A Missouri man who has been accused of breaking a self-quarantine as a family member was sickened with the new coronavirus was admonished by officials who warned that if it happened again, he and his family would be required to stay put "by the force of law."
Does that mean someone could face prison time for breaking a quarantine? In some cases, yes.
"Isolation for public health purposes may be voluntary or compelled by federal, state, or local public health order," the federal Centers for Disease Control and Prevention says on its website.
People with high risk of exposure to the virus causing COVID-19 – for example, they've traveled to China's Hubei province or live with a symptomatic person without taking the recommended precautions – could face quarantine or isolation under public health orders, the CDC says.
Isolation occurs when a person is known or believed to be infected with a disease and potentially infectious. It's the process of separating known sick people from those who are known to be not sick. An isolated person is usually told to stay in a separate room from other people in their homes and use a separate bathroom.
Quarantine occurs when a person may have been exposed to a disease but is not symptomatic. It restricts their movement to see if they become sick.
Like the Missouri case, many cases of quarantine or isolation amid the coronavirus outbreak have been recommended without the force or law. Breaking these quarantines does not mean jail time or fines.
St. Louis County Executive Sam Page said the man and his family were asked to self-quarantine when his daughter became symptomatic. Page said officials relied on "common sense and goodwill," assuming the whole family would comply.
The father and his other daughter went to a school dance Saturday. According to KTVI-TV, the two left the dance after they learned of the presumptive positive test result that day.
However, the lawyer representing the man and his family said health officials didn't tell the entire family to self-quarantine, only the daughter. Attorney Neil Bruntrager told the St. Louis Post-Dispatch the family wasn't instructed about what to do until Sunday.
Who has the authority to impose quarantine or isolation?
According to the CDC, the Commerce Clause of the U.S. Constitution grants the federal government isolation and quarantine authority.
The secretary of Health and Human Services can take actions to prevent the spread of communicable disease from foreign countries into the U.S. and between states.
For example, American passengers on Princess Cruises' Diamond Princess were evacuated and brought to U.S. military bases for 14-day quarantines.
Within states' borders, state and local health officials have quarantine and isolation enforcement power, the CDC says.
"These laws can vary from state to state and can be specific or broad. In some states, local health authorities implement state law. In most states, breaking a quarantine order is a criminal misdemeanor," the CDC wrote.
In New York, mandatory or precautionary quarantines or isolations may be imposed amid the coronavirus outbreak. According to the Staten Island Advance, under a mandatory quarantine or isolation, health officials must visit the home at least once a day and be in electronic contact once a day. Precautionary quarantines require only electronic communication.
"When we say you are on precautionary quarantine, that is a serious situation. We are assuming that you will act in good faith and that you will be following the rules of voluntary quarantine," New York Gov. Andrew Cuomo said, according to the newspaper.
According to a paper in 2018 in the Journal of Public Health Management and Practice, most states allow a person to have a hearing concerning a mandatory quarantine, though few allow the person to choose his or her medical provider.
What happens if you break a quarantine or isolation?
Fines and imprisonment are possible punishments for breaking a federal quarantine, the CDC says; however, federal quarantines are rarely used.
On state and local levels, the laws vary. More than half of states have "police powers" to enforce public health actions, according to the Journal of Public Health Management and Practice paper.
Violating Michigan's Public Health Code means a person could face fines up to $200 and up to six months in jail or both, said Lynn Sutfin, a spokeswoman for the Michigan Department of Health and Human Services.
"The penalty for a violation of the code, an order of a local health officer or an order of the department is a misdemeanor," she said.
Contributing: Kristen Jordan Shamus, Detroit Free Press
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