from the world's big
When is a quarantine justified? A group of philosophers offers an answer.
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.
The use of isolation and quarantine has a history of success going back to the black plague. The practice of isolating sick people form healthy ones intuitively strikes many of us as useful, and many of us do it on our own accord when we fall ill. It seems like a simple step up from that to the idea of quarantining people who are sick or have been exposed to deadly diseases to stop them from spreading.
However, the impositions on individuals that quarantine requires, such as isolation from friends, family, and activity is a rather steep price to pay. Besides, the use of force to limit people's freedoms for the greater good is always a moral minefield. Deciding exactly when, where, and how to implement a quarantine is a tricky business.
A paper by Alberto Giubilini, Hannah Maslen, Tom Douglas, and Julian Savulescu of the Oxford Uehiro Centre for Practical Ethics might have a solution. By taking a moral approach to the problem, one that seeks the most robust possible foundation for intervention, the authors hope to provide sound guidelines to people considering the question of when to intervene and when to take no action.
What is a quarantine exactly?
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)
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."
Why would quarantine be a good idea? After all, they aren't sick yet!
"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.
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 might 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.
This consequentialist 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.
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.
They use the example of Peter Singer's drowning child. 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.
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.
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.
But what about the freedom of the individual?
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."
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.
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.
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 brought against the state. This case should be a warning against over-application of quarantines, but not against their use when they are correctly implemented.
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 next pandemic, we may be ruminating more moral questions sooner than we think.
Ready to see the future? Nanotronics CEO Matthew Putman talks innovation and the solutions that are right under our noses.
Innovation in manufacturing has crawled since the 1950s. That's about to speed up.
Evolution doesn't clean up after itself very well.
- An evolutionary biologist got people swapping ideas about our lingering vestigia.
- Basically, this is the stuff that served some evolutionary purpose at some point, but now is kind of, well, extra.
- Here are the six traits that inaugurated the fun.
The plica semilunaris<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NjgwMS9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYxMTgyMzg1NX0.ZY8qmhtoZfbRMAqrNnmbgyk7GLabglx_9lBq3PKcy7g/img.png?width=980" id="99882" class="rm-shortcode" data-rm-shortcode-id="68e8758894b0359c6ef61b2c158832b2" data-rm-shortcode-name="rebelmouse-image" />
The human eye in alarming detail. Image source: Henry Gray / Wikimedia commons<p>At the inner corner of our eyes, closest to the nasal ridge, is that little pink thing, which is probably what most of us call it, called the caruncula. Next to it is the plica semilunairs, and it's what's left of a third eyelid that used to — ready for this? — blink horizontally. It's supposed to have offered protection for our eyes, and some birds, reptiles, and fish have such a thing.</p>
Palmaris longus<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NjgwNy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzMzQ1NjUwMn0.dVor41tO_NeLkGY9Tx46SwqhSVaA8HZQmQAp532xLxA/img.jpg?width=980" id="879be" class="rm-shortcode" data-rm-shortcode-id="970e9c15f3c3d846dde05e2b2c6ebf12" data-rm-shortcode-name="rebelmouse-image" />
Palmaris longus muscle. Image source: Wikimedia commons<p> We don't have much need these days, at least most of us, to navigate from tree branch to tree branch. Still, about 86 percent of us still have the wrist muscle that used to help us do it. To see if you have it, place the back of you hand on a flat surface and touch your thumb to your pinkie. If you have a muscle that becomes visible in your wrist, that's the palmaris longus. If you don't, consider yourself more evolved (just joking).</p>
Darwin's tubercle<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NjgxMi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0ODUyNjA1MX0.8RuU-OSRf92wQpaPPJtvFreOVvicEwn39_jnbegiUOk/img.jpg?width=980" id="687a0" class="rm-shortcode" data-rm-shortcode-id="b38a957408940673ccc744f0f6828d18" data-rm-shortcode-name="rebelmouse-image" />
Darwin's tubercle. Image source: Wikimedia commons<p> Yes, maybe the shell of you ear does feel like a dried apricot. Maybe not. But there's a ridge in that swirly structure that's a muscle which allowed us, at one point, to move our ears in the direction of interesting sounds. These days, we just turn our heads, but there it is.</p>
Goosebumps<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NzMxNC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyNzEyNTc2Nn0.aVMa5fsKgiabW5vkr7BOvm2pmNKbLJF_50bwvd4aRo4/img.jpg?width=980" id="d8420" class="rm-shortcode" data-rm-shortcode-id="f735418322b34382dcd882299c9ccc48" data-rm-shortcode-name="rebelmouse-image" />
Goosebumps. Photo credit: Tyler Olson via Shutterstock<p>It's not entirely clear what purpose made goosebumps worth retaining evolutionarily, but there are two circumstances in which they appear: fear and cold. For fear, they may have been a way of making body hair stand up so we'd appear larger to predators, much the way a cat's tail puffs up — numerous creatures exaggerate their size when threatened. In the cold, they may have trapped additional heat for warmth.</p>
Tailbone<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NzMxNi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxMDMzMDc3N30.p9BEtkf3-PV3EtDSQMUGUeopsimiCHUagx97P4f8IBw/img.jpg?width=980" id="e8ab8" class="rm-shortcode" data-rm-shortcode-id="0063ce99bdd22fbebe1279244b87935c" data-rm-shortcode-name="rebelmouse-image" />
