- Iowa public health officials have acknowledged the existence
of a blank template entitled FACILITY QUARANTINE ORDER in
the case of a Novel Influenza A H1N1. The official press release states, however, that
there is no draft or text of a "Quarantine Order"
by the Iowa Department of Public Health.
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- Reported by the Iowa Independent:
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- "A quarantine template created by the Iowa Department
of Public Health and accessible through the Centers for Disease Control
Web site should not be of great concern, according to a press release
from health department officials. 'IDPH wants to make it clear that Iowa
has not issued any isolation and quarantine orders for novel influenza
A (H1N1), and has no plans to issue any this fall,' officials wrote in
the press release. See Health officials: Iowa quarantine document
not cause for concern, Iowa Independent, Sept 1, 2009
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- The IDPH suggests in this regard that the drafting
of public health templates is a routine undertaking, while also confirming
that "in preparation for public health emergencies," ...
"isolation and quarantine orders are only very rarely used in
very specific situations." (emphasis added).
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- The last statement of the IDPH is notoriously ambiguous:
If indeed isolation and quarantine orders are rarely used, why then was
a template prepared which explicitly contemplates an ORDER pertaining
to a QUARANTINE FACILITY? Moreover, the template was issued on May
1st, at the very outset of the H1N1 swine flu crisis in Mexico, barely
two days after the WHO declared a level 5 pandemic advisory on April 29th.
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- Are we playing on words? The template already contains
the essential features of a formal QUARANTINE ORDER, which suggests
that quarantine procedures are contemplated within the Iowa Department
of Public Health. The result of these procedures have led to the formulation
of the blank template. .
-
- The issue, therefore, is not whether an quarantine order
has been activated. The issue is 1) the State of Iowa has contemplated
a policy of forced confinement, 2) at some future date, in the next
few months, the blank template entitled FACILITY QUARANTINE ORDER could
be activated with a view to actually implementing the quarantine
precedures.
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- Also of significance is the fact that this template
entitled FACILITY QUARANTINE ORDER was published on the website of
the Centre for Disease control (CDC), which is the main federal agency
responsible for H1N1 pandemic preparedness in coordination with State and
municipal governments, as well as in liaison with the WHO.
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- There are two quarantine documents on the CDC's website.
The first refers to HOME QUARANTINE ORDER, the second toFACILITY QUARANTINE
ORDER. (pdf) Click to access the CDC page, which identifies both templates
as CDC reference documents. The latter document envisages quite explicitly
forced confinement in the case of the H1N1 swine flu:
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- "The Department has determined that it is necessary
to quarantine your movement to a specific facility to prevent further spread
of this disease. The Department has determined that quarantine in your
home and other less restrictive alternatives are not acceptable because
[insert the reason home quarantine is not acceptable, the person violated
a previously issued home quarantine order, the person does not have an
appropriate home setting conducive to home quarantine, etc.] The Department
is therefore ordering you to comply with the following provisions during
the entire period of quarantine:
-
- 1. Terms of confinement. You are ordered to remain at
the quarantine facility, _____________________ [insert name and address
of facility], from ___________ to ____________ [insert dates of quarantine].
-
- ....
-
- 4. Legal authority. This order is issued pursuant
to the legal authority contained at Iowa Code chapters 135, 139A and 641
Iowa Administrative Code chapter 1, a copy of which is labeled Attachment
B and is attached to this order for your review. The Department shall comply
with the principles for quarantine contained in subrule 1.9(3) of this
attachment when issuing and implementing this order.
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- 5. Ensuring compliance. In order to ensure
that you strictly comply with this Quarantine Order the Department or persons
authorized by the Department may regularly inspect the quarantine facility.
-
- 6. Violations of order. If you fail to comply
with this Quarantine Order you may be ordered to be quarantined in a more
restrictive facility. In addition, failure to comply with this order is
a simple misdemeanor for which you may be arrested, fined, and imprisoned."
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- This is an official document of the Iowa State government.
If it were a preliminary or internal draft, it would not have been published
by the Atlanta Centre for Disease Control.
