Health Freedom Related Sections of CDC Notice of Proposed Rulemaking on Control of Communicable Disease

CDC Notice of Proposed Rulemaking (NPRM) on Control of Communicable Disease (Docket #: CDC 2016 0068) can be found by clicking here.  A pdf of the full 88 pages of the Notice can be found by clicking here.  Because it is so extensive and so long A Voice for Choice Advocacy is sharing the extracted sections that affect health freedoms, including forced vaccination, with comments which can be found on each below. (Credit given to an amazing activist for putting this together).  These can be used when giving public comment on this NPRM by clicking here.

Page 54232-33: Section 361 (42 U.S.C. 264) is divided into five subsections, (a)-(e).

subsection (a) does not seek to limit the types of communicable diseases for which regulations may be enacted, but rather applies to all communicable diseases that may impact human health. Section 361(a) (42 U.S.C. 264(a)) further authorizes the Secretary to promulgate and enforce a variety of public health regulations to prevent the spread of these communicable diseases including: Inspection, fumigation, disinfection, sanitation, pest extermination, destruction of animals or articles found to be sources of dangerous infection to human beings, and other measures. In contrast, section 361(b) (42 U.S.C. 264(b)) authorizes the “apprehension, detention, or conditional release” of individuals for the purpose of preventing the introduction, transmission, and spread of a limited subset of communicable diseases, specifically those communicable diseases specified in an Executive Order of the President, upon recommendation of the Secretary in consultation with the Surgeon General. HHS/CDC refers to this limited subset of communicable diseases as “quarantinable communicable diseases” because these are the communicable disease for which by statute quarantine, isolation, or conditional release are authorized. Section 361(c) (42 U.S.C. 264(c)) states that, except as provided in subsection (d), regulations regarding apprehension, detention, examination, or conditional release shall only be applicable to individuals coming into a state or U.S. territory from a foreign country or U.S. territory. 42 U.S.C. 264(c). Thus, subsection (c) provides the basis for the quarantine, isolation, or conditional release of individuals arriving into the United States from foreign countries for the purposes of preventing the introduction, transmission, and spread of quarantinable communicable diseases (as specified by Executive Order) while subsection (d) provides the statutory basis for interstate quarantine, isolation, and conditional release measures.

COMMENT: The CDC should not be making regulations on communicable diseases other than those on the quarantinable communicable diseases. Limiting the list of communicable diseases allows for the democratic decision of diseases to be added. Leaving the list unlimited, as proposed, leaves to much interpretation without feedback and too much power for the CDC/public health department. Measles, chicken pox, and the basic influenza should not be included in additional regulations of any kind. The communicable diseases the CDC wants to regulate should not be left open for them to add any disease that they want to add, such as Zika. Only the previous Executive Order quarantinable diseases such as Ebola, MERS, and TB should be included in CDC regulations. Also, regarding fumigating contaminated areas, this needs to be clarified that poison fumes, such as bug spray, will NOT be sprayed when humans are in the area.

Page 54233: Section 361 Subsection (d) states that regulations may provide for the apprehension and examination of any individual “reasonably believed to be infected with a communicable disease in a qualifying stage.” 42 U.S.C. 264(d)(1). As defined by this subsection, a “qualifying stage” means that the communicable disease is in “a precommunicable stage, if the disease would be likely to cause a public health emergency if transmitted to other individuals” or “a communicable stage.” 42 U.S.C. 264(d)(2). The subsection further states that if upon examination any such individual is found to be infected, he or she may be detained for such time and in such manner as may be reasonably necessary

COMMENT: Using a precommunicable stage to apprehend people is unacceptable and inappropriate. This could include any person in the world since we are all walking around getting exposed to other people. This is removing personal liberties. This part should be taken out of the rules.

Page 54233: Section 311 authorizes the Secretary to accept state and local assistance in the enforcement of quarantine rules and regulations and to assist states and their political subdivisions in the control of communicable diseases.

COMMENT: There should be no regulations for diseases not deemed quarantinable by executive order such as measles.

Page 54234: .B Historical Background for This Rulemaking: The 2005 proposal also stated that “provisional quarantine” could last up to 3 business days. CDC received public comments that the term “provisional quarantine” was inconsistent with public health practice and that relying on “business days” which by definition excludes weekends and holidays was inappropriate. In response, the current proposal does not use the term “provisional quarantine,” but rather uses the term “apprehension” which is a statutory term used in section 361 of the Public Health Service Act (42 U.S.C. 264(c) and (d)(1)), and is defined in this proposal as “the temporary taking into custody of an individual or group for purposes of determining whether Federal quarantine, isolation, or conditional release is warranted.” Furthermore, as explained in the preamble text explaining the use of the term “apprehension,” based on past experience, HHS/CDC believes that the service of a written order for quarantine, isolation, or conditional release can generally be accomplished within 24-48 hours of an apprehension.

