H1N1 Quarantine Documents from Iowa Department of Health Cause Confusion

DES MOINES, IOWA – An H1N1 (Swine-Flu) quarantine document found on the Iowa Department of Public Health¹ (IDoPH) website quickly circulated the internet causing a public relations headache for health officials in Iowa. Public health officials responded that the form was merely a template based on the limited use of such quarantine orders of the past and that no such orders were currently in effect. Further, IDoH, Public Information Officer, Polly Carver-Kimm states that she does not expect to see any such orders issued this fall due to the spread of H1N1.

Ms. Carver-Kimm went on to say that if the need ever did arise, public officials in Iowa most often opt to request voluntary home quarantine out of respect for an individual’s rights. She continued, that a form causing the uproar was used sparingly in the case of several homeless Iowans who contracted Tuberculosis (TB) and where thus confined to the hospital for treatment and monitoring.

From a historical standpoint, the authority to enforce quarantine is considered a state police power reserved explicitly under the Tenth Amendment to the U.S. Constitution². Dating back to as early as 1796, Congress explicitly sought to restrict involvement by the federal government except in manners of outbreaks crossing state lines, borders, and ports of entry. Moreover, the 4th Congress enacted legislation to ensure the federal government was confined further to a supervisory role, allowing intervention only upon dereliction of a state(s) duty to control the spread beyond the initial outbreak or if the situation deteriorates into domestic insurrection, or requested by the several states governments.³

Additionally, several Supreme Court⁴ and district court decisions ^{5, 6} have upheld this principle of state’s rights in conjunction with the right of the people to challenge their quarantine under the Tenth Amendment when such quarantine is found to be “unreasonable, unjust, and oppressive”.

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Nevertheless, the federal government under the Bush administration sought to circumvent the Constitution and the reinforcement thereof by numerous Supreme Court decisions in order to seize additional unConstitutional powers to the federal government under HSPD-5, HSPD-8, and P.L. 109-364, § 1076.

Coordinating the specific steps of what many see as further federal intrusion, the Homeland Security Council⁷ (HSC) issued the “National Strategy for Pandemic Influenza Implementation Plan” (NSPIIP) in 2006 linking the federal government’s response to the World health Organization’s (WHO) “Phase of Pandemic Alert”. Currently the WHO phase is at its highest level, pandemic-alert 6 in response to the outbreak of H1N1 from this past spring. Consequently, according to the NSPIIP, the response to a phase 6 alert instructs the Department of Health and Human Services (HHS) in Conjunction with DHS to:

“Activate domestic quarantine stations and ensure coordination at State, local, and tribal level, especially with health care resources.”

National Strategy for Pandemic Influenza Implementation Plan, 2006
Page 37

As of the writing of this report, Ms. Carver-Kimm has not received briefing from either DHS or HHS regarding the “domestic quarantine stations”. Additionally, calls placed to both the DHS and HHS have yielded no response regarding whether or not the quarantine stations are currently active as called for in NSIIP in conjunction with WHO alert level 6.

Source(s): ¹Iowa Department of Health Quarantine Order • ²CRS, FEDERAL and STATE QUARANTINE and ISOLATION AUTHORITY, by:Kathleen S. Swendimann, Attrny. & Jenifer K. Elsa, Attrny. – published January 23rd, 2007, Summary • ³ 5 Annals of Congress 1349-59 (1796) • ⁴ MORGAN’S STEAMSHIP CO. V. LOUISIANA BOARD OF HEALTH, 118 U. S. 455 (1886) • ⁵ State v. Snow 324 S.W.2d 532 (Ark. 1959) • ⁶ Wong Wai v. Williamson 103 F. Rep. 10 (1900) & Jew Ho v. Williamson 103 F. Rep. 15 (1900) • ⁷Homeland Security Council, “National Strategy for Pandemic Influenza Implementation Plan” 2006 •