- Federal health officials have ordered 14-day mandatory quarantines for individuals returned from the Hubei province in China.
- Four more flights filled with Americans are en route from Wuhan, China, and scheduled for quarantine.
- Quarantine is a drastic measure that should only be enforced when necessary to contain an outbreak, public health experts and human rights advocates say.
Jarred Evans spent his fourth night of quarantine on the March Air Reserve Base with the 194 other Americans he was evacuated with last week from Wuhan, China, the epicenter of the coronavirus outbreak.
Evans, who plays professional football for the Wuhan Berserkers in the Chinese National Football League, and the other evacuees at the Department of Defense facility shared a buffet of chicken wings, pizza and other snacks as they watched the Kansas City Chiefs take out the San Francisco 49ers in a nail-biting game across three big-screen televisions.
"We're playing card games, watching television, running outside, riding bikes, playing Frisbee," he said before Sunday's game over the phone. "You know, just the usual things to keep busy."
Evans and the other Americans at the base in Riverside, California, were the first U.S. citizens to be quarantined by the federal government since the 1960s, health officials said last week. The evacuees were initially asked to voluntarily stay at the base while medical tests were carried out, officials said. But two days later the CDC announced it was taking the "unprecedented action" of ordering a 14-day mandatory quarantine on the 195 passengers.
"Quarantining somebody is an extraordinary deprivation of their liberties," he said. "There's a burden on the government to determine that it's really using the least restrictive alternative."
Ordering someone into quarantine can put them at risk of losing their job and disable them from providing for dependents, Stanley said, adding that the threat of quarantine could deter sick people from seeking treatment. In this case, quarantine means the separation of someone who is not sick because they may have been exposed to the virus.
Evans said he was shocked when he was told about the mandatory quarantine. He wanted to go home, see his family and get ready to join a new football team in Switzerland later this month, he said.
"I think everybody wants to leave," he said. "We all want to get back to our families, get back to our personal lives, but we're all definitely understanding of the situation and how it's more than about just us, personally."
After it was announced that Evans and the others on the base were under a federal quarantine order, Department of Health and Human Services Secretary Alex Azar expanded mandatory quarantines to any U.S. citizen who visited Hubei province in the previous 14 days. On Monday, the Pentagon said it has prepared four facilities for up to 1,000 more evacuees from Wuhan who will face quarantine.
As of Wednesday, the virus has infected more than 24,300 people in over two dozen countries, killing at least 490 people. World Health Organization experts on Tuesday emphasized how little is still known about the virus, how it spreads and how fatal it is. Stanley said with so little known about the virus right now, the U.S. government cannot justify such drastic measures.
Four more flights filled with Americans are en route from Wuhan, CDC officials said Wednesday. Those passengers will also be held under quarantine at four different military bases across the U.S.: Camp Ashland in Nebraska; Travis Air Force Base in California; Marine Corps Air Station Miramar in San Diego and Lackland Air Force Base in Texas.
"The bottom line is these kinds of policies need to be based on science and not politics," Stanley said. "Is this a policy that originated with scientists or from politicians? Was this driven from the CDC or did it originate in the White House?"
CDC describes its authority to enforce quarantine as a "police power" to affect individuals for the benefit of society. The Public Health Service Act, which broadly empowers the government to prevent the spread of disease, includes language specifically identifying the family of viruses known as coronavirus as a disease that could justify mandatory quarantine orders.
With only 11 confirmed cases in the U.S. so far, though, Stanley said there was little reason to issue such sweeping quarantine orders.
"Quarantine can be a justifiable public health measure," he said, "but it has to be based on science."
The recent quarantine orders call to mind similar measures taken to contain the spread of Ebola in 2014, said Amy Kapczynski, co-director of the Global Health Justice Partnership at Yale Law School. During that outbreak, state officials acted without federal authority to forcibly quarantine American health-care providers returning from the epicenter of the outbreak in West Africa.
"The Ebola quarantines were a really disproportionate response to a lot of fear," Kapczynski said. "What was really notable in the Ebola context was both that there was no scientific justification for the quarantines and the ones that were imposed were often imposed in a way that really didn't respect the people that were being put into quarantine."
The Ebola quarantine orders were unnecessary, Kapczynski said, because that disease did not transmit before symptoms appeared, meaning that healthy-looking individuals could not unwittingly spread Ebola. There is growing evidence, however, that the new coronavirus can spread before symptoms emerge.
"We need to make sure the science leads us in terms of what is going to be effective and what is really necessary and not engage in security theater," she said. "One of the few times that a quarantine could be necessary would be when there is asymptomatic transmission."
Beyond the mandatory quarantine orders, Kapczynski is concerned about the government's self-quarantine orders for Americans recently returned from all of mainland China. HHS Secretary Alex Azar called for any American who has traveled to mainland China in the two weeks prior to the order taking affect to "self quarantine." Kapczynski said it's not clear what this means or how it will be enforced.
"I think what they're calling the 'self quarantine' side of this is much murkier," she said. "Are people going to be ordered to stay in their homes? Are they going to be supported and taken care of if they do so? People may well lose their jobs if they can't go to work for two weeks, so what will be done for people who are in more precarious circumstances?"