COMMENT: As in the 2005 rules, a time frame needs to be set. Leaving no frame for the time of being apprehended and detained is unacceptable. An absolute set time from of 24 hours needs to be set…..”generally can be accomplished” is not acceptable when you are talking about apprehending people against their will. Also apprehending people in the United States of America is against the Constitution. These are law-abiding people who have not committed a crime and who are being apprehended against their will with no way out. The former term “provisional quarantine” needs to be put back in and the term “apprehend” needs to be removed. As stated in other areas of the proposal, the CDC has NEVER in 50 years needed to use the forced quarantine. All people have voluntarily agreed and no Federal Order has needed to be issued. WHY does the CDC think that there is a reason to create stricter rules when they have never needed to use the “looser” rules before. That makes no sense.

Page 54236: IV. Rationale for Notice of Proposed Rulemaking: A third and historically more common example is measles. Measles is a highly contagious, acute viral illness that can lead to serious complications such as pneumonia, encephalitis, and even death. Although not a quarantinable communicable disease, every case of measles in the United States is considered a public health emergency because of its extremely high transmissibility….Importations from other countries where measles remains endemic continue to occur, which can lead to clusters of measles cases in the United States in pockets of unvaccinated persons.

COMMENT: Actually many of the measles cases in the United States have occurred in vaccinated people including the outbreak at Disneyland California. This false statement needs to be removed. Measles is not a quarantinable disease and people should NOT be tracked for having measles. That is against their freedom of privacy and Constitutional rights. Remove this from the proposal.

Page 54236: IV. Rationale for Notice of Proposed Rulemaking: Given the grave consequences for mortality and morbidity of introducing and spreading these diseases, a strengthening of this reporting requirement via mandatory reporting according to the revised definition of an ill person, as described in this NPRM, is essential. This is validated by several recent instances of individuals traveling interstate while symptomatic with MERS, Ebola, Lassa fever, and measles.

COMMENT: Measles should be taken off this list, it should not be included with Ebola. Neither measles or varicella should be included in these rules.

Page 54236: IV. Rationale for Notice of Proposed Rulemaking: The proposed updated definition of “ill person” also includes a provision for the CDC Director to revise the symptom definition as needed in response to a newly identified communicable disease; this will greatly enhance HHS/CDC’s ability to respond rapidly to emerging public health threats.

COMMENT: There should be no option to change these rules to update symptom definition in the future. If changes are needed, then a new proposal for the public needs to be given before the change. Basically leaving the option to add and change definitions as needed, with no one in the public having input, gives too much free reign for the CDC to do whatever they want against the peoples’ will.

Page 54237: In certain circumstances, HHS/CDC has allowed people contagious with or exposed to serious communicable diseases to travel interstate if this can be done in a manner that does not expose the public (e.g., by private vehicle). However, the needs of the individual to engage in travel must be carefully weighed against the public health risk due to the potential lack of public health oversight, especially during travel over long distances or crossing multiple states. For this reason, during the 2014-2016 Ebola epidemic, HHS/CDC recommended against long-distance travel by private vehicle for people with certain types of exposures to Ebola. State and local public health authorities, relying on their own legal processes, enforced these recommendations by imposing their own movement restrictions on individuals potentially exposed to Ebola. While HHS/CDC could similarly impose movement restrictions for individuals reasonably believed to be infected with a quarantinable communicable disease through the issuance of a Federal order for isolation, quarantine, or conditional release, codifying in regulation a separate, formal process to issue interstate travel permits for individuals subject to controlled movement allows for greater transparency and public understanding of what actions HHS/CDC may take to condition an individual’s travel on the observance of public health measures to assure the safety of other travelers and communities.

COMMENT: The CDC should not be adding these stricter movement rules. The movement rules were left up the Federal Executive Order, which the CDC acknowledges they have never had to use, so why add this where there is already an option to have it happen by Executive Order as needed, not whenever the CDC feels like it. Remove this strict portion.

