Quarantine also creates severe stigma. In 2014, two public-health workers and a family of six Liberian immigrants were quarantined in Connecticut. “Though none had been exposed to Ebola or posed any threat to public health, the state confined these individuals to their homes for weeks,” write Roth and Edwards, who represented them. “The state failed to provide these individuals with food or other basic necessities and failed to inform some that they had the legal right to challenge their quarantine orders in court. To this day, Liberian Americans in Connecticut experience shame and stigma as a result of wrongly being labeled a threat to public health.”
By contrast, other states used far less restrictive measures, like daily phone calls with health workers. That proved to be just as effective. Rather than immediately shooting for quarantines, the CDC could amend their rule to use such options where possible.
How the CDC will react to these criticisms is unclear. They left the rule online for a two-month period of public comment that ended on October 14. “Important people in this field did not know about this until the comment period had closed,” Nuzzo says. “If I was the CDC, and wanted to put these regulations through and make them as good as possible, I wouldn’t publish an 88-page document and hope whoever needs to know sees it in 2 months.”
Still, the agency received 15,794 comments. The vast majority of these were crank-like and incoherent, says Hodge, who reviewed them all. Around 500 to 600 were meaningful, and came from health agencies like Doctors Without Borders, legal scholars, the airline industry, and more. The CDC has to respond to these and then issue a final rule, which must be approved by senior members of the Department of Health and Human Services, and potentially by the President.
In a statement, Kathy Harben, from the CDC’s Division of Public Affairs, said: “During this active rule-making period, we are unable to discuss the proposed rule or disclose how CDC will respond to the public comments. CDC will carefully review and consider each comment before publication of a final rule.”
But Hodge says, “We were given some inside information that they’re trying to push this through prior to the change in administration.” That’s not comforting, given President-Elect Donald Trump’s documented responses to outbreaks of the past. During the Ebola outbreak, as I noted in a recent article, he: promoted false information about the disease; repeatedly called for the U.S. to stop all flights from Ebola-infected countries; and said that American health workers who became infected should be stopped from re-entering the country and “must suffer the consequences.” These statements provide little reassurance that he will respect scientific evidence or civil liberties during a future crisis.
The CDC came out against travel bans at the time, but their new regulation—though well-intentioned—might pave the way for similarly Draconian measures. “Its regulations inadvertently create a space for decisions that are not evidence-based and might violate constitutional liberties and principles of health ethics,” says Phelan. “It’s a space where ideology can play out.”
* This article originally misstated Craig Spencer’s name as Richard Spencer. We regret the error.