Quarantine system needs revamp, study says

Storied history
Little was done to prevent disease from entering the fledging U.S. colonies, despite the fact that quarantines were a proven strategy reaching back to the 14^th century. 

The colonies considered protection from disease to be a local matter; however, repeated yellow fever outbreaks moved the Congress to pass a federal quarantine law in 1878.

While not shifting all power to the federal government, the legislation did make it easier for the central government to take a more hands-on role in future epidemics, such as the 1892 U.S. cholera outbreak. The federal government, citing the 1878 law, took a greater role in enforcing quarantine requirements.  That move led to yet another law being passed in 1893 that further solidified the government’s role in quarantine matters.  By 1921 quarantine stations across the U.S. had been federalized and in 1944, with the creation of the Public Health Service, the federal quarantine role was clearly defined.

At the height of the U.S. quarantine system, in 1967, there were 55 stations employing more than 500 people.  By 2002 there were only eight quarantine stations left, run by about 40 people.

The CDC’s quarantine stations are, however, just a cog in what is called the “quarantine system network,” that is comprised of various state and federal agencies as well as local health organizations.

To make all those parts “fit” and effectively manage the quarantine system, the CDC is currently working on a national risk assessment and will develop a national strategic plan at that will “prioritize their activities and focus resources on people, animals, goods and conveyances from abroad that pose the greatest risks to the health of the U.S. population,” the study says.

Meanwhile, President Bush tossed a huge rock into the quarantine management pond two weeks ago when he revealed that he was considering using U.S. military forces to enforce quarantine in the event of a national health crisis.  To do so would require legislation; just the suggestion that the military might be used for quarantine enforcement sent shock waves through some parts of Congress and state and local leaders, who are traditionally the first to handle any type of quarantine.

Bush acknowledged the move was dicey.  “It’s one thing to shut down airplanes,” Bush said. “It’s another thing to prevent people from coming in to get exposed to the avian flu.” 

But Bush said he would press for the authority to do so.  “I think the president ought to have all… assets on the table to deal with something” like a pandemic flu crisis,” he said.

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