Coccyx. Image source: decade3d-anatomy online via Shutterstock<p>Way back, we had tails that probably helped us balance upright, and was useful moving through trees. We still have the stump of one when we're embryos, from 4–6 weeks, and then the body mostly dissolves it during Weeks 6–8. What's left is the coccyx.</p>
The palmar grasp reflex<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xOTA5NzMyMC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjY0MDY5NX0.OSwReKLmNZkbAS12-AvRaxgCM7zyukjQUaG4vmhxTtM/img.jpg?width=980" id="8804c" class="rm-shortcode" data-rm-shortcode-id="45469ca5ee5f43433a782f7d4ac0a440" data-rm-shortcode-name="rebelmouse-image" />
Palmar reflex activated! Photo credit: Raul Luna on Flickr<p> You've probably seen how non-human primate babies grab onto their parents' hands to be carried around. We used to do this, too. So still, if you touch your finger to a baby's palm, or if you touch the sole of their foot, the palmar grasp reflex will cause the hand or foot to try and close around your finger.</p>
Other people's suggestions<p>Amir's followers dove right in, offering both cool and questionable additions to her list. </p>
Fangs?<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Lower mouth plate behind your teeth. Some have protruding bone under the skin which is a throw back to large fangs. Almost like an upsidedown Sabre Tooth.</p>— neil crud (@neilcrud66) <a href="https://twitter.com/neilcrud66/status/1085606005000601600?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Hiccups<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Sure: <a href="https://t.co/DjMZB1XidG">https://t.co/DjMZB1XidG</a></p>— Stephen Roughley (@SteBobRoughley) <a href="https://twitter.com/SteBobRoughley/status/1085529239556968448?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Hypnic jerk as you fall asleep<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">What about when you “jump” just as you’re drifting off to sleep, I heard that was a reflex to prevent falling from heights.</p>— Bann face (@thebanns) <a href="https://twitter.com/thebanns/status/1085554171879788545?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script> <p> This thing, often called the "alpha jerk" as you drop into alpha sleep, is properly called the hypnic jerk,. It may actually be a carryover from our arboreal days. The <a href="https://www.livescience.com/39225-why-people-twitch-falling-asleep.html" target="_blank" data-vivaldi-spatnav-clickable="1">hypothesis</a> is that you suddenly jerk awake to avoid falling out of your tree.</p>
Nails screeching on a blackboard response?<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Everyone hate the sound of fingernails on a blackboard. It's _speculated_ that this is a vestigial wiring in our head, because the sound is similar to the shrill warning call of a chimp. <a href="https://t.co/ReyZBy6XNN">https://t.co/ReyZBy6XNN</a></p>— Pet Rock (@eclogiter) <a href="https://twitter.com/eclogiter/status/1085587006258888706?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Ear hair<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Ok what is Hair in the ears for? I think cuz as we get older it filters out the BS.</p>— Sarah21 (@mimix3) <a href="https://twitter.com/mimix3/status/1085684393593561088?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Nervous laughter<blockquote class="twitter-tweet" data-lang="en"><p lang="en" dir="ltr">You may be onto something. Tooth-bearing with the jaw clenched is generally recognized as a signal of submission or non-threatening in primates. Involuntary smiling or laughing in tense situations might have signaled that you weren’t a threat.</p>— Jager Tusk (@JagerTusk) <a href="https://twitter.com/JagerTusk/status/1085316201104912384?ref_src=twsrc%5Etfw">January 15, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Um, yipes.<blockquote class="twitter-tweet" data-conversation="none" data-lang="en"><p lang="en" dir="ltr">Sometimes it feels like my big toe should be on the side of my foot, was that ever a thing?</p>— B033? K@($ (@whimbrel17) <a href="https://twitter.com/whimbrel17/status/1085559016011563009?ref_src=twsrc%5Etfw">January 16, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
President Vladimir Putin announces approval of Russia's coronavirus vaccine but scientists warn it may be unsafe.
A new coronavirus vaccine on display at the Nikolai Gamaleya National Center of Epidemiology and Microbiology in Moscow, Russia.
Credit: Alexander Zemlianichenko Jr/ Russian Direct Investment Fund via AP
Medical workers draw blood from volunteers participating in a trial of a coronavirus vaccine at the Budenko Main Military Hospital outside Moscow, Russia.
Credit: Russian Defense Ministry Press Service via AP
A report from the New York Times raises questions over how the teletherapy startup Talkspace handles user data.
- In the report, several former employees said that "individual users' anonymized conversations were routinely reviewed and mined for insights."
- Talkspace denied using user data for marketing purposes, though it acknowledged that it looks at client transcripts to improve its services.
- It's still unclear whether teletherapy is as effective as traditional therapy.
Talkspace.com<p>Former employees also questioned the legitimacy of certain interventions by the company into client-therapist interactions. For example, after one therapist sent a client a link to an online anxiety worksheet, a company representative instructed her to try to keep clients inside the app.</p><p style="margin-left: 20px;">"I was like, 'How do you know I did that?'" Karissa Brennan, a therapist who worked with Talkspace from 2015 to 2017, told the Times. "They said it was private, but it wasn't."</p><p>Other former employees said the company would pay special attention to its "enterprise partner" clients, who worked at companies like Google. One therapist said Talkspace contacted her for taking too long to respond to Google clients.</p><p>Talkspace responded to the Times with a Medium <a href="https://medium.com/@founders_22883/talkspace-founders-respond-to-a-new-york-times-article-78d6f5c45c59" target="_blank">post</a>, which claimed the Times report contained false and "uninformed assertions."</p><p style="margin-left: 20px;">"Talkspace is a HIPAA/HITECH and SOC2 approved platform, audited annually by external vendors, and has deployed additional technologies to keep its data safe, exceeding all existing regulatory requirements," the post states.</p>