Metro

Evan Horowitz

Can states really quarantine anyone they want?

This morning, Kaci Hickox took a short bike ride. It wouldn’t be news except that she’s supposed to be under quarantine at her home in Maine, having recently returned from treating Ebola patients in West Africa.

Maine officials have said they are going to seek a court order to enforce her quarantine, which raises some big legal questions. Can states quarantine anyone they think might pose a public health hazard? And can they hold them indefinitely, even if they’ve done nothing wrong, apart from risking their lives to help Ebola patients? Believe it or not, the answer may well be yes.

Can states quarantine anyone they want?

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Not anyone, no. Governors can’t have their political opponents thrown into quarantine on specious grounds. There has to be a good faith reason to believe that the individual placed in quarantine poses a danger to others.

Also, people in quarantine are entitled to due process. Shortly after her mandatory quarantine began last week, Kaci Hickox availed herself of these due process rights, hiring a lawyer and threatening to contest her detention.

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Ultimately, though, states have wide authority to protect public health, and courts have given them a lot of leeway. If governors act in a reasonable way and if the quarantine conditions are not needlessly restrictive, the quarantine is likely to stand. What is more, so long as the person continues to pose a risk, there’s no fixed deadline when the quarantine must end.

Can the White House block state quarantines?

Probably not. The way our Constitution is written, states have the authority to ensure public health and the power to pass appropriate laws, including quarantines.

There are ways the president might try to supersede state actions — perhaps by declaring Ebola a national security issue — but it’s not clear how that would play out.

Why do states have such broad power to quarantine?

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Because the risks are similarly broad. Once infectious diseases gain a foothold, they can decimate societies. Quarantines can help prevent that, but they only work if states have the power to enforce them.

What that means, though, is that in the case of quarantine, states can actually deprive people of their liberty without ever proving that they’ve done anything wrong.

Has Massachusetts imposed an Ebola quarantine?

So far, Massachusetts has not implemented a mandatory quarantine, but it remains a possibility. During a gubernatorial debate earlier this week Martha Coakley seemed to suggest that it was unnecessary, but Charlie Baker called it a “reasonable strategy.”

Are quarantines a good idea?

Simply because something is legal doesn’t mean it’s a good idea. All it means is that the future of quarantines is likely to be settled through politics, rather than in a courtroom.

The political story began last Friday, when the governors of New York and New Jersey introduced mandatory quarantines for all health care workers returning from West Africa after treating Ebola patients. That decision was condemned by the UN secretary general and criticized by the White House. The New England Journal of Medicine called it “unfair and unwise,” and Kaci Hickox herself noted that it might dissuade health care workers from traveling to West Africa where they are desperately needed.

Despite the criticism, other states followed suit, and the US Army announced that soldiers who have been building medical facilities in Liberia will be quarantined when they leave the country. How far these quarantines spread may depend, ultimately, on how far Ebola itself spreads in the United States.

Evan Horowitz digs through data to find information that illuminates the policy issues facing Massachusetts and the United States. He can be reached at evan.horowitz@globe.com. Follow him on Twitter @GlobeHorowitz
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