Illinois has ‘supreme authority’ to enforce coronavirus quarantine — but won’t use it
Gov. J.B. Pritzker’s stay-at-home order represents only a fraction of the power he could bring to bear in fighting the COVID-19 pandemic.
The governor, through the Illinois Department of Public Health, has “supreme authority” to declare and enforce quarantine or isolation. To defy an order is a Class A misdemeanor, which can come with a $2,500 fine and up to a year in jail.
The department can impose an immediate quarantine on entire areas or businesses, though they must obtain a court order or permission from those affected within two days. The state can also order testing for coronavirus. Anyone who refuses to comply could be subject to quarantine or isolation.
If people don’t adhere to stay-at-home guidelines, the number of coronavirus cases could increase, and the government could take stricter action.
“If people don’t stay at home, they can expect to see numbers climb,” said Herb Simmons, director of St. Clair County Emergency Management Agency. “If we’re not careful, what is the governor going to do? Well, he could say, ‘Nothing’s going to operate.’ People would not like that.”
The chances of Pritzker making such a declaration are close to zero — even if compliance with stay-at-home guidelines deteriorates. The reasons are political, financial and cultural. Pritzker has said as much.
“To be honest, we don’t have the resources, the capacity or the desire to police every individual’s behavior,” Pritzker said on March 20. “Enforcement comes in many forms and our first and best option is to rely on Illinoisans to be good members of their communities.”
Quarantine culture
Quarantine laws in Illinois date back to 1918, when Spanish Flu killed thousands across the state, including at least 147 people in Belleville. That was the last time the United States government quarantined entire areas to stop the spread of influenza.
But implementing a statewide quarantine in the 21st century would be a last resort because of the immensely complicated logistics, said Wendy Parmet, a professor at Northeastern University School of Law in Boston who specializes in public health law.
One of the most difficult logistical hurdles would be cultural.
“Could you imagine if March 1 your governor had said, ‘OK, total lockdown. If anybody leaves the house, we’re going to arrest them’? I think there would have been an outcry.”
Instead, Parmet said, state governments “tiptoed” through the steps of closing schools, then bars and restaurants, then non-essential businesses.
Illinois State Police Director Brendan Kelly said troopers “haven’t had to get to that level” of arresting and charging citizens for reckless behavior or violating a doctor’s order.
The state instructed police to first educate citizens. If that doesn’t work, police issue a verbal warning, then a written warning, followed by a cease and desist letter and then a court-ordered command to comply. The final option is arrest.
“Usually you’re able to get people into compliance by just having a discussion,” Kelly said. “There are signs that the curve is being bent, but now is not the time to let up. That process of education and gradual increasing measures of enforcement, we’re going to keep doing that. We’ll go as long as is required.”
The incremental approach to enforcement is what Americans expect, unlike in the Chinese city of Wuhan, where the government implemented a total lockdown to prevent the spread of coronavirus.
“We are not set up like the Chinese government to have the army come in,” Parmet said. “The way they did things in Wuhan would be sort of hard to imagine here. If we’re going to really enforce a stay-at-home order in a strict and stringent way, the government has to make it feasible to (stay at home).”
That would mean both consequences for breaking the rules, and a social safety net that allows people to stay at home. It would have to include generous unemployment benefits, paid leave, reliable access to supplies and drug prescriptions with more than a 30-day supply.
Because those nets were not in place, the crisis laid bare the inequality of a health care system based on employment, said Dr. Karen Joynt Maddox, a public health expert for Washington University and cardiologist at Barnes-Jewish Hospital.
“Some people have said (coronavirus) is the great equalizer,” Joynt Maddox said. “It’s not equal. It’s not at all equal. It’s going to hit the most marginalized communities hardest. It really exposed some of the fault lines in our society.”
Logistics of quarantine
Mass quarantines would be difficult for the government to pull off practically and legally, Parmet said. Federal and state governments have been daunted by the challenge of supplying protective equipment and ventilators to hospitals. How could they manage to deliver food and prescriptions?
“The government cannot constitutionally detain someone without providing for them,” Parmet said. “Are they going to go to the drug store and get your insulin? And get your food? We could go on and on and on. But we’re not set up for this.”
Legally, quarantine laws tend to apply on smaller, individual scales rather than for an entire state or area. The state’s powers are broad and powerful, but courts historically have established “a general principle of the least restrictive alternative,” Parmet said.
While regional models show cases might peak in the St. Louis area in late April, prematurely lifting or ignoring stay-at-home orders could prove devastating, said Maddox.
“If we just stick with it for a few more weeks, hopefully we will have crested the hill, and we’ll be able to start thinking about getting back to normal,” she said. “But if we let up too soon, we’ll be staying home for months and months more.”
