States, Cities Jump In With Virus Decrees As U.S. Holds Off
If Coronavirus Closes Schools, It Won’t Be the Feds Who Order It
(Bloomberg) --
California demanded an on-board quarantine for 3,400 passengers and crew on a cruise ship. Ohio scrapped most of a fitness convention. And Austin, Texas, canceled the popular SXSW conference that typically draws 150,000 people.
The actions on coronavirus shows that in the U.S., states and localities take the lead in combating epidemics. Federal authorities follow.
“The state and local public health departments are the leaders in the country on any type of response like this,” Health and Human Services Secretary Alex Azar told reporters. “We get our information from them. They’re experts. We provide background support. We surge in to help them.”
That’s different from other nations. As examples, Italy restricted movement for a quarter of its citizens, Japan shut schools nationwide, France banned large indoor gatherings, and China isolated an entire province to fight the coronavirus. Israeli Prime Minister Benjamin Netanyahu declared a 14-day quarantine for all arrivals.
But when an outbreak was detected on Carnival Corp.’s Grand Princess cruise ship in the waters off San Francisco, it was California officials who demanded it be quarantined. The vessel docked Monday after days circling offshore. In Florida, state health officials on Monday briefly told all arriving international travelers to stay home, then narrowed the advice to those coming from high-risk countries including China, Iran, Italy and South Korea.
Elsewhere, Ohio officials canceled the bulk of a fitness convention backed by Arnold Schwarzenegger, New York City was monitoring 2,770 people in home isolation, and the city of Austin, Texas decided to cancel the popular SXSW conference.
California Governor Gavin Newsom has said it was a “question of when” and not if some California schools will be closed due to the coronavirus outbreak.
Federal authority has reigned over international travel, though. The Trump administration has restricted flights from China and Iran to prevent infected people from entering the country. It’s also set up health screening at some airports, and loosened rules to accelerate testing for the virus.
Still, states are “where the action is,” said James Hodge, a law professor at Arizona State University.
“It’s where the manpower is. They have a very broad public health authority. They can do almost whatever they want,” Hodge said.
The federal government can demand stepped-up enforcement of quarantines and isolation orders if it finds states haven’t acted forcefully enough, said Efthimios Parasidis, a professor of law and public health at The Ohio State University.
But the limits of such powers aren’t clear. “The extent of federal power has never been tested in the context of a public health crisis,” Parasidis said.
Foreign Travel
The federal government can bar interstate and foreign travel to prevent the spread of disease, and can issue waivers during emergencies -- for instance, allowing the use of unproven drugs. It can also force quarantines, ground flights and seize contaminated property.
Most of the time the relationship is cooperative. The federal Centers for Disease Control and Prevention, along with California authorities, were deciding where to send Carnival’s infected ship. And Washington Governor Jay Inslee declared at a news conference with Vice President Mike Pence that “we have a good partnership” with the federal government. That state has been the hardest hit so far.
“The federal-state balance that we’ve consistently utilized in public health emergencies can play out very effectively and is so far playing out reasonably well, despite some gaffes and miscues,” Hodge said.
In Ohio, state officials stepped in to bar most attendance as Schwarzenegger’s Arnold Sports Festival brought the prospect of tens of thousands at a crowded exposition last week. Governor Mike DeWine cited the “unique and unacceptable risk” for the spread of the virus. There have been no known confirmed virus cases in Ohio, but the event attracts people from across the U.S. and other countries.
School Closings
Decisions about school closings normally are left to localities.
“The feds can talk tough and might say things like, ‘We expect pursuant to CDC guidance that all states will close schools in the latter half of March and keep them closed,’ as we’re seeing in Japan,” said Hodge. “But in the end, can the feds physically go into a state and shut down state-owned and operated schools? I don’t think so.”
Federal involvement can expand dramatically, though, if a national emergency is declared. Even without a declaration, the secretary of health and human services can establish quarantines, help needy families, and allow medicine to be dispensed without a prescription. A declaration gives the secretary more power: for instance, to award grants. With a presidential declaration, the federal government gains freedom to quickly hire people and distribute food, medicine and supplies.
“They can do anything they want” during emergencies, said Howard Markel, a professor of the history of medicine at the University of Michigan. “They can confine you, they can put you in mandatory quarantine. They can close down a city, they can close down airports, train stations.”
Markel called such steps “the nuclear option of public health.”
There are reasons to be cautious with federal authority, said Parasidis, the Ohio State professor. For example, there was a “public health catastrophe” in the 1970s brought on by a swine flu outbreak at Fort Dix, New Jersey, that killed one person and hospitalized 13.
“There, the federal government over-reacted and instituted a national immunization program,” Parasidis said. “But the vaccine did not have a thorough safety review, and ended up causing thousands of serious adverse reactions and dozens of deaths.”
--With assistance from Ryan Beene, Peter Blumberg, Jeannie Baumann and David R. Baker.
To contact the reporters on this story: Todd Shields in Washington at tshields3@bloomberg.net;Billy House in Washington at bhouse5@bloomberg.net
To contact the editors responsible for this story: Jon Morgan at jmorgan97@bloomberg.net, Elizabeth Wasserman
©2020 Bloomberg L.P.