanket approach to quarantine announced in New Jersey. “This is, I think, pushing the envelope quite a bit and is highly counterproductive,” Gostin said. “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.”

 The U.S. Army has announced that troops returning from deployments to Liberia would be quarantined so they can be monitored for possible exposure to the Ebola virus. ABC News reports that the order immediately affected about a dozen soldiers who returned to their home base in Italy this weekend, including Maj. Gen. Darryl Williams, the former top U.S. commander in Liberia.

“Out of an abundance of caution the Army directed a small number of personnel, about a dozen, that recently returned to Italy to be monitored in a separate location at their home station of Vicenza,” Col. Steve Warren, a Pentagon spokesman, said yesterday. “None of these individuals have shown any symptoms of exposure.”

 The Army later released a statement confirming that the decision was made by Gen. Ray Odierno, the Army chief of staff.

“The Army Chief of Staff has directed a 21-day controlled monitoring period for all redeploying soldiers returning from Operation United Assistance,” the statement said. “He has done this out of caution to ensure soldiers, family members and their surrounding communities are confident that we are taking all steps necessary to protect their health.”