Wednesday, August 13, 2014

What Will Happen if Ebola Arrives in America?

Scott Gottlieb writes at Forbes:

Given the scope of the Ebola outbreak unfolding in Western Africa, it seems possible that a case will eventually emerge in the U.S. We could even see an isolated cluster of infections in an American city...

For most Americans, it may be the first time they glimpse the tools that our government has staked out over the last decade, as preparation for public health emergencies like a pandemic flu, or even bioterrorism. Some of these authorities are wholly necessary. Others will prove controversial and worthy of closer scrutiny.

Chief among them are authority maintained by the Centers for Disease Control to quarantine Americans suspected of having a dangerous, communicable disease. In some cases, this includes the power to isolate people, and hold a healthy person against his will. The CDC’s quarantine authority has been strengthened in recent years...

The response could include invocation of the CDC’s evolving quarantine authorities.

Updated quarantine regulations were first proposed in 2005 during the Bush Administration amid fears of pandemic flu. The regulations spelled out in detail how CDC would exercise its sweeping powers to involuntarily confine sick individuals and those believed to be exposed to certain deadly and contagious diseases...

 President Obama withdrew the Bush quarantine rule in 2010 because the provisions, when spelled out in regulation, proved controversial. Airlines, in particular, balked. Yet in its place the Obama Administration implemented a series of Executive Orders, and fell back on the CDC’s original quarantine provisions. The status quo could be just as troubling as the controversial regulation that it displaced.

The existing rules leave a murky and potentially intrusive scheme largely intact. The Bush era regulation laid out some spooky scenarios where people could be detained for long periods, merely on a suspicion they might have been exposed to some pathogen.  And forced to submit to certain medical interventions to gain their freedom. But the existing rules in force today leave possible these same scenarios – only without any protections that could be spelled out in clear regulations...

In the absence of clear, modern rules implementing CDC’s authority, there’s reason to worry that the current measures don’t readily afford the proper protections.

In the presence of a suspect case of Ebola, the official CDC website details ‘Specific Laws and Regulations Governing the Control of Communicable Diseases’, under which even healthy citizens who show no symptoms of the virus could be forcibly quarantined at the behest of medical authorities. The existing regulations stipulate, “Quarantine is used to separate and restrict the movement of well persons who may have been exposed to a communicable disease to see if they become ill.”

In other words, you don’t have to be sick to be detained. Just suspected by health officials of having been in contact with someone who might have had the disease...

Under involuntary quarantine, people only need to be held until they test negative for the suspected pathogen. But that can also include the period of time it would take for them to incubate the disease after an alleged exposure. In the case of Ebola, that could last weeks. Moreover, testing for Ebola could take some time as well.


  1. And it would be a very nice way to harass dissidents. Imagine that every time you fly you get detained for weeks on suspicion of being ill with some nasty disease.

    1. And make sure they get it while in captivity.

    2. I was planning on spending October in NYC, but changed plans last week. I'd rather be in a small(ish) city with access to isolated family farmland than risk this shit going nova.

      Please, God, don't let this go NOVA. millions (billions?) of dead bodies is NOT my idea of a fun birthday!

  2. Aesome, and equally hilarious, review. Much appreciated.

  3. Hmmm obviously wrong thread. No need to approve!
    Though Ebola is delicious.