By Matt Leingang
The Cincinnati Enquirer

Local health commissioners have more power to confine people during a public health emergency under revisions to Ohio's quarantine laws that take effect today. Inspired by modern risks of a bioterror attack, the changes give health commissioners the authority to declare a quarantine without having to wait for full approval from their boards of health.

Prior laws - most of which were written in the late 1800s - were ambiguous about whether a local health commissioner could act on his own authority.

"This fills a gap," said Socrates Tuch, assistant legal counsel for the Ohio Department of Health. "There could be times during a large disease outbreak when waiting for a full board of health to convene would compromise the public's safety."

Once board members have had time to gather, they can reaffirm or nullify the commissioner's action, Tuch said.

Passed by the Ohio legislature last year and signed by Gov. Bob Taft in mid-November, the law takes effect todayfollowing the 90-day waiting period.

States are revamping their public health laws at the urging of the U.S. Centers for Disease Control and Prevention, the agency that would likely take charge if there were a large-scale bioterror attack or outbreak of an infectious disease. But in those critical first hours, state and local officials probably would make key decisions on quarantines and other medical matters.

During a quarantine, people believed to have been exposed to a disease are asked to stay at home or at another location, such as a medical facility. Compliance is voluntary, but public health officials could ask police for help if people refused.

"Quarantine is an extreme measure that would only be done under the most drastic circumstances, and I hope and pray that I never have to use it," said Hamilton County Health Commissioner Tim Ingram.

The county has other options - rapid public vaccinations and the canceling of mass gatherings, such as sporting events - before turning to quarantine to control an outbreak of smallpox or other diseases that spread quickly, Ingram said.

Civil libertarians say they are watching these new laws closely to make sure that state legislatures find the right balance between protecting individual rights and protecting the public's health.

Is Ohio giving too much authority to its 137 local health commissioners?

Quarantine power could turn out to be meaningless or it could turn out to be a nightmare, said Vernellia Randall, a law professor at the University of Dayton who teaches health care law.

"There's no reason why health commissioners can't panic like anyone else and abuse that power," Randall said. "But at the same time, we want them to be able to control outbreaks and to protect the public."

Ohio's last widespread use of quarantine occurred during the 1950s polio outbreaks and before that, the 1918 flu pandemic.

Other changes in the public health law that take effect today:  The state Health Department is authorized to buy antibiotics, vaccines and other pharmaceutical supplies that can be stockpiled in case of emergencies. This would avoid a possible delay in receiving medical supplies from the national stockpile.

 Hospital trauma centers are required to file a report with the state describing their preparedness and capacity to respond to disasters, mass casualties and bioterrorism.

E-mail mleingang@enquirer.com