The world is preparing to tackle the spread of the new Corona virus at a time when a construction team, in China, is racing to build a new hospital with a capacity of 1,000 beds in just six days. As the virus spreads in one of the world's largest cities, no one is allowed to leave. When the number of victims in Wuhan reached 15, a few days ago, government officials announced the start of the quarantine. Hence, trains, flights and public transport stopped. The authorities urged residents to stay at home, wear masks if they should go out, and demanded that they "not spread alarming rumors." As of last week, the district essentially imposed quarantine on nearly 35 million people, i.e. a population of 10 American cities combined.
It is an unprecedented intervention, and all over the world stock markets have slumped. Pictures of doctors and health personnel, dressed in full suits as they scan the front lines of passengers on planes, have drawn attention and grave concern over the seriousness of the situation.
Quarantine was common during the Middle Ages in Europe, and it continued to be the primary means of controlling the plague outbreak until 1900. After the advent of antibiotics and diagnostic tests, the relative damage began to outweigh the benefits. International agreements have been put in place to curb this practice as a controversial issue, because of the burden it places on people and economies, as well as basic questions of effectiveness. Quarantine can be used in isolated cases, especially before an outbreak. But in China, the new virus was first reported to the World Health Organization, just three weeks ago, and has since been detected in Japan, South Korea, the United States, Thailand, Singapore and Vietnam, and experts believe that any opportunity for effective containment has been lost.
Emergency scenarios
Soon after the quarantine was announced, the Washington Post reported an increase in food prices in Wuhan. Some citizens reported groceries free of goods, while social media circulated leaflets about people who had no access to medical facilities to carry out viral tests.
The main argument for quarantine is that in emergency scenarios, individual rights must be sacrificed for the collective good. In the United States, the constitutional basis for quarantine is somewhere between weak and non-existent, depending on legal experts. According to University of Arizona law professor James Hodge, restrictions on a large population may lead to some restrictions, and are unconstitutional in the United States. Another expert, Georgetown University legal researcher, Alexandra Phelan, questioned the response to the Corona epidemic, considering it overrated.
But crises call for extraordinary measures of state power anywhere. America's Centers for Disease Control and Prevention sought to detain people in 2018, despite the concerns of some human rights defenders and legal bodies. In 2014, before he became president, Donald Trump called for strict isolation during the Ebola outbreak, including the suspension of all flights to and from the affected states.
Lessons learned
The administration of President Barack Obama has monitored nearly 10,000 Americans for 21 days, and cases of Ebola have been discovered. The health authorities decided to keep the health-care worker in Liberia in quarantine, Connecticut, despite the fact that his test result was negative, prompting a lawsuit by civil societies, which claimed that the quarantine of the Ebola patients, violated Individual rights undermine efforts in West Africa.
Last year, the Johns Hopkins Center for Health Security designed a model of what would happen if the outbreak of the Corona virus reached the United States, and found that it could affect about 65 million people. One of the lessons learned from the model is that no country can be prepared on its own. Meanwhile, experts said a coordinated global response is key to understanding such an outbreak, including how it spreads, how to detect and treat the disease, and to prevent its spread.
Effective way
American scientists praised their Chinese colleagues for quickly sharing the virus genome with the rest of the world. Scientists at the National Institutes of Health reported this week that they are already working on a prototype vaccine, which may be available within three months. Scientists at Johns Hopkins University have launched a site to obtain genetic information and a map of cases.
On the other hand, Chandi John, former president of the American Society for Tropical Medicine and Hygiene, says: “It is still relatively early in the disease outbreak, and therefore non-travel prevention is an effective way to contain it in a region, especially since (Wuhan) seems to be a major transportation hub. And travel in China, ”he continued,“ the travel ban reduces the risk of moving residents of Wuhan or nearby cities carrying the virus, the epidemic, to another location. ” "From this point of view, I think it can be effective in limiting the spread, but there is something less severe than restricting all travel, such as telling people who have symptoms of infection to stay home," explains John, who is a professor of pediatrics at Indiana University.
Local culture
Quarantining an entire big city, or several cities, is not an approach that will work elsewhere. "A quarantine cannot ever be imposed on a city the size of New York, for example," said Arthur Kaplan, a biologist at New York University School of Medicine, noting that US authorities could not even enforce a quarantine imposed on a nurse who returned to the country, after a treatment mission Ebola patients in Sierra Leone, in 2014.
"Whether it is more effective in imposing quarantine on cities, as China has done, or just inviting individuals who feel ill to stay in their homes, it is a matter of local culture," explains Kaplan.
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Thousands of Americans were put on probation during the Barack Obama administration for 21 days.
An acceptable life
Whenever a government decides to quarantine someone, it must ensure that those affected have an acceptable quality of life, says New York University medical school biologist Arthur Kaplan. If a person is “kept in a room without television, heating or running water, this is not acceptable, for example,” and he continued, “Not allowing a person to leave a city of 11 million people” is not very heavy, at least. Until more information is known about the virus and its severity.
The stone has social repercussions, too, especially for marginalized individuals in society. Experts say that historically, the strict control needed in quarantine can link the disease to marginalized people, and may increase existing concerns about specific segments.
In 1901, after the outbreak of the plague, authorities in Cape Town established quarantine camps separated racially, a measure that was subsequently used as a scheme of apartheid during the apartheid era.
On the other hand, quarantine often has economic and financial implications, as the flow of trade to and from the quarantine region stops, and the goods that are shipped may be damaged, depending on how long the process takes.
Quarantine in Cape Town targeted marginalized groups. Archive
Quarantine cases
New York typhus fever (1892)
70 Russian immigrants were quarantined, placed and trapped in tents on an island off the city, and it became clear that migrant ships from Russia were the source of the epidemic.
San Francisco Plague (1900)
The city authorities cut out a residential compound, in Chinatown, with barbed wire, after allowing all white residents to leave. Fear of the plague spread, after the body of a Chinese immigrant was found in the basement of a hotel.
Flu in Europe and the United States (1917-1919)
This global epidemic necessitated widespread quarantine, as well as the suspension of studies in Europe, and a ban on public gatherings in parts of America.
SARS Epidemic in Canada (2003)
Although the SARS epidemic in 2003 led to the imposition of quarantine in several countries, Canada's response is largely disproportionate to these risks.
Ebola in Liberia and Sierra Leone (2014)
The West Point neighborhood in Liberia was cordoned off for 10 days in August, after residents raided a suspected patient center. The patients fled to the densely populated slums, prompting the government to isolate the neighborhoods for 21 days.