More About the Separate Quarantine at US Mission China

13 Going on 14 — GFM: https://gofund.me/32671a27

 

Yesterday, we posted: FS family members 14 and up are forcibly quarantined separately from their families in China?  As often the case when we post questions in this blog, we get a reaction. Below is what we learned from a correspondent who is currently serving in China and who has “happily extended” their tour there. Our correspondent gave a different perspective about the quarantine process upon arrival in China and life there during the pandemic. He/She also answered additional questions we have.
Quarantine with children
— The quarantine rules, including those affecting children have been known by the entire mission and the EAP bureau a year ago.
— If there are two parents, they decide who takes what kid during quarantine. For single parents, you take all the kids and be in the same room; the bed is reportedly extra large king. In the case of illness concerning a baby or a young child, the PRC would allow one parent to stay at the hospital under the negotiated agreement. This was not the case at the beginning; apparently, there was a three month old baby of French diplomats who stayed alone in the hospital although reportedly with “constant monitoring.”
— When ill, mission employees go to two hospitals where the doctors are 20% Western and the Chinese doctors have been educated in the US, UK, or Australia.
— Diplomats are lodged at franchise hotel in Shanghai and Guangzhou with room sizes similar to a that of a regular Marriott room with about 420 sqft of space.
— The hotel offers at least Chinese, Muslim, Western menus that are “quite cheap.” There are additional choices from the VIP menu with a higher price but still within the authorized per diem.
— Last year, people could order online but this privilege was rescinded for fresh food because it was apparently sprayed with disinfectant upon arrival, so people could only order closed/canned foods. There is second hand account attributed to folks who recently concluded their quarantine that people were able to order salads, cheese, etc. again this year.
— Diplomats are allowed to do part of their quarantine at home, unlike other people (for example, business people). We were informed that EAP/Mission negotiated this. Also in late December, China started requiring a second test (blood) from an approved lab in a city with direct flights to China. Despite these precautions, there are reportedly continuing imported cases from Africa, Europe and the Middle East. Beijing and now Shanghai reportedly require a third week of quarantine with relaxed protocol like a hotel where the families can be together. For our diplomats, the negotiated agreement is that this third week can be done at home.
— The correspondent pointed out that the assignment in China requires an investment of at least a year of language but signing up for the Foreign Service requires acceptance of assignments that include hardships.
— We understand that people can curtail their assignments as some employees did last summer; they never went back after the evacuation.
We asked about the rationale for the cut-off age; 12 year olds are allowed to stay with parents but 14 year olds must quarantine separately?
Our correspondent said that previously, this was kids who are 15 and above. Now the requirement to quarantine separately is 14 years and above. Our correspondent did not have a clear answer but points at the likelihood that local authorities have probably determined that this is the age when kids are infected or transmitting like adults.
Medevac Flights
Our correspondent confirmed that the Department used charter flights to transport people back to Mission China last year. There were standby flights to return anyone who tested positive back to the U.S. “Happened once.” We learned that the Department stopped the charters in September/October when majority of the staff had returned or arrived PCS. Incoming staff to China used commercial flights thereafter.
Communication
Our correspondent said EAP and Mission China were  “almost too communicative”.  Our correspondent pointed out that in June-August, China folks received three emails per week to update them “of the progress.”  They apparently also had a FAQs with over 30 pages. A separate source notes that while the transfer season is always busy,  there is a special China packet, as well as town halls that people should read/tune in.
Isolation
Our correspondent said that “most kids 14-18 were actually happy” to be able to be on their cellphone and other social media without their parents on their back. “With Skype or WeChat you can have video calls if you wish, you are not isolated.”
Life During a Pandemic
Our correspondent explained that Beijing was never in lockdown, the embassy never closed its doors, that people continued to go to work, restaurants remained open, etc.  He/She asks, “Is 14 days a hard price to pay for a regular life?”  He/She writes, “It is much better than over a year of lockdowns, curfews, and other restrictions and worrying to catch the virus.”
At the end of the day, the sentiment expressed by our correspondent is — we are all extremely happy that China has strict rules because it meant a regular life (with a mask) for all Posts (except Wuhan).
One anecdotal evidence from a recently returned employee from China expressed a similar sentiment, that the quarantine process “sucked” but when it was done, they were able to move around and live a “more normal” daily life – although with masks.
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US Embassy Jamaica Employee Reportedly Tested Positive of COVID-19, Routine Consular Services Suspended

