Rockland County, New York officials have issued a new order banning people exposed to measles from going to public places. This comes after a judge halted the county executive’s state of emergency April 5th.
Republican Rockland County Executive Ed Day says the measles outbreak is currently the longest one in the nation and the largest in the state in 30 years. Day says the outbreak in his county is accelerating.
“We have seen 33 new cases since we declared our now nullified state of emergency three weeks ago,” Day says. “In short, we saw this coming.”
His concern is amplified with the upcoming Passover and Easter holidays, and all the anticipated gatherings. The outbreak is mainly in Hasidic and Orthodox Jewish areas of the county. Day says Rockland was ahead of the crisis but became hamstrung with recent court rulings.
“The fact of the matter is that we have had five cases go to intensive care units, including one infant,” Day says. “Need we wait for someone to die?”
Day had issued his initial emergency declaration at the end of March under New York State Executive Law, Section 24, which he still believes was an appropriate vehicle.
“I plan to renew Rockland’s state of emergency when it expires on April 25 in the place of an emergency order related to that declaration of emergency, which I am permitting to expire,” says Day.
He says emergency declarations have been issued in this manner for storms, which Day says are far less critical than a public health emergency. Goshen attorney Michael Sussman represents parents of unvaccinated children who filed suit against the emergency order that barred those under 18 years of age unvaccinated against measles from public places. He says it is unfortunate that Day continues to assert emergency authority under a state law intended for different purposes. For now, Day is going a different route, through the county health department. County attorney Thomas Humbach explains.
“This is a whole different authority of law that this is, authorizing this action by the commissioner. It is a different theory of how to go about enforcement of the law,” Humbach says. “The emergency declaration is issued on a statute that does not have a lot of precedent and case law behind it. However, the powers of the commissioner of health to protect the public heath are very strong and have been the subject of much precedent in the court.”
County Health Commissioner Dr. Patricia Schnabel Ruppert has issued new guidelines under a “Communicable Disease & Exposure Exclusion Order.” First: any person diagnosed with the measles or exposed to a person diagnosed with the measles must be excluded from indoor and outdoor public places for up to 21 days. Individuals are required to cooperate with county public health authorities by providing information regarding details of one’s illness, exposures and contacts. Failure to comply can result in a $2,000 fine per violation per day.
“So my focus now will be on the children. As I mentioned, over 84 percent of cases in those have occurred in 18 years of age and younger,” Ruppert says. “And this order will be given to the parents of the children who are responsible for the child.”
Sussman says calls this a quarantine of the sort for which he has advocated for several months. Ruppert says another component of her order concerns unvaccinated students. MMR is the vaccine against measles, mumps and rubella. In December, Ruppert issued an exclusion order that applies to two zip codes considered hotspots, and keeps unvaccinated children from attending schools with vaccination rates below 95 percent. Now, she is expanding the exclusion order by ordering unvaccinated children, without medical or religious exemptions, from attending schools that have achieved the 95 percent rate.
“I have the authority from the state commissioner of health to exclude those children who are not up to date on their immunizations,” Ruppert says. “With this outbreak, I am implementing further exclusions of students without evidence of proper MMR vaccination, and that’s effective immediately.”
Schools in the two zip codes must continue to exclude unvaccinated students and turn over to the health department all requested attendance and vaccination records. Ruppert says the expanded order comes as she now has information resulting from a state and county audit that identifies students who are not vaccinated against measles or who do not have evidence of immunity against measles. Ruppert says the first order was delivered April 12 to parents of an unvaccinated child.
As of April 17, Rockland had 190 confirmed cases of measles since the outbreak began in October, with the visit of seven travelers from Israel. Separate from the suit against Day’s initial emergency order, parties are back in court this week as part of a lawsuit filed by more than 20 parents against the Rockland County Health Department and its commissioner. The lawsuit challenges the breadth of the December exclusion order barring their unvaccinated children from attending the Green Meadow Waldorf School in Chestnut Ridge.
Meantime, Westchester officials earlier in April confirmed the first eight cases of measles in their county and Orange County’s number of confirmed cases rose to 15. Sullivan County officials are taking precautions ahead of their summer season, when they expect an influx of visitors and second homeowners. Sullivan reported two cases in March. Dutchess County has no confirmed cases, but health officials there urge residents to know their measles vaccine status.
There also is a measles outbreak in Brooklyn, where city officials have mandated mandatory measles vaccinations. This, too, faces legal challenges.