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A Rare Legal Battle: Can a State Force a City to House Coronavirus Patients? A Rare Legal Battle: Can a State Force a City to House Coronavirus Patients?
(about 4 hours later)
In the 19th century, towns across the American South guarded themselves against yellow fever by refusing to allow anyone in. And in 1918, some towns shut down transportation and set up quarantines to keep out the Spanish flu.In the 19th century, towns across the American South guarded themselves against yellow fever by refusing to allow anyone in. And in 1918, some towns shut down transportation and set up quarantines to keep out the Spanish flu.
But in outbreaks of disease since, states have largely asserted themselves as the authorities in the fight against contagion. Any battles with local officials over where infected people should stay have largely taken place behind the scenes.But in outbreaks of disease since, states have largely asserted themselves as the authorities in the fight against contagion. Any battles with local officials over where infected people should stay have largely taken place behind the scenes.
So the situation that unfolded on Monday in a packed federal courtroom in Santa Ana, Calif., was unusual: The city of Costa Mesa was pleading that a judge block California from moving people infected with the new coronavirus into a state-owned facility in the city, where they would remain in isolation while recovering.So the situation that unfolded on Monday in a packed federal courtroom in Santa Ana, Calif., was unusual: The city of Costa Mesa was pleading that a judge block California from moving people infected with the new coronavirus into a state-owned facility in the city, where they would remain in isolation while recovering.
“This is a new one in terms of claiming a right not to have infectious disease introduced into your community,” said Polly Price, a professor of law and global public health at Emory University. Although cities and towns once claimed “an absolute right” to guard against disease, she said, state-level control over isolation and quarantine has been the norm for more than a century.“This is a new one in terms of claiming a right not to have infectious disease introduced into your community,” said Polly Price, a professor of law and global public health at Emory University. Although cities and towns once claimed “an absolute right” to guard against disease, she said, state-level control over isolation and quarantine has been the norm for more than a century.
In a decision that could complicate California’s efforts to deal with the coronavirus crisis, Judge Josephine L. Staton on Monday kept a temporary restraining order in place that would prevent the infected patients from being moved to Costa Mesa, at least for now. The judge said she would reconsider the issue after state and federal authorities provide more details about how they plan to protect the health of the community, as well as the people with coronavirus. She set a hearing for March 2.In a decision that could complicate California’s efforts to deal with the coronavirus crisis, Judge Josephine L. Staton on Monday kept a temporary restraining order in place that would prevent the infected patients from being moved to Costa Mesa, at least for now. The judge said she would reconsider the issue after state and federal authorities provide more details about how they plan to protect the health of the community, as well as the people with coronavirus. She set a hearing for March 2.
“The state has shown great empathy for the patients,” the judge said in a ruling that drew applause, adding that she wanted to see “the same empathy for the residents of Costa Mesa.”“The state has shown great empathy for the patients,” the judge said in a ruling that drew applause, adding that she wanted to see “the same empathy for the residents of Costa Mesa.”
It was uncertain exactly how many people California intended to move into the facility in Costa Mesa, but they are among the 53 people in the United States who have tested positive for the virus, according to the Centers for Disease Control and Prevention. Nearly all of those people had traveled to Asia, and many of them have been staying on American military bases since returning to the United States on government-arranged flights.It was uncertain exactly how many people California intended to move into the facility in Costa Mesa, but they are among the 53 people in the United States who have tested positive for the virus, according to the Centers for Disease Control and Prevention. Nearly all of those people had traveled to Asia, and many of them have been staying on American military bases since returning to the United States on government-arranged flights.
In recent days, officials had announced that infected Americans at Travis Air Force Base who were not ill enough to be hospitalized would have to leave the base in Fairfield, Calif. Many of them had been evacuated from a cruise ship in Japan.In recent days, officials had announced that infected Americans at Travis Air Force Base who were not ill enough to be hospitalized would have to leave the base in Fairfield, Calif. Many of them had been evacuated from a cruise ship in Japan.
The proposal had set off a flurry of objections from Costa Mesa residents, who filled the courtroom to watch local officials argue that patients infected with coronavirus should not be brought to a former residential home for developmentally disabled people. The area, which is in Orange County, is too heavily populated to host people infected with such a dangerous virus, the local officials argued.The proposal had set off a flurry of objections from Costa Mesa residents, who filled the courtroom to watch local officials argue that patients infected with coronavirus should not be brought to a former residential home for developmentally disabled people. The area, which is in Orange County, is too heavily populated to host people infected with such a dangerous virus, the local officials argued.
Given the Costa Mesa area’s popularity with tourists, “you almost couldn’t pick a better disease vector,” said Jennifer L. Keller, a lawyer hired by Costa Mesa to try to block the transfer.Given the Costa Mesa area’s popularity with tourists, “you almost couldn’t pick a better disease vector,” said Jennifer L. Keller, a lawyer hired by Costa Mesa to try to block the transfer.
Judge Staton, of the U.S. District Court for the Central District of California, pressed state officials to explain why it selected “a facility in the second-most populated county in the state of California.”Judge Staton, of the U.S. District Court for the Central District of California, pressed state officials to explain why it selected “a facility in the second-most populated county in the state of California.”