 

Local media in Jamaica reports that the second COVID-19 case in the island is a U.S. Embassy Jamaica employee who recently returned from the UK.  Jamaican Minister of Health and Wellness Dr. Chris Tufton tweeted confirmation of the second case on March 11.
The US Embassy released a statement acknowledging the media reports but cites “privacy concerns” in declining to share additional information. It has, however, announced the suspension of routine consular services until further notice and that the “Embassy is in the process of sanitizing the premises to prevent further outbreak.”

Kingston, Jamaica – We are aware of reports of a COVID-19 case related to an Embassy Kingston employee.  Due to privacy concerns, we are not able to share additional information.

The U.S. Department of State has no greater responsibility than the safety and security of U.S. citizens overseas and locally-employed staff.

In coordination with Jamaican authorities, Embassy Kingston is implementing all appropriate measures to help control the spread of COVID-19.

The Embassy is in the process of sanitizing the premises to prevent further outbreak.

Our Consular Section will not be providing routine services – including visa processing and American citizens services – until further notice.  U.S. citizens who require emergency assistance should call 876-702-6000.

U.S. citizens who decide to travel to Jamaica  should review and follow the Centers for Disease Control and Prevention’s guidelines for the prevention of coronavirus, read the Travel Advisory and Country Information Page for Jamaica on travel.state.gov, and enroll their travel plans in the Smart Traveler Enrollment Program (STEP.state.gov).

Alerts

US Embassy Israel: Enhanced Screening and Quarantine For U.S. Citizens, and Other Foreign Travelers

On March 10, 2020, the US Embassy in Israel issued a Health Alert noting that effective Thursday, March 12, 2020, at 20:00 (Israel time) foreign travelers, including U.S. citizens, arriving from any country will be required to remain in home quarantine until 14 days have passed since the date of entry into Israel.  It notes further that travelers should be prepared for travel restrictions to be put into effect with little or no advance notice:

Location:  Israel, the West Bank, and Gaza

Event:  The Government of Israel has implemented enhanced screening and quarantine measures for travelers arriving to Israel to reduce the spread of COVID-19.  Effective Thursday, March 12, 2020, at 20:00 (Israel time), foreign travelers, including U.S. citizens, from locations in the United States and all other countries aside from those listed below will be required to remain in home quarantine until 14 days have passed since the date of entry; non-Israeli residents will be required to prove they have the means to self-quarantine to be admitted into Israel.  This restriction is immediate for Israeli citizens and residents.  Hotels may refuse to honor reservations for individuals in quarantine.  Transportation options from the airport to any location may be limited.  Restrictions are continually being updated by the Government of Israel.

The Israeli Population and Immigration Authority will deny entry to any person who is not an Israeli resident or citizen who has traveled in the last 14 days to:

    • China, South Korea, Italy, Iran, Iraq, Syria, and Lebanon (applies to connecting flights in these locations)
    • Thailand, Hong Kong, Singapore, Macau, Japan, France, Germany, Switzerland, Spain, Austria, San Marino, Andorra, and Egypt (does not apply to connecting flights in these locations if you did not leave the airport)
    • Any traveler in the last 14 days who attended any gatherings of more than 100 people or an international conference.

In addition, on March 9, 2020, the Israeli Ministry of Health instructed anyone who has visited the West Bank cities of Bethlehem, Beit Jala or Beit Sahour in the last 14 days to enter home quarantine according to the Israeli Ministry of Health’s instructions.  This does not include those who have transited through those areas without stopping.