Page 54237: Table for required data elements of public health interest:

Address while in the United States (number and street, city, state, and zip code), except that U.S. citizens and lawful permanent residents will provide address of permanent residence in the U.S. (number and street, city, state, and zip code; as applicable)(18)X

 

Primary contact phone number to include country code                                                                                                                                   X

 

Secondary contact phone number to include country codeXEmail Address                                                                                                  X

 

Seat or Cabin Number                                                                                                                                                                                               X

COMMENT: phone number and email address should not be added to collected passenger information

Page 54238: A. Updates to Part 70:
§ 70.1 General Definitions Apprehension:  In certain circumstances, the individual may remain apprehended pending confirmation that he or she is not infected or not reasonably believed to be infected with a quarantinable communicable disease. If it is necessary to issue the individual a Federal order for quarantine, isolation, or conditional release, the individual will remain apprehended pending the service of the written order. The factors that may give rise to an order for quarantine, isolation, or conditional release are discussed in detail in the preamble section discussing the definition of “reasonably believed to be infected, as applied to an individual.” Based on past experience, HHS/CDC believes that a written Federal order may be served to an individual within 24-48 hours of an apprehension. These timeframes are merely offered as guidance and HHS/CDC believes that the facts and circumstances of each case will dictate the expected length of an apprehension. Generally, however, HHS/CDC does not expect that the typical public health apprehension will last longer than 72 hours. It is not HHS/CDC’s intent through this definition to allow for extended apprehensions absent the issuance of a Federal order for quarantine, isolation, or conditional release. HHS/CDC requests public comment concerning the expected apprehension period (no longer than 72 hours), and whether there are any public concerns with the absence of a specific maximum apprehension period in the regulation.

COMMENT: A time frame must be given. People cannot be held for an unlimited amount of time against their will. Using the term “generally” not longer than 72 hours is not binding by any means. Keep the original language of “provisional quarantine” and 3 day limit.

Page 54239: Conditional Release: HHS/CDC is proposing to define conditional release to mean “surveillance” as that term is proposed in 42 CFR 71.1 and update the definition to include public health supervision through in-person visits by a public health official (or designee), telephone, or through electronic or internet-based monitoring as that term is defined. Surveillance under § 71.1 is currently defined as temporary supervision by a public health official (or designee) of an individual or group, who may have been exposed to a quarantinable communicable disease, to determine the risk of disease spread. HHS/CDC is proposing to expand the definition of conditional release to clarify that it may include electronic or internet-based monitoring in addition to in-person visits by a public health official or telephone reporting by the individual under a conditional release order. A proposed definition for electronic or internet-based monitoring has been included as part of this proposal and is discussed below. In general, such monitoring may include electronic or internet-based systems, such as video chat and voice calls from computers, tablets and mobile devices. This language is intended to be broad and would apply to any new or existing technologies that would allow for the public health supervision and monitoring of an individual under a conditional release order.
Electronic or Internet-Based Monitoring: HHS/CDC has proposed a definition for “electronic or internet-based monitoring” that defines this term as referring to mechanisms or technologies allowing for the temporary public health supervision of an individual under conditional release, including electronic mail, SMS texts, video conference or webcam technologies, integrated voice-response systems, entry of information into a web-based forum, wearable tracking technologies, and other mechanisms or technologies as determined by the Director or supervising health authority. HHS/CDC specifically solicits comment regarding whether this proposed definition is sufficiently broad to apply to any new or existing technologies that would allow for the public health supervision and monitoring of an individual under a conditional release order. HHS/CDC also solicits comment regarding whether the proposed definition raises any privacy implications for an individual who is reasonably believed to be infected with a quarantinable communicable disease and who is subject to a conditional release order.

COMMENT: This does raise privacy implications for an individual. The CDC is proposing to force the person to wear trackable devices. Many electronic devices emit dangerous EMF rays and should not be worn directly on the body. Also using a webcam to video and view the person around their home is an invasion of privacy. There should be no portion of this proposal that allows for more ways to track the individual to be added. A new public forum for any additions to the a proposal is needed at that time.

