Having worked w/ @CDCgov & ph law for 30 years, I'm deeply concerned that @CDCgov & @DistrictofC ph are being pushed aside in investigating major #COVID19 clusters at the @WhiteHouse. The @WhiteHouse is a public health & ethics free zone. It is lawless. Why? See this thread 1/X
Let's start w/ an analogy that seems over the top. Suppose the president assaulted a staffer in the @WhiteHouse. DC law enforcement doesn't have jurisdiction. What if @POTUS directed @FBI to stand down? Lawlessness, right? But that's not the same as #COVID transmission. Wrong!
Knowingly exposing others to #SARSCoV2 w/ ongoing transmission would produce even greater harm. @CDCgov has core expertise to trace contacts, find patient zero, save lives. But @Potus freezes CDC out. Stand down. DC health can't protect the public b/c it can't access @WhiteHouse
What would happen in a sane, safe world? @WhiteHouse physicians would rapidly report COVID positive patients to DC Health. @CDCgov would then partner w/ DC Health to test, trace, isolate, quarantine. Everyone else follows those ph rules
It is the very purpose of CDC and DC Health to safeguard the public from infectious diseases. That's is their legal mandate & that is their core expertise. Imagine a lawless world where they're both totally excluded. That is the USA today.
DC law requires physicians & other health providers to rapidly report COVID-positive cases. The District would then strictly isolate infected patients, trace contacts & quarantine those w/ close exposure. It would be unthinkable to mingle w/ the public, especially w/o a mask.
Failure to comply w/ DC ph law is an offense. Health officials & police could enforce the law, requiring safe behavior.
The @CDCgov's quarantine regs & Public Health Service Act grant the agency the power & duty to prevent interstate transmission of infectious diseases. Many in the @WhiteHouse live in VA or MD. COVID-19 is being spread not only on federal land, but in the District, MD, VA & beyond
How is it possible that in the heart of our govt a cluster of COVID cases can emerge, spread to Cong, the Pentagon, presidential debate, & to communities throughout the region? And we have no right to know. We can't rely on core ph agencies to protect us.
The @WhiteHouse has become an ethics-free, public health-free, and law-free zone? Does that comport with American values? Let @CDCgov & DC health do their jobs to protect the public. Enforce ph laws. COVID spread won't stop w/ top officials. It will affect families & communities
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Trump physicians are citing HIPAA Privacy Rule for w/holding key med info. Wrong on many levels. Yes, HIPAA could legally apply. But here's 3 major reasons why HIPAA cannot justify utter failure to be honest & transparent on the presiden'ts health.
1) The president is the chief executive w/ const'l duties. His health impacts our national security. The public has the right to know his condition honestly & in full. Right now we are being kept in the dark about key facts concerning his health & ability to govern.
2) HIPPA has a ph exception b/c ph officials need medical info to protect the public. PH agencies need to know when he tested #SarsCoV2 positive, when he was (or still is) infectious. They must know with whom he's been in contact. All needed for tracing, quarantine & isolation.
Should Trump return to @WhiteHouse? Yes, but only if he is fully cleared by Walter Reed treating physicians to return home. He should not leave against medical advice even if his own personal physician approves it. Why? See my thread. 1/X
The president should follow the advice treating physicians at Walter Reed because they are independent & experienced. The president's physicians, as we have seen, feel under pressure to present an "upbeat" picture even if unwarranted by clinical facts. It wouldn't be safe.
If the president returns to the @WhiteHouse he must self-isolate. @CDCgov recs isolation at least 10 days since symptoms first appeared & 24 hours w/o fever. Because Mr Trump was hospitalized & needed oxygen, he may need to isolate up to 20 days.
Thread explains why US w/drawal from @WHO is unlawful & unethical, among most ruinous presidential decisions in history. It will weaken US health & security in midst of a historic #COVID19 pandemic. That's why we sent a letter to Congress urging action:
Let's start w/ fact that @SecPompeo sent letter to @UN w/o first notifying @WHO or Congress. They weren't informed until a day later. No press briefing or media scrutiny. This lack of transparency & accountability is exactly the unfounded charge @POTUS made against @tedros.
Trump cannot unilaterally w/draw from @WHO w/o Congress. My article w/ @HongjuKoh explains why:
US entered WHO under Joint Congressional resolution. @POTUS can't w/draw w/o consent of Congress. US also owes all past & current @WHO dues through July 2021.
Why @POTUS threat to w/draw from @WHO is unlawful, reckless, and dangerous. See this thread 1X
Trump has no power to w/draw from @WHO unilaterally w/o Congress consent. US spearheaded WHO as 1st @UN agency. US ratified WHO Constitution. US also a party to IHR. IHR governs pandemic response. @POTUS cannot at a whim end treaty obligations w/o violating Const & Rule of Law 2X
Trump swore an oath to faithfully execute law of the land. Congress already funded @WHO. @POTUS has a duty to execute duly made laws incl spending bills. He can do great damage: obstruct, disrupt, delay. But his const'l duty is clear. He must fund @WHO as Congress provided 3X
Does @POTUS have legal power, as he claims, to #Quarantine NY, NJ & CT? This thread explains who has that power, whether a ban on travel between states is a good ph strategy for #Covid_19, & how such a mass cordon sanitaire could be enforced. 1/5
Re #Quarantining NY, NJ, CT is legal, effective & enforceable. 2/5
Conclusions:
★ @POTUS & governors both lack legal power to shutter a state
★ Mass quarantines are ineffective ph strategy
★ Patrolling state borders not feasible, contrary to US const'l & ethical values
3/5 Congress has exclusive power to reg interstate commerce (Art 1, s8, cl 3) Cong could restrict travel among states, but @POTUS cannot w/o statutory authority. @CDCgov (42 CFR § 70.2) can't ban interstate travel. Governors also have no power to stop exit/entry from their state
Language re #covid law, ethics, policy is wooly/confusing. What is #SocialDistancing Mass #Quarantine#Lockdown? We can't possibly balance PH & HRs w/o knowing exactly the intervention. This thread explains what policies are ethical & lawful, & those that are troublesome.
Following is lawful/ethical w/ individualized risk assess based on sci:
❖ Isolation: positive #SARSCoV2 test
❖ Quarantine: known exposed
❖ Close venues posing sig risk of spread (schools, businesses, mass gatherings)
These actions stretch law/ethics, no clear precedent in modern con law:
❖Cordon sanitaire of large area (incorrectly termed "lockdown")
❖So-called "Mass Quarantine" of large venue (nursing home, cruise ship, apartment block)
❖Draconian enforcement: armed guards, intrusive surv