Quarantine and isolation are public health powers that are as complicated as they are controversial.
Remember Typhoid Mary?
Mary was an immigrant from Ireland in the late 1880’s and a carrier of Typhoid Fever who didn’t believe she was infected because she wasn’t symptomatic. Still, wherever she worked people ended up dead. Eventually she was forced into isolation on an island off the coast of New York, where she died more than twenty-five years later.
We’re a few months into isolation and some are questioning the government’s right to impose it.
Does society’s interest to protect the health of its citizens take precedence over the civil liberties of individuals?
Is your right to live in a safe environment more important than my freedom to leave my home?
We should be allowed to leave our homes.
the constitution and individual freedom
The reason to take away our right to freedom is because doing so slows the spread of the coronavirus. In order to be lawful, the order needs to be reasonable, not discriminatory, and transparent.
example: Kentucky church wins lawsuit in lockdown
Parishioners planned to social distance by staying in their cars for a church service. But this was in violation with the city’s lockdown order, which prohibited all church services.
A federal judge ruled that while the city’s lockdown order was legitimate, it was also too broad and, at the same time, too selective. It allowed drive-up liquor stores to remain open but not drive-up churches. The judge ruled that the policy violated the First Amendment’s “free exercise of religion” clause because it was “not narrowly tailored” to advance the government’s purpose (of slowing the spread of the virus).
example: New Jersey’s state-wide lockdown
In New Jersey, the entire state is in lockdown. Is it reasonable to require all residents to shelter-in-place when some have been exposed to the virus and are now immune?
the coronavirus lockdown discriminates
We can’t all work (or school) remotely, which means the quarantine is not equally distributed to all Americans. In other words, social distancing is itself a privileged position.
less extreme measures
Are less extreme measures being pursued by our lawmakers? For example, how much collective effort has gone into developing antibody testing that would allow the COVID-immune population to return to work?
The chain of transmission could stop without sheltering in place if:
- Widespread testing occurs.
- It is followed by isolation of the people who test positive.
- The people who test positive are subjected to “contact tracing” in which they identify all the people with whom they’ve had contact.
- The people who are identified as contacts are quarantined.
We should stay at home for the collective good of the country.
international human rights principles
International human rights principles stress the importance of individual rights and freedoms, but make clear that freedoms can be restricted when the public health is threatened.
CDC’s role in protecting US public
The government (federal, state, local and tribal) has the authority to isolate and quarantine for a number of communicable diseases, including smallpox, Ebola, tuberculous, and others.
cures and therapies
Currently, there are no cures or therapies for COVID-19. Remdesivir has shown some early promise to shorten the virus but much more testing needs to be done.
effectiveness of shelter-in-place order
Shelter-in-place has been an effective strategy to flatten the curve, or to avoid overwhelming the healthcare system so that patients have the best access to doctors, equipment and therapies. Flattening the curve does not mean that the number of infected stop; it simply means that they are spread out over time.
It is a broad brushstroke approach that could be refined (to include a smaller number of people) through the use of contact tracing.
methods of contact tracing are currently being developed
If a patient tests positive, every person in contact with the patient is contacted. Every person in contact with the patient is asked to quarantine. It’s a time-consuming, labor-intensive process that could stop the chain of transmission and isolate cases as they spring up. In other words, it could effectively stop the spread of the disease rather than prolong it.
Contact tracing methods including cell phone technology are under development in the US, and were widely used in South Korea, considered exemplary in their ability to control COVID-19.
South Korea is much smaller than the US, they have a centralized healthcare system and fewer personal privacy concerns than the US. They also started the pandemic only one day before the US, and yet have recently had zero new cases after extensive and early use of testing and contact tracing.
Read more here.