Using quarantines as a disease-prevention tool began during the fourteenth century in an effort to protect coastal cities from plague epidemics. Ships arriving from infected ports were required to sit at anchor for 40 days before landing. Therefore, the practice of quarantine acquired its name from the Italian wordsquaranta giorniwhich literally means, ‘40 days.’
In 1944, with the passage of the Public Health Service Act (USPHSA), the federal government’s authority to quarantine was clearly established for the first time. In 1953, the Public Health Service became part of the Department of Health, Education, and Welfare (HEW), which later morphed into the Department of Health and Human Services (HHS). In 1967, the role of quarantine was later transferred to the National Communicable Disease Center now known as the CDC.
About the same time as the establishment of the USPHS, a list of communicable diseases that could be corralled using quarantines was declared in 1946 through ExecutiveOrder (E.O.) 9708, issued by President Truman. Periodically updated over the last 50 years, infections that have been explicitly listed since 1983 are cholera, diphtheria, infectious tuberculosis, plague (typhoid), smallpox, yellow fever, and viral hemorrhagic fevers (such as Lassa, Marburg, and Ebola).
On April 4, 2003, President Bush added SARS to the list of communicable diseases that could be quarantined through Executive Order 13295. SARS is described as “a disease associated with fever and signs and symptoms of pneumonia or other respiratory illness. It is transmitted from person to person predominantly by the aerosolized droplets and if spread in the population, would have severe public health consequences.” At the urging of the CDC, this description was kept intentionally vague. The language opens the potential for detaining mild to moderately ill persons completely against their will.
EO 13285 has been amended several more times since SARS was added. On April 1, 2005, EO 13375 added certain Influenza Viruses (that can cause a pandemic) to the list, and on September 17, 2021, Executive Order 13674 was revised to add measles to the list of quarantinable diseases.
Title 42 of the Public Health Service Act has many subsections. The regulations contained in Chapter 6A, Section G, called, “Quarantine and Inspection,” give the public health service full responsibility for preventing the transmission of communicable diseases. Prior to 2002, the steps were clearly defined: On the recommendation of aconsensus of the National Advisory Health Committee and in agreement with the US Surgeon General, the president would be notified of a disease thought to cause significant risk to the general population. The name of that disease would be added to the list of risky communicable diseases by an Executive Order. However, this chain of command was changed with the passage of the “Public Health Security and Bioterrorism Preparedness and Response Act of 2002,” also referred to as “The Bioterrorism Act.”
Section 142 of the Bioterrorism Act was rewritten to “streamline and clarify” previously established provisions regarding quarantine. The rules went from needing theconsensus of a National Health Committee to decide whether a disease warrants quarantine to only needing the opinions of two people in government: the Secretary of HHS and the US Surgeon General.
In the original provisions, the Surgeon General made the decisionsin consultation with the president and the Secretary of HHS. With the passage of the Bioterrorism Act, decisions can now be made by the Secretary of HHS “in consultation with the Surgeon General.” This is an important distinction. The Surgeon General is a medical doctor; the Secretary of HHS is a politician. Notably, both officials are appointeesand completely removed from accountability to the general public. Quite frankly, they have enormous power over the citizens of this country.
One of the most unnerving changes in The Bioterrorism Act of 2002 is the new definition of…
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