With the rise of global pandemic COVID-19, increasingly strict restrictions on movement and self-imposed isolation have become prevalent as both state and local governments scramble to control what could quickly become a national disaster. Out of concern for the health, safety, and welfare of its citizens, North Carolina has declared itself to be in a “state of emergency,” with many of its counties following suit.
North Carolina has a number of laws regulating and defining public health violations, which may be found in Chapter 130A of the General Statutes. The North Carolina Administrative Code provides additional regulations in Chapter 10A, Section 41A. Both make it clear that a public health violation may be enforced either civilly or criminally. A civil enforcement would occur when the health director seeks a court order mandating that a particular person follow isolation or quarantine orders that have already been issued for them by someone such as a physician or other healthcare worker. A violation of this order could result in that person being held in contempt of court. A criminal enforcement of such order would be classified as a misdemeanor, punishable by up to two years in prison. In the event that someone is arrested for the violation of a public health order, that person may be detained in a location other than the magistrate’s office or jail, to protect the health of others being held in detention.
Although the terms “isolation” and “quarantine” have been used interchangeably in the midst of the Coronavirus crisis, it is important to note that, legally, these terms have different definitions. Under North Carolina law, an “isolation” is defined as limits to the freedom of movement of a person infected with either a communicable disease or communicable condition. On the other hand, a “quarantine” refers to limits placed on the movement of a person who has been exposed to a communicable disease or condition. Furthermore, a quarantine may also limit access to an area or facility that may have been contaminated with a virus or other agent of infection, or it may limit the freedom of movement of the unimmunized public during the outbreak of an infectious disease. By way of example, a person diagnosed with Coronavirus would be considered in “isolation” when he or she is kept away from the public to prevent him or her from spreading the infection to others. The current state of affairs could more appropriately be referred to as a “quarantine,” based on the above definitions, as the general public, whether infected or not, are limited as to where they can go and what they can do in public places.
An order limiting freedom of movement may be issued by the health director of a particular county or locality. These orders may effectively prohibit individuals from either going to some place or confine them to a certain place, such as their home. However, any isolation or quarantine orders issued must be consistent with guidelines set in place by the Center for Disease Control and Prevention (CDC). These orders must also be “reasonably expected” to decrease the risk of transmission of the communicable disease, while at the same time adhering to established scientific or medical research. For airborne diseases, for example, the health director could require physical isolation or quarantine of the public for the entire period of infectivity.
Under N.C.G.S. § 130A-145(a), the duration of a public health quarantine may last as long as the health of the general public is endangered or otherwise threatened. However, the law of North Carolina does place restrictions on this, as the length of time must be “reasonable,” and the maximum period of quarantine is 30 days. If necessary, the health director may get an extension on this statutorily-set maximum period by appealing to the court. The burden of proof to show the reasonableness of this extension is on the health director. Thus, the health director must be able to demonstrate to the court that an extension is reasonably necessary to protect the health, safety, and welfare of the people.
Although the courts in North Carolina have yet to hear a case involving the constitutionality of either an isolation or quarantine order, in 2016 this exact issue was heard by the federal district court in New Jersey in the case Hickox v. Christie. This case specifically involved a nurse who was quarantined for several days in a hospital after returning to New Jersey from Sierra Leone, where she had been assisting victims of the Ebola virus. She filed a civil rights claim under 42 U.S.C. § 1983 against various state government officials, alleging that her rights against unreasonable search and seizure, as protected by the Fourth and Fourteenth Amendments to the United States Constitution, had been offended. In this case, the court reasoned that Ms. Hickox needed to show a violation of clearly established law. The court ultimately held that the detention of Ms. Hickox was not unconstitutional, and it was a valid exercise of the state’s police powers, which are the powers that a state has to enact laws or other regulations protecting the health, safety, and welfare of its citizens. Since the actions against Ms. Hickox in this case were neither unreasonable nor arbitrary, her confinement was legal. The state’s primary purpose was to protect its public from an Ebola outbreak. Similar reasoning could be applied to quarantine and isolation orders that have been affected to prevent the spread of COVID-19.
The Emergency Management Act, found in N.C.G.S. § 166A, gives government officials the authority to enact emergency measures to manage a crisis situation. Under this law, an “emergency” is defined as an imminent threat of widespread or severe damage, injury, or death—this includes disease and other threats to public health. By declaring a county in a “state of emergency,” certain powers are triggered that enable government officials to impose limits on several things, including: (1) the movement of people in public places, such as by enacting curfew, evacuations, or closures of public roads; (2) the closing of offices or businesses where people are likely to congregate; (3) the possession, transportation, or sale of alcohol; (4) the possession or sale of gas or dangerous weapons; or (5) the restriction of other activities that should be controlled to the extent reasonably necessary to maintain order and protect life. This does not give the officials the ability or authority to suspend state or federal law or to deny constitutional protections to its constituents.