Visit the Israeli Ministry of Health’s COVID-19 website for updated information and self-quarantine instructions in Israel.  Visit the website of the Palestinian Authority Ministry of Health (available only in Arabic) for additional information on measures in the West Bank:  http://site.moh.ps/index/ArticleView/ArticleId/4839/Language/ar

Travelers should be prepared for travel restrictions to be put into effect with little or no advance notice.  Travelers may be subjected to screening at airports or ports of entry.  Flights into or out of Israel may be cancelled with little or no advance notice.

 

US Embassy Turkmenistan Now on Voluntary Departure For Non-Emergency USG Staffers/Family Members

 

On March 6, 2020, the State Department issued a “Level3: Reconsider Travel” for Turkmenistan due to travel restrictions and quarantine  procedures instituted by the Government of Turkmenistan in response to COVID-19. It also announced the voluntary evacuation of non-emergency USG personnel and their family members:

Reconsider travel to Turkmenistan due to travel restrictions and quarantine procedures instituted by the Government of Turkmenistan in response to the novel coronavirus (COVID-19). 

On March 6, 2020, the Department allowed for the voluntary departure of non-emergency personnel and family members of U.S. government employees.  The Government of Turkmenistan has implemented enhanced screening and quarantine measures to reduce the spread of COVID-19.  All incoming international flights are being redirected to Turkmenabat, approximately 291 miles from Ashgabat.  Passengers will be required to undergo medical screening and possibly involuntary quarantine at local medical facilities.   

Travelers should be prepared for travel restrictions to be put into effect with little or no advance notice. Visit the website of U.S. Embassy Ashgabat for additional information on these new measures.

Medical protocols in Turkmenistan are not consistent with U.S. standards and some travelers have been required to undergo medical testing unrelated to COVID-19 including but not limited to HIV testing.  Consider declining any medical procedures including testing unrelated to COVID-19.

Due to the possibility of quarantine of unknown length, carry additional supplies of necessary medication in carry-on luggage.  Contact the U.S. Embassy if you are subject to quarantine or prior to undergoing any invasive medical testing or procedures.

Please read the Safety and Security section on the country information page

If you decide to travel to Turkmenistan:

U.S. citizens who travel abroad should always have a contingency plan for emergency situations. Review the Traveler’s Checklist.

Two Charter Flights From #DiamondPrincess Depart Tokyo, Few “High Risk” Patients Now in Nebraska

 

The U.S.  Embassy in Tokyo announced that on February 17 at 0705 JST, two charter flights carrying passengers from the Diamond Princess cruise ship departed Tokyo en route to the United States.
This letter was sent to American passengers and crew on Sunday morning. It includes details on the repatriation operation as well as information for those who opts not to board. Letter in part says “Based on the high number of COVID-19 cases identified onboard the Diamond Princess, the Department of Health and Human Services made an assessment that passengers and crew members onboard are at high risk of exposure. Given this assessment, the U.S. Government is chartering these flights to minimize the risks to your health going forward.”
The Centers for Disease Control and Prevention also released a statement on repatriation of American passengers and crew.
The letter further notes that passengers on the chartered aircraft will be quarantined in the United States at Travis Air Force Base in Fairfield, California or Lackland Air Force Base near San Antonio, Texas for 14 days upon arrival. However, it looks like the two flights initially landed in California and Texas, then proceeded to Nebraska with a few patients considered “high risk.”. One local report says that “13 Americans who were on the cruise ship in Japan arrived in Omaha today.”

@StateDept Evacuation Flights From China Heads to Military Bases in CA, CO, TX For 14-Day Quarantine

 

The State Department issued a health alert on February 4 indicating that it “may be staging additional evacuation flights with capacity for private U.S. citizens on a reimbursable basis, leaving Wuhan Tianhe International Airport on February 6, 2020. The alert notes that evacuees from Hubei Province will be subject to up to 14 days of mandatory quarantine.

