Coronavirus SARs-CoV-2 to be Added to Ryan White Act Disease Notification Requirements

The Centers for Disease Control and Prevention has undertaken steps to add the novel coronavirus, SARs-CoV-2, to the list of diseases that are subject to the emergency responder notification requirements of the Ryan White Act. Enacted in 1990 with a focus on HIV/AIDS, the Ryan White Act was expanded in 2009 to cover a range of infectious diseases that are subject to the notification requirements.

As enacted, the law authorizes the Secretary of Health and Human Services (HHS) to designate which diseases are subject to the notification requirements. The HHS has delegated authority for the list to the CDC, with input from the National Institutes for Occupation Safety and Health (NIOSH).

The law mandates that when a medical facility receives an exposure report from the “designated officer” of an “emergency response employee” (ERE) involving “a realistic possibility that the exposure incident … could potentially transmit an infectious disease” and when the “medical facility possesses sufficient medical information allowing it to determine that the victim of an emergency treated and/or transported by the involved ERE had a listed infectious disease that was possibly contagious at the time of the potential exposure incident” it shall “promptly” inform the designated officer (promptly being as soon as “practicable” but no later than 48 hours of the facility finding out).

A big limitation of the Ryan White Act is that it does not require a medical facility to conduct testing to determinate a source patient’s disease status. However, if the patient’s condition warrants testing, and/or the facility is otherwise aware of the patient’s disease status, it may so inform the designated officer, who in turn is to notify the ERE.

Inexplicably, HHS, the CDC, or NIOSH did not see fit to add SARs-CoV-2 to the list of diseases subject to the notification requirements until recently. Yesterday, after researching this extensively trying to ascertain if SARs-CoV-2  had indeed been added, I reached out to the CDC. This morning I received the following reply:

Currently Part G of the Ryan White Act does not include SARs-CoV-2 and the disease it causes, COVID-19. NIOSH is working quickly to add this to the List of Potentially Life-Threatening Infectious Diseases to which Emergency Response Employees May be Exposed; the Federal Register Notice adding this is scheduled to publish on March 27, 2020.

Thank you,


Chad H. Dowell, MS, CIH

Commander, U.S. Public Health Service

Deputy Associate Director for 

     Emergency Preparedness and Response 

National Institute for Occupational Safety and Heath

How about that for a coincidence! It just so happens they will be starting the bureaucratic process to add SARs-CoV-2 to the list tomorrow.

At any rate, the Ryan White Act is federal law. Many states have first responder protection laws that exceed the protections offered by the Ryan White Act. Many states have laws that apply to any infectious disease (no need for the bureaucracy to have to act affirmatively to add new illnesses to a list). In addition, many states have the ability to mandate that the source patient be tested once an exposure has been documented.

At least we are heading in the right direction…

Here is a webinar Billy Goldfeder and I did for Lexipol and the IAFC on the legal considerations associated with SARs-CoV-2.

UPDATE March 27, 2020: Here is the Federal Register entry:

About Curt Varone

Curt Varone has over 45 years of fire service experience and 35 as a practicing attorney licensed in both Rhode Island and Maine. His background includes 29 years as a career firefighter in Providence (retiring as a Deputy Assistant Chief), as well as volunteer and paid on call experience. He is the author of two books: Legal Considerations for Fire and Emergency Services, (2006, 2nd ed. 2011, 3rd ed. 2014, 4th ed. 2022) and Fire Officer's Legal Handbook (2007), and is a contributing editor for Firehouse Magazine writing the Fire Law column.

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