from the world's big
Quarantines are worth the trouble to keep the next pandemic at bay but they need to be applied intelligently.
- A new essay argues that quarantines are often needed, but require strict guidelines on when they can be used.
- Pandemics are inevitable, and actions that can save lives must be planned now.
- The arguments in this essay will undoubtedly be of use during the next outbreak.
What is a quarantine exactly?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xODYzMzkwMy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTU5ODc2Njg5N30.O_NoAoV1sVwKEpmlq6cVRxS6MjWxtU0fzBR9Qls4g8Y/img.jpg?width=1245&coordinates=0%2C0%2C0%2C122&height=700" id="fb3ee" class="rm-shortcode" data-rm-shortcode-id="7779ac5059618e73bbd1697876c8d133" data-rm-shortcode-name="rebelmouse-image" />
Health workers are seen with a young patient under quarantine at the Nongo Ebola treatment unit in Conakry, Guinea on August 21, 2015. The World Health Organization WHO has lost track of 45 people under surveillance, who had been in contact with a patient who contracted Ebola, in Guinea. (CELLOU BINANI/AFP/Getty Images)<p>For the purposes of this paper, isolation and quarantine had two different meanings. As the authors define them: "Isolation separates sick people with a contagious disease from people who are not sick. Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick."</p>
Why would quarantine be a good idea? After all, they aren't sick yet!<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xODYzMzkzMy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0NzI1ODg3OX0.RIT9_b3XhEJ5n5Aohr0PkWCBV7Lv8Y9dhHh6zq1EFT0/img.jpg?width=1245&coordinates=0%2C0%2C0%2C1&height=700" id="7d62a" class="rm-shortcode" data-rm-shortcode-id="4065a9a1ceb5bbb228cdc9cc6daeb0de" data-rm-shortcode-name="rebelmouse-image" />
"Typhoid" Mary Mallon, far left, in quarantine. Her refusal to wash her hands while carrying typhoid fever bacteria may have killed fifty people. She was forced into quarantine for the safety of the public.
(Public Domain)<p>The first argument that the authors make is the obvious one, society benefits a great deal from quarantining a person who might be carrying a deadly disease at a relatively low cost to that society and a moderate cost to the person quarantined. A person who is exposed to Ebola <em>might </em>contract the disease and start spreading it before they are aware of their illness. Quarantines try to prevent this by hiding away anybody who might have been exposed to a disease, even if they are asymptomatic. <br></p><p>This <a href="https://bigthink.com/scotty-hendricks/how-much-we-trust-someone-depends-on-their-response-to-this-moral-dilemma" target="_blank">consequentialist</a> stance is the one typically invoked by governments and state agencies when quarantines are introduced, but the authors don't think it is the best ethical foundation. After all, it might be for everybody's benefit to lock away anybody exposed to the common cold for a week to keep infection rates down. This seems excessive, suggesting that the final answer lies elsewhere. </p>
Personal responsibility<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="a55a6c0e463e3d07dad75d666f5d9b43"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/W3BmxyA3QPQ?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>The authors then argue that, in many cases, the individual exposed to a potentially deadly disease will have a moral duty to quarantine themselves; making what the authorities do merely the enforcement of what a person ought to do anyway.<br></p><p>They use the example of <a href="https://bigthink.com/scotty-hendricks/seven-thought-experiments-thatll-make-you-question-everything" target="_blank">Peter Singer's drowning child</a>. Singer famously asked if we had a moral obligation to save a drowning child if the act of saving them was at a low cost to us. He concluded that we do, and many people agree with him. The authors call this the duty of "easy rescue" and argue that it applies in many quarantine cases since the cost of a person hiding in their room until they know they won't make others sick is typically low while the payoff could include saving lives.</p><p>The authors then suggest that, "when the cost to us of engaging in some activity is small, and the harm to others which is prevented is great, the state may permissibly compel us to engage in that activity." They place this inside of certain parameters, however. </p><p>Most of us would agree that we must keep other people from getting sick when we are ill. However, the suggestion here is that in severe cases, like when the illness in question is deadly, that the state has legitimate power to make sure we stay home. This is more limited than just comparing costs and benefits and doing whatever gives the best payoff, but still allows for interventions during the worst outbreaks.</p>
But what about the freedom of the individual?<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="854435b868180f092dbd4a553a2b5408"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/gKYmVIUwEAw?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>The authors don't suggest that the authorities should always start with quarantines and use them whenever the mood strikes. They make it clear at the beginning of their paper that, "we will argue that authorities ought to implement quarantine and coercion in such a manner that they have the strongest justification possible for those measures.<em>"</em><br></p><p>They also point out that any rational use of quarantines would be limited to severe cases. As they note, while it might be a social net-positive to quarantine people with the stomach flu, the lack of threat it poses makes the action unthinkable. Ebola, on the other hand, is enough of a threat to people that quarantines would be justified. </p><p>At some point though, the freedom of a person to do what they like would be infringed on for the sake of the public health. Many people are put off by this. The question is determining when an individual poses enough of a threat to the people around them that forcing them into quarantine is justified. The authors are of the mind that this is permissible when a person might have a very deadly disease. </p><p>In some cases, quarantine laws are overused and not based on a cost-benefit analysis, such as when New Jersey introduced a quarantine of people who had been in certain African countries during the 2014 Ebola outbreak. The poorly thought out law was changed after a lawsuit was <a href="https://www.nytimes.com/2017/07/27/nyregion/new-jersey-accepts-rights-for-people-in-quarantine-to-end-ebola-suit.html" target="_blank">brought against the state</a>. This case should be a warning against over-application of quarantines, but not against their use when they are correctly implemented. </p><p>The idea of using force to lock people in their rooms to assure that others don't get sick is a tricky one. It makes perfect sense when we're healthy, but seems like a potential use of excessive force when we might be on the sick bed. Nevertheless, the ethics surrounding this issue are far from settled though. Given that we're already preparing for the <a href="https://www.scientificamerican.com/custom-media/jnj-champions-of-science/preparing-for-the-next-pandemic/" target="_blank">next pandemic</a>, we may be ruminating more moral questions sooner than we think.</p>
1.5 million children die each year from preventable diseases arising from poor sanitation systems. That's why some of the world's top scientists are working to make a 21st-century toilet without links to water, energy, or sewer lines, and which costs users under $0.05 a day.
In 2011, a research team featuring several Hertz Foundation Fellows received a grant to participate in the Bill & Melinda Gates Foundation’s ‘Reinvent the Toilet Challenge’. To bring sustainable sanitation to the 2.5 billion people globally who don’t have access to safe toilets, which leads to millions of deaths each year from highly preventable diseases, this team developed a self-powered combustion toilet that transforms feces into biological charcoal (biochar), clean water, and minerals. With the support of the Fannie and John Hertz Foundation, epidemiologist Philip Eckhoff pursued a PhD in applied and computational mathematics at Princeton University, receiving his degree in 2009.
Despite decades of research, there is no reliable vaccine for malaria. Dr. Philip Eckhoff lays out the strategies and collaborations required to eradicate this disease and the half a million lives it takes each year.
Philip Eckhoff is a
and recipient of the prestigious Hertz Foundation Grant for graduate study in the applications of the physical, biological and engineering sciences. Eckhoff is Principal Investigator of the disease modeling team at Intellectual Ventures. In this video, he explains what is involved in total global eradication of malaria and how interdisciplinary collaboration is the key to out-thinking and out-maneuvering this disease. With the support of the Fannie and John Hertz Foundation, he pursued a PhD in applied and computational mathematics at Princeton University, receiving his degree in doctorate in 2009.