Mary Ann Ngo, a local resident who stood outside the courthouse with a sign that read “Yes to compassion, no to mass infection,” said she prayed every day for “our brothers and sisters who are infected.” Still, she said, the Costa Mesa site is not an appropriate location.Mary Ann Ngo, a local resident who stood outside the courthouse with a sign that read “Yes to compassion, no to mass infection,” said she prayed every day for “our brothers and sisters who are infected.” Still, she said, the Costa Mesa site is not an appropriate location.
The state’s lawyers argued that officials in Costa Mesa have no legal right — or good reason — to block the move, which the state said involved frail and elderly patients.The state’s lawyers argued that officials in Costa Mesa have no legal right — or good reason — to block the move, which the state said involved frail and elderly patients.
Authorities in California selected the site after the Department of Defense informed them that patients who tested positive for the virus could no longer stay at Travis Air Force Base. Federal officials had planned to move the patients to a facility in Alabama operated by the Federal Emergency Management Agency, court documents said, but officials in California thought that moving the group out of the state — most of the patients are said to be California residents — would be detrimental to their health and well-being.Authorities in California selected the site after the Department of Defense informed them that patients who tested positive for the virus could no longer stay at Travis Air Force Base. Federal officials had planned to move the patients to a facility in Alabama operated by the Federal Emergency Management Agency, court documents said, but officials in California thought that moving the group out of the state — most of the patients are said to be California residents — would be detrimental to their health and well-being.
“The forced relocation of these Californian residents from California to Alabama for the duration of their isolation period, after having already undergone quarantine for weeks on a cruise ship, poses health risks to these repatriated individuals, many of whom are over the age of 65 and have chronic underlying conditions,” wrote Xavier Becerra, the attorney general of California. He was writing on behalf of the California Governor’s Office of Emergency Services.“The forced relocation of these Californian residents from California to Alabama for the duration of their isolation period, after having already undergone quarantine for weeks on a cruise ship, poses health risks to these repatriated individuals, many of whom are over the age of 65 and have chronic underlying conditions,” wrote Xavier Becerra, the attorney general of California. He was writing on behalf of the California Governor’s Office of Emergency Services.
Updated June 12, 2020Updated June 12, 2020
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Complicating matters, Alabama officials also have objected to the prospect of housing the patients. Gov. Kay Ivey, a Republican, had raised concerns about the idea and said on Sunday that President Trump promised her that the patients would not be sent to her state.Complicating matters, Alabama officials also have objected to the prospect of housing the patients. Gov. Kay Ivey, a Republican, had raised concerns about the idea and said on Sunday that President Trump promised her that the patients would not be sent to her state.
Other options, Mr. Becerra wrote, were to put patients up in hotels near Travis Air Force Base or send them to hospitals, where there was a risk of infecting other patients. Other sites, including the Sonoma Developmental Center, Army National Guard Camp Roberts and closed youth correctional facilities, were considered and dismissed, he said.Other options, Mr. Becerra wrote, were to put patients up in hotels near Travis Air Force Base or send them to hospitals, where there was a risk of infecting other patients. Other sites, including the Sonoma Developmental Center, Army National Guard Camp Roberts and closed youth correctional facilities, were considered and dismissed, he said.
The possibility of a “local veto” on deciding where to house patients would “fly in the face of a compelling need for a centralized state authority to control and manage communicable disease outbreaks,” Mr. Becerra wrote.The possibility of a “local veto” on deciding where to house patients would “fly in the face of a compelling need for a centralized state authority to control and manage communicable disease outbreaks,” Mr. Becerra wrote.
The standoff over where to send the patients underscored the unwieldy, decentralized nature of the U.S. health system, even as federal authorities were warning of serious risks from the coronavirus outbreak, which has killed more than 2,000 people in China. The federal government generally relies on states to carry out quarantine orders, and states are within their rights to refuse. Quiet negotiations often take place when it comes to isolating tuberculosis patients, with federal officials convincing states to house them. But cities cannot generally refuse a state’s order to assist.The standoff over where to send the patients underscored the unwieldy, decentralized nature of the U.S. health system, even as federal authorities were warning of serious risks from the coronavirus outbreak, which has killed more than 2,000 people in China. The federal government generally relies on states to carry out quarantine orders, and states are within their rights to refuse. Quiet negotiations often take place when it comes to isolating tuberculosis patients, with federal officials convincing states to house them. But cities cannot generally refuse a state’s order to assist.
“If somehow, the military were forcing California to do this, they’d be on very weak grounds,” said Lawrence Gostin, a law professor at Georgetown University who specializes in public health law.“If somehow, the military were forcing California to do this, they’d be on very weak grounds,” said Lawrence Gostin, a law professor at Georgetown University who specializes in public health law.
The scale of the current crisis — with hundreds of evacuees brought to American military bases from China and Japan — is extremely rare.The scale of the current crisis — with hundreds of evacuees brought to American military bases from China and Japan — is extremely rare.
“We’ve never seen anything on this level in modern history,” Professor Gostin said.“We’ve never seen anything on this level in modern history,” Professor Gostin said.