“In accordance with the Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus, beginning at 5:00 p.m., Eastern Standard Time, Sunday, February 2, the United States government will implement temporary measures to increase our abilities to detect and contain the coronavirus proactively and aggressively.  Any U.S. citizen returning to the United States who has been in Hubei Province in the previous 14 days will be subject to up to 14 days of mandatory quarantine to ensure they are provided proper medical care and health screening.” 

Military bases in California, Colorado and Texas are currently preparing to accommodate up to 1,000 people who will be quarantined upon arrival. U.S. Northern Command announced that it is expecting 350 inbound passengers in the “initial flights” destined for Travis Air Force Base and Miramar Marine Corps Air Station, both in California.
Also see Proclamation on Suspension of Entry as Immigrants and Nonimmigrants of Persons who Pose a Risk of Transmitting 2019 Novel Coronavirus.

 

CRS: Ebola Outbreak – Quarantine v. Isolation, Travel Restrictions, Select Legal Issues

— Domani Spero
[twitter-follow screen_name=’Diplopundit’ ]

 

On October 25, WaPo reported that the governors of New York Andrew Cuomo and New Jersey Gov. Chris Christie ordered on Friday the imposition of a mandatory 21-day quarantine for medical workers returning from the countries hit hardest by the ebola epidemic. Illinois later in the day imposed similar restrictions. Today, NYT reported that the Obama administration has expressed deep concerns to the governors and is consulting with them to modify their orders to quarantine medical volunteers returning from West Africa.

Ebola CRS report via Secrecy News (pdf):

On August 8th, the World Health Organization declared the outbreak of the Ebola Virus Disease in West Africa a Public Health Emergency of International Concern. The recent arrival in the United States of several health care workers who contracted the disease, combined with the first diagnosis of a case in the U.S. at a hospital in Dallas, has sparked discussion about the appropriate government response. Aside from the various policy considerations at issue, the outbreak has generated several legal questions about the federal government’s authority to restrict specific passengers’ travel and/or contain the outbreak of an infectious disease. These questions include, inter alia, whether the federal government may: (1) restrict which countries U.S. nationals may travel to in the event of a public health crisis; (2) bar the entry into the United States of people who may have been infected by a disease; and (3) impose isolation or quarantine measures in order to control infectious diseases.

Passport restrictions on which countries U.S. citizens may visit can be imposed by the Secretary of State. Pursuant to the Passport Act, the Secretary of State may “grant and issue passports” according to rules designated by the President, and may impose restrictions on the use of passports to travel to countries “where there is imminent danger to the public health or the physical safety of United States travellers” (sic). The Supreme Court has recognized that the authority to “grant and issue” passports includes the power to impose “area restrictions” – limits on travel to specific countries (restrictions must comply with the Due Process Clause of the Constitution). Although passport restrictions are not criminally enforceable, they may prevent travelers from boarding a flight to a restricted area.

Restrictions may also be imposed on who may enter the United States, though the range of applicable restrictions may differ depending upon whether a person seeking entry into the country is a U.S. national. The government enjoys authority under federal immigration law to bar the entry of a foreign national on specific health-related grounds, including when a particular foreign national is determined to have a “communicable disease of public health significance.” More broadly, section 212(f) of the Immigration and Nationality Act authorizes the President, pursuant to proclamation, to direct the denial of entry to any alien or class of aliens whose entry into the country “would be detrimental to the interests of the United States.”

These restrictions do not apply to U.S. citizens, who may enjoy a constitutional right to reenter the country. Nonetheless, certain travel restrictions may impede the ability of any person – regardless of citizenship – from traveling to the United States in a manner that potentially exposes others to a communicable disease. For example, airlines flying to the U.S. are permitted under Department of Transportation regulations to refuse transportation to passengers with infectious diseases who have been determined to pose a “direct threat” to the health and safety of others. In making this determination, airlines may rely on directives from the CDC and other government agencies. Pilots of flights to the United States are also required to report certain illnesses they encounter during flight before arrival into the U.S.