Page 54239: Ill Person Definition: However, HHS/CDC is also including a provision in this NPRM to allow it to include additional signs and symptoms of illness in case our understanding of the recognizable symptoms of communicable diseases of public health concern, such as Ebola, may change or to respond to communicable diseases that may emerge as future concerns. Notice of such additional signs and symptoms will be published in the Federal Register.
Skin rash: This term means that the individual has areas on the skin with multiple red bumps
Persistent cough: This term means that the cough is frequent and severe enough that it catches the attention of the crewmember, or the individual or another passenger voices concern about it. Persistent cough, along with fever, may indicate the traveler has pertussis/whooping cough

COMMENT: The new definition of an ill person is too open, especially for the addition of skin rash and persistent cough. The CDC admits that none of the travelers that had Ebola and flew to spread it to other countries has no signs of illness. This new definition appears geared more toward non-quarantinable diseases such as measles, chickenpox, and whooping cough. In fact the proposal mentions those three diseases specifically when it is defining an ill person even though it states the new ill person definition is aimed to catch those with Ebola. Measles, varicella, and whooping cough are NOT diseases that are “quarantinable”. What is the CDC trying to do with this new definition? It appears that they are more concerned with getting airlines to turn on people who have NON-quarantinable diseases versus Ebola. The former definition of ill person needs to be maintained and this new definition needs removed. Additionally this updated definition if going to include those with seasonal allergy coughs, general cold coughs and fever, and those with ecezema and bug bites that are itching and oozing from being scratched.

Page 54241: Medical reviewer means a physician, nurse practitioner, or similar medical professional qualified in the diagnosis and treatment of infectious diseases who is appointed by the HHS Secretary or CDC Director to conduct a medical review. The medical reviewer may be an HHS or HHS/CDC employee, but only if the employee differs from the HHS/CDC official who issued the Federal order for quarantine, isolation, or conditional release. The medical reviewer’s role will be to review the medical or other evidence presented, make medical or scientific findings of fact, and issue a recommendation to the CDC Director concerning whether the quarantine, isolation, or conditional release should be continued, rescinded, or modified. The medical reviewer and the medical representative will be different individuals

COMMENT: The medical reviewer should not be an employee of the CDC. This can represent a conflict of interest. The CDC employed physician may continue a quarantine for fear of being reprimanded by the CDC employer if he releases the person sooner than expected. An independent contractor should be used as the medical reviewer.

Page 54241: Public Health Emergency:  Under section 361(d) of the Public Health Service Act, in order to authorize the quarantine, isolation, or conditional release of any individual traveling interstate, CDC must reasonably believe that an individual is infected with a communicable disease in a qualifying stage. 42 U.S.C. 264(d)(1). As defined by this subsection, a “qualifying stage” means that the communicable disease is in “a precommunicable stage, if the disease would be likely to cause a public health emergency if transmitted to other individuals” or “a communicable stage.” 42 U.S.C. 264(d)(2). While the phrase “public health emergency” also appears under section 319 of the Public Health Service Act (42 U.S.C. 247d(a)), the use of the same phrase in both sections 319 and 361(d)(2) are not necessarily synonymous. Accordingly, HHS/CDC felt it was important to define “public health emergency” as used under section 361(d)(2) to provide the public with a clear understanding of HHS/CDC’s authority for interstate quarantine, isolation or conditional release. Public health emergency as used in this part means any communicable disease event as determined by the CDC Director with either documented or significant potential for regional, national, or international communicable disease spread or that is highly likely to cause death or serious illness if not properly controlled; or any communicable disease event described in a declaration by the Secretary pursuant to § 319(a) of the Public Health Service Act (42 U.S.C. 247d(a)); or any communicable disease event the occurrence of which is notified to the World Health Organization, in accordance with Articles 6 and 7 of the International Health Regulations, as one that may constitute a Public Health Emergency of International Concern; or any communicable disease event the occurrence of which is determined by the Director-General of the World Health Organization, in accordance with Article 12 of the International Health Regulations, to constitute a Public Health Emergency of International Concern; or any communicable disease event for which the Director-General of the World Health Organization, in accordance with Articles 15 or 16 of the International Health Regulations, has issued temporary or standing recommendations for purposes of preventing or promptly detecting the occurrence or reoccurrence of the communicable disease. HHS/CDC specifically requests public comment on this definition and its utility in identifying communicable diseases that “would be likely to cause a public health emergency if transmitted to other individuals” under 42 U.S.C. 264(d)(2)(B).

COMMENT: In my opinion this is one of the worst portions of this proposal. It appears to allow the CDC to quarantine, isolate, and conditional release of almost anyone with a communicable disease such as chickenpox or measles. The “would be likely to cause a public health emergency if transmitted to other individuals” needs to be removed. Only qualified quarantinable diseases under Federal Order should be included in this proposal. No other communicable diseases should be involved in this or have any updated rules. This leaves the CDC wide open to taking individuals freedom, privacy, and movement.

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