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Shelter-in-place lockdowns aim to contain coronavirus

Pedestrians cross an empty street in San Francisco,

Pedestrians cross an empty street in San Francisco, where the Bay Area is under a shelter-in-place that started Tuesday. Credit: Bloomberg/David Paul Morris

Across Italy, Hoboken, Palm Springs, California, and the San Francisco Bay Area alone, there are nearly 70 million people living under mandatory lockdowns, shelter-in-place orders to stay at home to limit coronavirus infections.

New York City Mayor Bill de Blasio said Tuesday there could be a city lockdown. Gov. Andrew M. Cuomo on Wednesday night prohibited localities from issuing coronavirus-related orders without state permission.

"Social distancing" is in place in much of the country, including New York: limiting public gatherings, encouraging at least 6 feet between people, and other rules. Shelter-in-place lockdowns, a more aggressive epidemiological step, include those restrictions, but also mandates staying home and not leaving except for limited activities. Both are meant to slow infectious disease transmission and prevent surges that could overwhelm the healthcare system.

How much leeway is permitted during a shelter-in-place mandate can vary.

In Italy, which March 10 became the first democracy since World War II to go on lockdown, the country’s 60 million people aren’t allowed to move around without a business- or health-related reason; only essential businesses may remain open.

The Bay Area imposed shelter-in-place starting Tuesday and lasting until at least April 7; the order covers about 7 million people. The rules are more relaxed than Italy's but are still restrictive relative to normal living: no leaving home except for essential work, services or food. Homeless people are excluded from the rules.

On Tuesday, de Blasio said such an order in his city would need “some kind of method for knowing if people are actually doing one of the things authorized or not. And a lot of presence out on the streets to enforce. But we would have to create that from scratch.”

There's also been a shelter-in-place order in Palm Springs— where there were three deaths in the area. The order started Wednesday morning at 7 a.m. and lasts until at least April 2, when the city council must consider whether to extend it.

While not ruling one out for New York State, Cuomo said that he doesn’t see the need for a shelter-in-place mandate in the city, and that such an order would be ineffective unless coordinated with neighboring states. 

On Tuesday, Hoboken Mayor Ravi S. Bhalla issued "a new policy of self-isolation within our mile square," with exceptions for essentials akin to the Bay Area's; “activities such as running, jogging, bike-riding, walking, and other similar types of exercise are permitted... but only if social distancing of at least six feet is observed.”

Lockdowns paralyze local economies and test social networks. 

De Blasio on Wednesday told Hot 97 radio’s morning show: “Here's the challenge if you go with shelter in place. There are many people right now who have no money.”   He said that such a mandate would need to “find a way to compensate for the reality of folks who have no money for food, no money for medicines who may not, you know, have a place to turn when they need those prescription meds.”

“We've got to put all those structures in place immediately if there's any possibility of shelter in place because it alters the whole pattern of things,” he said. 

The government has long been able to limit individual rights to preserve the common good — a power that dates back to colonial America, according to a 2005 article in the journal Public Health Reports.

A few years after the Revolutionary War, for example, Philadelphia was isolated to contain the threat of a yellow fever outbreak, the article says. Isolation and other public-health measures were well established when the Constitution was drafted. Those measures have been upheld by the U.S. Supreme Court  — “salus publica suprema lex est” or “public well-being is the supreme law” is one of the legal doctrines at play — though the measures can be challenged in court. There have also been limits over the past 70 years set by the judiciary and legislature.

 State and local laws grant broad powers to local governments to control and prevent disease; mandating shelter-in-place is one of them.

Cuomo and de Blasio, among other public officials, have signed executive orders authorizing the escalating measures possible to contain the outbreak. 

Shelter-in-place mandates are enforced by the police, and the California order warns that disobeying it is a misdemeanor punishable by fine, imprisonment or both.

A 2007 analysis published in the Walsh Center for Rural Health Analysis found that about 80% of responding adults in metropolitan areas said they're likely to obey shelter-in-place instructions in the case of flu pandemic, with a little less than 20% unlikely.

But shelter-in-place is no cure-all.

In Asia, despite lockdowns, social-distancing mandates and public testing, the number of coronavirus cases has risen again, “crushing hopes that the region had contained the outbreak,” the Financial Times reported Wednesday: Many came from abroad once restrictions were lifted.