St. Louis County Executive Sam Page provides an update on local coronavirus cases during a news conference at the Office of Emergency Management in Baldwin. Image Credit: AP

When a St. Louis-area woman called her county's coronavirus hotline Thursday to report that she was experiencing symptoms, health officials said she and her whole family should self-quarantine at home. Her father took his other daughter to a school gala two days later.

The pair arrived Saturday at Villa Duschene's father-daughter dinner-dance, a formal affair at a Ritz-Carlton open to roughly 274 middle and high school girls and their guests. The man learned while he was there that the test results of the daughter with the symptoms indicated she had a presumptive case of the coronavirus, and he and his other daughter left the event, school officials said in an email circulating on social media.

The upscale Catholic school in St. Louis, and sibling school Oak Hill, canceled classes and activities on Monday "out of an abundance of caution" because of dance attendees' potential exposure to the contagious virus.

"We will use the day to gather information and guidance from health officials," school administrators wrote to parents. "Our priority is our students and we want to mitigate any risk within our community."

Community members on Facebook expressed outrage that the patient's father ignored officials' direction to self-quarantine, and some suggested the man should face legal consequences. Jenny Koziatek Benz, whose nieces attended the dance with their father, said in an interview that she was "furious" and concerned for her 81-year-old mother, who lives across the street from her nieces.

"This is absolutely unacceptable," said Benz, of Denver. "What kind of person would do something like that?"

The intense reaction underscores the resulting anger when someone disregards instructions to voluntarily stay home, as well as broader global anxiety about the virus that has infected more than 100,000 people around the world. The Missouri incident parallels a situation in which New Hampshire's first coronavirus patient ignored direction to self-isolate and is believed to have infected another person.

In addition to attending the father-daughter dance, the Missouri man visited Deer Creek Coffee in Ladue on Saturday morning, the St. Louis Post-Dispatch reported. The coffee shop's employees alerted the local health department and then started scrubbing the cafe.

"Disinfectant and bleach, a thorough cleaning," owner Kent McCarty told the Post-Dispatch. "There is no cleaner surface right now than at Deer Creek Coffee. I can promise you that."

St. Louis County Executive Sam Page told reporters on Sunday that health officials had assumed that "common sense and good will toward the community" would keep at home the family of the state's first coronavirus patient, a woman in her 20s who recently traveled to Italy. The family had expressed agreement with repeated requests to voluntarily self-quarantine, Page said.

By all accounts, the patient complied with the direction. Her father and sister, however, violated the main point of a quarantine - staying away from other people.

"The county health directors informed him today that he must remain in his home, or they will issue a formal quarantine that will require him and the rest of his family to stay in their home by the force of law," Page said Sunday.

Thousands of people across the country have been asked to self-quarantine since the coronavirus was first reported in the United States in January. Whether it comes from a person's doctor or from health officials, a request to self-quarantine is voluntary and lacks legal force, said Wendy Parmet, a health policy and law professor at Northeastern University.

A person could theoretically be held civilly or criminally liable for transmitting the virus after disregarding a self-quarantine request, but Parmet said those consequences are unlikely. A lawsuit would have to show that the infected person caused someone else's illness and failed to take reasonable care, while Parmet said criminal prosecution would be a bad way to make public health policy.

State officials, local officials or both in each state also have the power to issue quarantine orders, which are legally compulsory and carry a variety of consequences if violated. Some agencies need a judge to sign off on a quarantine order for it to last beyond a short period of time, Parmet said, while other agencies require the subject of the order to challenge it if they think it's unwarranted.

The Department of Health and Human Services, the parent organization of the Centers for Disease Control and Prevention, has broad authority to quarantine people "reasonably believed" to have been exposed to communicable diseases. A person who wants to challenge a CDC quarantine has to request an internal review or take their case to court.

In the most strict scenario, Parmet said police can enforce legally-binding quarantine orders. An in-between scenario also exists, where government officials threaten to file a legally-binding quarantine order but have not actually done so.

To get people to comply with self-quarantine requests before legal orders come into play, Parmet said officials should streamline their messaging around the virus and the purpose of staying away from other people when you might be infected.

"People are hearing that it's just a cold, or it's a hoax, or you can't get tested anyway," she said. "And then people are being sort of scapegoated for being the one who's out."