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New Quarantine Authority Gives CDC More Power To Stop Outbreaks


When Ebola broke out three years ago in West Africa, an old public health tool proved key - quarantine. It can help contain the spread of a deadly disease. Of course, the act of detaining someone, possibly against their will, can be controversial. That's why a move expanding the Centers for Disease Control and Prevention's quarantine powers has people paying attention in the public health world and beyond, as NPR's Rob Stein reports.

ROB STEIN, BYLINE: When an outbreak of a dangerous, contagious disease erupts, one of the most powerful weapons the government has to protect the public is the quarantine, but it's rarely used.

LAWRENCE GOSTIN: It's really a quite, I would say, draconian public health measure - the most draconian measure.

STEIN: Lawrence Gostin is a public health law expert at Georgetown.

GOSTIN: Because it allows you to literally imprison somebody who you don't know for sure is a danger to the public. You just have a reasonable belief that they've been exposed.

STEIN: But, Gostin says, quarantines can be key to stopping people from spreading deadly bugs, so Gostin says the CDC's decision to update its quarantine powers is long overdue.

GOSTIN: We know that the United States is vulnerable to a whole range of infectious diseases that are circulating around the world, but we don't know which one will be next. And so when something sweeps upon our shores, we don't want to have a delay and political debate.

STEIN: Under the old rules, the CDC could only quarantine people if they tried to enter the country or cross state lines. And even then, the CDC generally let state and local health officials take charge. But public health experts like James Hodge of Arizona State University have long felt that those rules were outdated, so at the end of the Obama administration, the CDC announced it was changing all that. Under the new rules, the CDC could...

JAMES HODGE: ...Apprehend, quarantine, isolate, test and screen individuals - both foreign travelers coming into the United States and citizens within the United States - without having to seek state or local permission or approval to do so.

STEIN: The new rules would also let the CDC detain people who just have symptoms of dangerous diseases.

HODGE: Because of the breadth and scope of the definition of ill persons, CDC can target a much wider swath of persons to assess and screen. It can conduct its apprehension, quarantine and isolation measures both on an individualized basis, like that one person who is on a train that they need to pull off the train, but also on a group basis - that entire flight of individuals.

STEIN: But these strong new powers make some people very nervous. Experts like Wendy Parmet at Northeastern University say the rules just go too far.

HODGE: It could represent a great danger to Americans health and civil liberties.

STEIN: For example, sick people might hide their symptoms to avoid getting detained. And Parmet worries the new rules don't provide nearly enough safeguards to prevent abuse. The CDC gets a lot of power to decide whether it can keep holding people before they can appeal.

HODGE: The concern is that unless these regulations are carried out with care and by people who act based on science, that they can be used to trammel the civil liberties of Americans.

STEIN: Parmet us especially concerned that the CDC's new powers are supposed to kick in just as the Trump administration is taking over. During Ebola, Trump tweeted that American doctors and nurses who got sick in Africa should be prevented from returning home for medical care. The president's also a self-described germophobe. But Gostin of Georgetown says that while the new rules aren't perfect, they do create a modern appeals process for the first time.

GOSTIN: If you're a germophobe, then you're going to overreact, and the last thing we want in the face of a public health crisis is overreaction. And I think having rules in place that are modern at least will provide some buffet against the whims of an administration that may overreact.

STEIN: The CDC did not make anyone available to talk about all this. There's a chance the new administration could delay or completely block the new regulations from going into effect. But if that doesn't happen, the CDC will get these new quarantine powers by the end of March. Rob Stein, NPR News. Transcript provided by NPR, Copyright NPR.

Rob Stein is a correspondent and senior editor on NPR's science desk.