In addition, the Department of Homeland Security and Centers for Disease Control and Prevention (CDC) maintain a public health “Do Not Board” (DNB) list, which contains the names of people who are likely to be contagious with a communicable disease, may not adhere to public health recommendations, and are likely to board an aircraft. Airlines are not permitted to issue a boarding pass to people on the DNB list for flights departing from or arriving into the United States. People placed on the DNB list are also “assigned a public health lookout record,” which will alert Customs and Border Protection officers in the event the person attempts to enter the country through a port of entry. The CDC’s Division of Global Migration and Quarantine (DGMQ) can conduct exit screening at foreign airports to identify travelers with communicable diseases and alert the relevant local authorities.

Finally, both federal and state governments have authority to impose isolation and quarantine measures to help prevent the spread of infectious diseases. While the terms are often used interchangeably, quarantine and isolation are actually two distinct concepts. Quarantine typically refers to separating or restricting the movement of individuals who have been exposed to a contagious disease but are not yet sick. Isolation refers to separating infected individuals from those who are not sick. Historically, the primary authority for quarantine and isolation exists at the state level as an exercise of the state’s police power in accordance with its particular laws and policies.

However, the CDC is also authorized to take measures “to prevent the introduction, transmission, or spread of communicable diseases from foreign countries into the States or possessions, or from one State or possession into any other State or possession.” In order to do so, the implementing regulations “authorize the detention, isolation, quarantine, or conditional release of individuals.” This authority is limited to diseases identified by an Executive Order of the President, a list which currently includes Ebola. Whether an isolation or quarantine order originates with the federal or state government, such orders will presumably be subject to habeas corpus challenges, and must also comport with the Due Process Clause of the Constitution.

View the original CRS Legal Sidebar here (pdf) includes active links.

And that legal challenge may soon be upon us. On October 26, Kaci Hickox, a nurse placed under mandatory quarantine in New Jersey, went on CNN on Sunday and criticized the “knee-jerk reaction by politicians” to Ebola.  According to CNN, Hickox, an epidemiologist who was working to help treat Ebola patients in Sierra Leone, has tested negative twice for Ebola and does not have symptoms.  Norman Siegel, Hickox’s attorney, and a former director of the New York Civil Liberties Union told CNN that he will be filing papers in court for Hickox to have a hearing no later than five days from the start of her confinement. Siegel told CNN that Hickox’s quarantine is based on fear.

Here is the link to the Executive Order 13295 of April 4, 2003 cited above by the CRS brief via:

[T]he following communicable diseases are hereby specified pursuant to section 361(b) of the Public Health Service Act:

(a) Cholera; Diphtheria; infectious Tuberculosis; Plague; Smallpox; Yellow Fever; and Viral Hemorrhagic Fevers (Lassa, Marburg, Ebola, Crimean-Congo, South American, and others not yet isolated or named).

July 31, 2014 Update

“(b) Severe acute respiratory syndromes, which are diseases that are associated with fever and signs and symptoms of pneumonia or other respiratory illness, are capable of being transmitted from person to person, and that either are causing, or have the potential to cause, a pandemic, or, upon infection, are highly likely to cause mortality or serious morbidity if not properly controlled. This subsection does not apply to influenza.”

A side note, the U.S. Ambassador to the United Nations, Samantha Power is currently traveling to the countries in West Africa hardest hit with the ebola outbreak:

 

 

Now, since Ambassador Power is not a medical worker, she probably will not be subjected to the NJ/NY mandatory quarantine when she gets back. However, on October 22, the Centers for Disease Control and Prevention (CDC) announced that public health authorities will begin active post-arrival monitoring of travelers whose travel originates in Liberia, Sierra Leone, or Guinea.  Active post-arrival monitoring, according to the CDC  means that travelers without febrile illness or symptoms consistent with Ebola will be followed up daily by state and local health departments for 21 days from the date of their departure from West Africa. Except that Ambassador Power’s return trip will not be originating from West Africa but from Belgium, the last stop on this West Africa-Europe trip before returning to the U.S.

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