Community Disease Containment During Pandemic FAQ
Answers to questions posed at the May, 2006 pandemic plan preview meetings.
What will be the legal basis/authority for law enforcement to enforce quarantine isolation?
The authority for enforcement is in Minnesota Statutes 144.4195 subd. 1(d) and subd. 2(c). The language is similar in both. Under subd. 1(d), any peace officer, as defined in section 144.4803, subdivision 16, may use force as described by sections 609.06 and 609.066 to apprehend, hold, transport, quarantine, or isolate a person subject to a court order of isolation and quarantine if the person flees or forcibly resists the officer. This subdivision is authority to carry out enforcement duties under this section. The commissioner of health or an agent of a local board of health must advise the peace officer on request of protective measures recommended to protect the officer from possible transmission of the communicable disease. The peace officer may act upon telephone, facsimile, or other electronic notification of the order from the court, commissioner of health, agent of a local board of health, or commissioner of public safety. This paragraph expires August 1, 2009.
Subd. 2(c) provides similar enforcement authority for a temporary hold for isolation and quarantine issued by the commissioner of health.
Who pays people to stay home? Who will enforce it and what will the penalties be?
Many employers are developing continuity of operations plans for use during a pandemic including personnel policies.
The isolation and quarantine statute contains a provision that prohibits the discipline or discharge of an employee who is in isolation or quarantine because of a written recommendation of the commissioner of health or an order. (see Minnesota Statutes 144.4196). There is no provision for payment but sick leave may be applicable.
How do you tell people to stay home if they live from paycheck to paycheck and missing one paycheck may mean starving, eviction or the loss of their car? Many of these people may not have sick or vacation days provided for by their employers.
Quarantine is imposed for the purpose of stopping or slowing disease spread, and thus, it can be a critical public health measure. At the same time, we recognize that quarantine will cause hardship to people. MDH is developing plans, with local public health, for mechanisms to identify and address the needs of people in quarantine without the resources to care for themselves. Social service and volunteer agencies will also play a critical role.
Why wait for Phase 6 to close schools instead of Phase 5? Why not begin Social Distancing in Phase 5? Why wait until Phase 6?
This will all depend on what is happening in the world. Changes in the WHO pandemic influenza alert phases are declared when the criterion for the next phase is reached anywhere in the world. Therefore, when pandemic phase 5 (evidence of significant human-to-human transmission) is declared by WHO, it is very likely that significant person-to-person transmission of pandemic influenza will not yet be occurring in the U.S. Therefore, it would be premature to close Minnesota schools at that time because such an act would not yet be useful for disease control.
MDH would be monitoring the situation closely and conducting surveillance for human cases of pandemic influenza. If human cases were identified in Minnesota and if there were significant person-to-person transmission in Minnesota, it is then likely that schools would be closed. However, it is also likely that at the time Minnesota reached phase 5, pandemic alert phase 6 (efficient and sustained human-to-human transmission) would have been declared by WHO due to disease activity in other countries.
In short, MDH would anticipate school closures in response to a combination of the WHO pandemic phase and disease occurrence in the U.S. and the state.
If a traveler enters the state with pan flu symptoms, who has authority to isolate the person and/or quarantine a plane full of people? What level of review would be done? Are we prepared to continue court resources to maintain due process?
The legal authority to isolate and/or quarantine individuals generally
rests with the state, and Minnesota has taken significant steps to prepare
for the possibility that we may have to exercise the police power of
the state to isolate or quarantine individuals. State law provides a
legal framework for isolating and quarantining individuals as necessary.
Ramsey County state court, which has statewide jurisdiction in this type
of case, has been involved in the planning to handle such an event. If
state action is necessary, immediate steps could be taken to isolate
and/or quarantine the infected/exposed people at the same time that appropriate
court orders are obtained, assuring individuals of
due process under the law.
If a person arrives in Minnesota via either an international or interstate flight and is identified in transit or upon arrival as possibly infected with or exposed to pandemic influenza, the CDC has authority to isolate or quarantine an individual administratively, without the necessity of going to court. CDC has a Quarantine Office at the Minneapolis/St. Paul International Airport. The CDC Officer in Charge or the CDC Medical Officer from the Quarantine Office could issue an administrative order after consultation with their federal headquarters. There will be avenues for challenges to orders – CDC has proposed new regulations on the process for review of isolation and quarantine orders. Minnesota may have concurrent jurisdiction with the federal government depending on the situation. State and federal agencies will coordinate the most appropriate legal response depending on the facts that require isolation and/or quarantine. Courts have begun to plan for continuity of essential operations during a pandemic.
If instituted, how long would I&Q last?
The duration of isolation or quarantine for an individual will depend on the epidemiology of the pandemic virus. Isolation of a case would be recommended for the period of infectivity. For quarantine, HHS has noted that the incubation period of a pandemic virus could be as long as 10 days. Once again, this time period may be adjusted as more is known about the virus.
During pan flu, public health will be asking the public to “social distance” themselves. The first wave can last up to 6-8 weeks. Placing decision makers in one room for 6-8 weeks does not make sense to me. Will EOCs need to be adopted to disease outbreak with minimal medical intervention?
Anyone who works during a pandemic should engage in social distancing practices. This includes public health officials who staff emergency operations centers. MDH will make recommendations for social distancing the in the workplace. In general, workers should avoid face-to-face meetings and communicate through other means.