-
-
- The full text of the controversial Iowa Template is indicated
below:
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- BEFORE THE IOWA DEPARTMENT OF PUBLIC HEALTH
-
- DIRECTED TO: [insert full name and address of subject
of order]
-
- [insert case #]
-
- FACILITY QUARANTINE ORDER
-
- The Iowa Department of Public Health (Department) has
determined that you have had contact with a person with Novel Influenza
A H1N1. Novel Influenza A H1N1 is a disease which is spread from person
to person and is associated with fever (greater than 100.0 F), cough, sore
throat, rhinorrhea (runny nose), nasal congestion, body aches, headache,
chills and fatigue. Novel Influenza A H1N1 presents a risk of serious harm
to public health and if it spreads in the community severe public health
consequences may result.
-
- The Department has determined that it is necessary to
quarantine your movement to a specific facility to prevent further spread
of this disease. The Department has determined that quarantine in your
home and other less restrictive alternatives are not acceptable because
[insert the reason home quarantine is not acceptable, the person violated
a previously issued home quarantine order, the person does not have an
appropriate home setting conducive to home quarantine, etc.] The Department
is therefore ordering you to comply with the following provisions during
the entire period of quarantine:
-
- 1. Terms of confinement. You are ordered to remain at
the quarantine facility, _____________________ [insert name and address
of facility], from ___________ to ____________ [insert dates of quarantine].
-
- 2. Requirements during confinement. During the period
of quarantine:
-
- a. You must not leave the quarantine facility at any
time unless you have received prior written authorization from the Department
to do so.
-
- b. You must not come into contact with anyone except
the following persons:
-
- (i) other persons who are also under similar quarantine
order at the quarantine facility;
-
- (ii) authorized healthcare providers and other staff
at the quarantine facility;
-
- (iii) authorized Department staff or other persons acting
on behalf of the Department; and
-
- (iv) such other persons as are authorized by the Department.
-
- c. Your daily needs, including food, shelter, and medical
care, will be provided for you during the period of quarantine at the quarantine
facility. You should bring clothing, toiletries, and other personal items
with you to the quarantine facility. You will have limited access to a
telephone at the quarantine facility. You may bring your cell phone with
you should you desire to have greater access to a means of communication.
-
- d. You should inform your employer that you are under
quarantine order and are not authorized to physically come to the work
place, although you may work from the facility via electronic or other
means if appropriate. You should be aware that Iowa law prohibits an employer
from firing, demoting, or otherwise discriminating against an employee
due to the compliance of an employee with a quarantine order issued by
the Department. (Iowa Code Section 139A.13A)
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- 3. Information about Novel Influenza A H1N1. You should
review the information contained at Attachment A for information about
Novel Influenza A H1N1. You should refer to information provided at the
quarantine facility to address specific concerns and questions you have
about Novel Influenza A H1N1. In order to find out more information about
Novel Influenza A H1N1 and its symptoms and spread, you may also access
the Department's web-page at www.idph.state.ia.us. If you do not have
access to the internet from the quarantine facility, you may contact the
Department at 1-800-362-2736.
-
- 4. Legal authority. This order is issued pursuant to
the legal authority contained at Iowa Code chapters 135, 139A and 641 Iowa
Administrative Code chapter 1, a copy of which is labeled Attachment B
and is attached to this order for your review. The Department shall comply
with the principles for quarantine contained in subrule 1.9(3) of this
attachment when issuing and implementing this order.
-
- 5. Ensuring compliance. In order to ensure that you strictly
comply with this Quarantine Order the Department or persons authorized
by the Department may regularly inspect the quarantine facility.
-
- 6. Violations of order. If you fail to comply with this
Quarantine Order you may be ordered to be quarantined in a more restrictive
facility. In addition, failure to comply with this order is a simple misdemeanor
for which you may be arrested, fined, and imprisoned.
-
- 7. Your rights B appeal rights. While under quarantine
you have the rights as described in subrule 1.9(8) of Attachment B. In
addition, you have the right to appeal this order pursuant to subrule 1.9(7)
of Attachment B.
-
- (signed & dated)
- DIRECTOR or MEDICAL DIRECTOR
- IOWA DEPARTMENT OF PUBLIC HEALTH
- Lucas State Office Building
- Des Moines, IA 50319
-
- Attachments to this Order:
- Attachment A - Facts About Novel Influenza A H1N1
- Attachment B - 641 Iowa Administrative Code chapter 1
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