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Federal Register / Vol. 86, No. 21 / Wednesday, February 3, 2021 / Notices
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those who are sheltered.37 In the context of the pandemic, increased emergency department use is untenable given the existing strains on the healthcare system.38
Additionally, research suggests that the population of persons who would be evicted and become homeless would include many who are predisposed to developing severe disease from COVID
19. Five studies have shown an association between eviction and hypertension, which has been associated with more severe outcomes from COVID19.39 Also, people experiencing homelessness often have underlying conditions that increase their risk of severe outcomes of COVID
19.40 Among patients with COVID19, homelessness has been associated with increased likelihood of hospitalization.41
These public health risks may increase seasonally. Each year, as winter approaches and the temperature drops, many persons experiencing homelessness move into shelters to escape the cold and the occupancy of shelters increases.42 At the same time, there is evidence to suggest that the homeless are more susceptible to respiratory tract infections,43 which may include seasonal influenza. While there are differences in the epidemiology of COVID19 and seasonal influenza, the potential cocirculation of viruses during periods of 37 Raven MC, Tieu L, Lee CT, Ponath C, Guzman D, Kushel M. Emergency Department Use in a Cohort of Older Homeless Adults: Results From the HOPE HOME Study. Acad Emerg Med. 2017
Jan;241:6374. doi: 10.1111/acem.13070. PMID:
27520382; PMCID: PMC5857347.
38 https www.wsj.com/articles/covid-19-surgestrains-hospitals-once-again-11605100312.
39 Hugo Vasquez-Vera, et al. The threat of home eviction and its effects on health through the equity lens: A systematic review. Social Science and Medicine. 175 2017 199e208.
40 Fazel S, Geddes JR, Kushel M. The health of homeless people in high-income countries:
descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet.
2014;3849953:15291540.
41 Hsu HE, et al. Race/Ethnicity, Underlying Medical Conditions, Homelessness, and Hospitalization Status of Adult Patients with COVID19 at an Urban Safety-Net Medical Center Boston, Massachusetts, 2020. MMWR 2020 Jul 10;6927:864869. Historically, African Americans and Hispanic Americans are disproportionately represented in evictions compared to other races.
They are more likely to experience severe outcomes of COVID19. Id.
42 See, generally, the Annual Homeless Assessment Report to Congress 2007, available at:
https www.huduser.gov/Publications/pdf/ahar.pdf acknowledging the seasonality of shelter bed use.
43 Ly TDA, Edouard S, Badiaga S, et al.
Epidemiology of respiratory pathogen carriage in the homeless population within two shelters in Marseille, France, 20152017: Cross sectional 1-day surveys. Clin Microbiol Infect. 2019; 252:249.e1
249.e6.

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increased occupancy in shelters could increase the risk to occupants in those shelters.
In short, evictions threaten to increase the spread of COVID19 as they force people to move, often into close quarters in new shared housing settings with friends or family, or congregate settings such as homeless shelters. The ability of these settings to adhere to best practices, such as social distancing and other infection control measures, decreases as populations increase.
Findings and Action For the reasons described herein, I am extending and modifying the September 4, 2020 Order, as further extended by Section 502 of Title V, Division N of the Consolidated Appropriations Act, 2021.
I have determined that extending the temporary halt in evictions in this Order constitutes a reasonably necessary measure under 42 CFR 70.2 to prevent the further spread of COVID19
throughout the United States. I have further determined that measures by states, localities, or territories that do not meet or exceed these minimum protections are insufficient to prevent the interstate spread of COVID19.44
Based on the convergence of COVID
19, seasonal influenza, household crowding and transmission, and the increased risk of individuals sheltering in close quarters in congregate settings such as homeless shelters, which may be unable to provide adequate social distancing as populations increase, all of which may be exacerbated as winter continues, I have determined that extending the temporary halt on evictions, subject to further extension, modification, or rescission, is appropriate.
Therefore, under 42 CFR 70.2, subject to the limitations under the Applicability section, the September 4, 2020 Order is hereby modified and extended through March 31, 2021.
Accordingly, a landlord, owner of a residential property, or other person with a legal right to pursue eviction or possessory action shall not evict any covered person from any residential property in any state or U.S. territory in which there are documented cases of COVID19 that provides a level of public-health protections below the requirements listed in this Order.
44 In the United States, public health measures are implemented at all levels of government, including the federal, state, local, and tribal levels. Publiclyavailable compilations of pending measures indicate that eviction moratoria and other protections from eviction have expired or are set to expire in many jurisdictions. Eviction Lab, COVID
19 Housing Policy Scorecard, available at: https
evictionlab.org/covid-policy-scorecard/.

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This Order is not a rule within the meaning of the Administrative Procedure Act APA but rather an emergency action taken under the existing authority of 42 CFR 70.2. The purpose of 70.2 is to enable CDC to take swift steps to prevent contagion.45
In the event that this Order qualifies as a rule under the APA, notice and comment and a delay in effective date are not required because there is good cause to dispense with prior public notice and comment and the opportunity to comment on this Order and the delay in effective date. See 5
U.S.C. 553b3B. Considering the public-health emergency caused by COVID19, it would be impracticable and contrary to the public health, and by extension the public interest, to delay the issuance and effective date of this Order.
In the September 4, 2020 Order, the previous CDC Director determined that good cause existed because the public health emergency caused by COVID19
made it impracticable and contrary to the public health, and by extension the public interest, to delay the issuance and effective date of the Order. The previous Director also found that a delay in the effective date of the Order would permit the occurrence of evictionspotentially on a mass scale that would have potentially significant consequences. One such potential consequence would be that evicted individuals would move into close quarters in congregate or shared living settings, including homeless shelters, which would put the individuals at higher risk for COVID19. Another potential consequence would be if evicted individuals become homeless and unsheltered, and further contribute to the spread of COVID19. For these reasons, the previous Director concluded that the delay in the effective date of the Order would defeat the purpose of the Order and endanger the public health and, therefore, determined that immediate action was necessary. As a result, the previous Director issued the Order without prior notice and comment and without a delay in the effective date. Because these conditions continue to existindeed, have worsenedand because the extension granted in section 502 of Title V, Division N of the Consolidated Appropriations Act, 2021 is set to expire on January 31, 2021, I hereby conclude that immediate action is again necessary without prior notice and comment and without a delay in the effective date.
45 Chambless Enters., LLC v. Redfield, No. 20
1455, 2020 WL 7588849, W.D. La. 2020.

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