A federal quarantine order is putting Health Secretary Robert F. Kennedy Jr. at the center of a public health and civil liberties fight.
The Wall Street Journal reported that Kennedy ordered Florida resident Angela Perryman to remain in federal quarantine in Nebraska after her possible exposure to the Andes strain of hantavirus on a cruise ship. The order came despite a medical review by the Centers for Disease Control and Prevention(CDC)that recommended Perryman be allowed to finish monitoring at home.
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Perryman was among the 18 U.S. cruise passengers taken to a Nebraska quarantine unit after possible exposure to the Andes strain, which has a long incubation period.
She has said she feels as if she is “in prison” in Nebraska, where she believes she is being used as “a prop and a political stunt.”
The case raises a central public health law question: what process and evidence are required before the federal government keeps someone confined against their will after exposure to a dangerous disease?
Due process and legal challenges
Lawrence Gostin, a Georgetown University public health law expert who helped draft CDC quarantine regulations, told Straight Arrow that Perryman could challenge the order on due process grounds. He said the same official should not both issue a quarantine order and decide whether to uphold it.
“Secretary Kennedy issued a quarantine order and then reviewed his own order,” Gostin said. “A political appointee cannot both issue an order and then be the one who affirms it.”
He said the CDC reviewer had already recommended that Perryman could finish monitoring outside the Nebraska facility.
The administration’s defense
The Department of Health and Human Services defended the decision in a statement to Straight Arrow, saying Kennedy reviewed the medical recommendation before continuing the quarantine order.
“Secretary Kennedy specifically considered the medical recommendation before deciding to continue the current order consistent with Director [Jay] Bhattacharya,” HHS Spokeswoman Courtney Spencer said, referring to the acting CDC director. “The Andes virus has a 40% case fatality rate – 40 times that of COVID-19 – and a known incubation period of up to 42 days during which anyone exposed to this disease can become symptomatic and transmit it to others.”
The administration considered the Nebraska quarantine necessary because proper home monitoring was unavailable.
“In the absence of proper home monitoring by state authorities, the Administration’s quarantine order is necessary to ensure both Ms. Perryman’s and her community’s wellbeing,” Spencer said.
Jurisdictional dispute and practical questions
An HHS official said other exposed people who returned home for monitoring did so with the cooperation of their state health authorities. The official also said Perryman did not have a home in Florida and had planned to stay in an Airbnb.
That explanation leaves a practical question in the legal dispute: whether home quarantine was feasible if Florida would not provide the monitoring HHS sought and Perryman planned to stay in a short-term rental.
The Journal reported that the dispute partly turned on Florida’s refusal to follow the federal monitoring plan.
Perryman told CNN she felt caught between state and federal officials.
“At this point, it’s just a state-federal spat, and I’m just a hostage,” Perryman said.
Gostin told Straight Arrow that the government must show “clear and convincing evidence” that home quarantine would pose a significant public risk before confining a person in a facility for quarantine.
“The secretary overturned the medical review without giving reasons or providing any evidence,” Gostin said. “The medical review was thorough and scientific. It should stand.”
Gostin said the disagreement with Florida does not justify keeping Perryman confined.
“A person’s liberty should not hinge on a dispute between the federal government and a state,” Gostin said. “That is not her fault.”
Political ironies and ‘medical freedom’
The decision also contrasts with Kennedy’s past criticism of pandemic-era restrictions.
Kennedy and other health officials in the administration have criticized pandemic-era restrictions, according to the Journal. Gostin said Kennedy’s decision conflicts with his past “medical freedom” messaging.
“Kennedy is being hypocritical,” Gostin said. “He has governed under the banner of ‘medical freedom’ yet uses compulsion. He has also criticized the Biden administration for using compulsion during the pandemic. That is exactly what he is doing now.”
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