MISSOULA - At their Aug. 24 meeting, the Missoula County Board of Health voted unanimously to follow the Center for Disease Control (CDC) guidelines regarding quarantine that differentiates between vaccinated and unvaccinated individuals. While still unchallenged in court, this decision has the potential to violate House Bill 702 which created vaccine status as a protected class under the Montana Human Rights Act, a state law that prohibits discrimination.
Prior to the discussion Missoula City-County Health Officer D’Shane Barnett explained the difference between quarantine and isolation.
Members of the public are asked to quarantine if they has been exposed to a positive case. This will keep them separate from others and not perpetuate the spread should they become positive. CDC guidelines now state that most people who are fully vaccinated and are not showing symptoms do not need to quarantine if they get tested and wear a mask for two weeks.
People are asked to isolate if they have tested positive for COVID-19. This is important to prevent others from contracting the virus. Barnett said individuals who test positive will be asked to isolate regardless of vaccination status.
Barnett also clarified what it means to be labeled a close contact. Close contacts are someone who was within six feet of an infected person for a cumulative total of 15 minutes within a 24-hour period within two days of the positive case developing symptoms or two days of the positive test if the person was asymptomatic.
This is slightly different within a K-12 indoor classroom. If an infected and exposed student are within three to six feet of each other and both were wearing masks consistently, then the exposed person is not considered a close contact. That does not apply to adults.
Except under certain circumstances, Barnett said the CDC states that close contacts who are not exhibiting symptoms and have been vaccinated from COVID or those who have been diagnosed with COVID within the last three months do not need to be quarantined.
Barnett explained the reason for treating vaccinated and unvaccinated people differently is the efficacy of the vaccines in keeping people from getting severely ill. The average age for those in Missoula who have been vaccinated that are experiencing severe illness if they contract COVID is 80. The average age for those who are experiencing severe illness among unvaccinated is 65.
Anna Conley, Missoula’s chief civil deputy county attorney, explained the conundrum should the Health Board continue to follow CDC guidelines, that they agreed to do in June 2021.
First the Health Board has state-assigned duties to implement quarantine and isolation measures to ensure the health and safety of the public. However, how that plays out is left up to the individual county boards.
House Bill 702 created vaccine status as a protected class under the Montana Human Rights Act, a state law that prohibits discrimination. Conley said there is a clear exception to the Human Rights Act that states there can be no discrimination unless reasonable grounds exist, such as vision requirements for drivers. HB 702 does not have a distinction based on reasonable grounds statements.
“That leaves a little bit of ambiguity on whether this very traditional, commonly used, ubiquitous, reasonable grounds justification for differential treatment applies in the HB702 context,” Conley said.
On Aug. 16 the Montana School Board Association issued an interpretation that stated that local school boards are not in compliance with HB 702 should they enter into a Memorandum of Understanding with local health department that follow CDC guidance releasing vaccinated individuals from quarantine. Conley explained this interpretation of HB 702 requires health departments to either quarantine every one regardless of vaccination status or no one at all. There are at least four counties in the state that are no longer issuing quarantine orders for anyone.
“It is hard to reconcile the ‘shall’ and the ‘must’ in those rules creating those [Health Board] duties, quarantine clearly being one of those, and just deciding we are not going to quarantine anymore especially just knowing that decision will result in potentially more spread of the communicable disease,” Conley said.
The Board of Health considered five options:
1. No quarantine requirements for anyone.
2. Quarantine both vaccinated and unvaccinated individuals equally which could create an issue with contact tracing.
3. Follow CDC guidance and quarantine only those unvaccinated close contacts but not the vaccinated close contacts with a potential legal challenge in regards to HB702.
4. Order quarantine for close contacts for individuals age 12 years old and younger and recommend quarantine for those older than 12.
5. Quarantine individuals based on a number of factors with preexisting conditions and vaccination status as one of those factors.
Conley explained that should they choose any of the options other than one or two, they could face legal challenge and may not be successful in regards to HB 702. However, she feels someone needs to answer the important question about the legality of HB702.
“It seems extreme to me that state law would prohibit us from following CDC guidance,” Conley said.
“I think option four moves us forward, it is not perfect, but it definitely gets started, gets our schools started and we can watch how things go,” Barnett said.
The Board of Health voted unanimously to continue following CDC guidance and quarantine only those unvaccinated close contacts but not the vaccinated close contacts. They recognized they could face legal challenge in regards to HB702, however, agreed this was the right thing to do for the health and safety of Missoula and its surrounding areas.
Following the Board’s decision, the Missoula City-County Health Department provided more details about how this decision will be implemented for those identified by the Health Department as a close contact.
Generally, unvaccinated close contacts who don’t develop symptoms and test negative for COVID-19 on their fifth day or later after exposure, only need to quarantine for seven days. If they develop symptoms or test positive, they need to isolate.
Vaccinated close contacts do need to quarantine after their exposure until the health department has proof of their vaccination status. Once proof is provided, then they do not need to quarantine further.
The CDC also recommends vaccinated close contacts get tested three to five days after they are exposed and wear a mask for two weeks. If their tests come back positive, they will need to isolate. If a vaccinated close contact develops COVID-19 symptoms, they will also need to isolate and get tested.
There are also a few other circumstances where vaccinated people may not be able to get around quarantine, such as a vaccinated parent who is caring for a COVID-19 positive child for several days resulting in continuous exposure to the virus and other circumstances. These special circumstances are why it is important for vaccinated close contacts to speak to the Health Department when we call.
For the most current information and data visit missoulainfo.com
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