Tom Frieden, the director of the U.S. Centers for Disease Control, said recently that there’s a very real possibility that someone infected with Ebola will enter the United States. However, he suggested the chances of a U.S. outbreak are highly unlikely, “it is a matter of isolating patients.” Can a patient with Ebola, or merely exposed to Ebola, be isolated or quarantined in Pennsylvania?
The U.S. Constitution prohibits the federal government as well as state governments from depriving individuals of specifically protected liberty rights. There are exceptions. In Pennsylvania, the health and well being of the community at large may supersede individual rights of freedom and liberty.
Although matters relating to public health have been left largely to individual states to manage, the federal government does have jurisdiction over cases where communicable disease is introduced into this country from a foreign source or to prevent or curtail the interstate movement of communicable disease.
In more than 40 years, only one person -- Andrew Speaker a newlywed form Georgia who was honeymooning in Europe in 2007 and contracted a drug-resistant form of tuberculosis — has been isolated under federal law.
In Pennsylvania the Disease Prevention and Control Law (DPCL) provides that the state Department of Health, county/municipal health departments or a local heath authority may — without court intervention -- order an individual quarantined or isolated if the individual poses a significant threat to the health of the public and no lesser restrictive means is warranted.
The DPCL defines quarantine as the “limitation of freedom of movement of persons ... who have been exposed to a communicable disease.” The limitations may continue for a period of time equal to the incubation period of the disease. Isolation is the separation of persons already infected, from other people to prevent direct transmission of disease.
"Ebola is so scary and so unfamiliar; it’s really important to outline what the facts are, and that we know how to control it," Frieden told NBC News.
In 2002, only months after the 9/11 attacks, the Pennsylvania Legislature went even further by enacting the Counterterrorism Planning, Preparedness and Response Act. The law provides the governor with authority to order the temporary isolation or quarantine of individuals or groups. The law was intended for use following a suspected act of bio-terrorism. The statute does not specifically preclude the law from being utilized during a pandemic.
The governor also has the authority to order a "cordon sanitaire" which is the quarantining of an entire town or city. Such an act by the government has serious civil rights implications. People who have no apparent manifestations of a disease are forced, against their will, to remain in an area where other people are infected.
Another concern is the cost of quarantine or isolation and who bears the responsibility for payment. A 1990 tuberculosis outbreak in Fort Worth, Texas, resulted in various levels and durations of quarantine and isolation for 10 patients. The cost reached nearly $1 million. Pennsylvania public health authorities may be required to provide reimbursement for costs associated with isolation or quarantine.
In Pennsylvania, the local health office may order treatment, put restrictions on an individual's movement, restrict an individual to his or her home, put the individual under surveillance or even isolate the individual in an institution to ensure compliance.
However unlikely an outbreak of Ebola may be in Pennsylvania, it appears the commonwealth has the tools to deal with it in an effective and efficient manner -- even if it means some civil rights get trampled in the process.
-- This post first appeared as a guest column in the Delaware County Daily Times on Aug. 22, 2014
(Image: A hazmat worker cleans outside the apartment building of a Texas health care employee who tested positive for Ebola after providing hospital care for deceased Ebola patient Thomas Eric Duncan. LM Otero/Associated Press)