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February 13, 2020

US Emergency Legal Responses to Novel Coronavirus: Balancing Public Health and Civil Liberties

Author Affiliations
  • 1O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC
  • 2Center for Public Health Law and Policy, Sandra Day O’Connor College of Law, Arizona State University, Phoenix
JAMA. Published online February 13, 2020. doi:10.1001/jama.2020.2025

With increasing numbers of cases of coronavirus disease 2019 (COVID-19) globally and in the United States, Health and Human Services (HHS) Secretary Alex Azar declared a national public health emergency on January 31.1 The emergency declaration of the HHS authorizes additional resources, enhanced federal powers, interjurisdictional coordination, and waivers of specific regulations. State and local public health emergency declarations are also likely. During crises, government has a special responsibility to thoughtfully balance public health protections and civil liberties.

While epidemiological data are evolving, human-to-human transmission of COVID-19 has been documented over an incubation period of 2 to 14 days.2 Based on available data, the case fatality rate appears lower than that associated with other novel coronaviruses (severe acute respiratory syndrome [SARS] and Middle East respiratory syndrome [MERS]), likely no more than 2%. China has reported the majority of cases and deaths, especially in Wuhan and surrounding Hubei Province. The US population currently is at low risk, but infections could escalate if sustained transmission occurs. Absent rapid diagnostic tests, effective vaccines, or antiviral medications, health officials are focused on identifying cases and separating persons exposed or infected.

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