Why aren’t we talking about forcible quarantine more?

That is the topic of my latest Bloomberg column, here is one excerpt:

There has been surprisingly little debate in America about one strategy often cited as crucial for preventing and controlling the spread of Covid-19: coercive isolation and quarantine, even for mild cases. China, Singapore and South Korea separate people from their families if they test positive, typically sending them to dorms, makeshift hospitals or hotels. Vietnam and Hong Kong have gone further, sometimes isolating the close contacts of patients.

I am here to tell you that those practices are wrong, at least for the U.S. They are a form of detainment without due process, contrary to the spirit of the Constitution and, more important, to American notions of individual rights. Yes, those who test positive should have greater options for self-isolation than they currently do. But if a family wishes to stick together and care for each other, it is not the province of the government to tell them otherwise.

What I observe is people citing those other countries as successes, wishing to “score points,” but without either affirming or denying their willingness to engage in coercive quarantine.  Here is another bit:

Furthermore, all tests have false positives, not just medically but administratively (who else has experienced the government making mistakes on your tax returns?). Fortunately, current Covid-19 tests do not have a high rate of false positives. But even a 1% net false positive rate would mean — in a world where all Americans get tested — that more than 1 million innocent, non-sick Americans are forcibly detained and exposed to further Covid-19 risk.

And this:

Coercive containment was tried during one recent pandemic — in Castro’s Cuba, from 1986 to 1994, for those with HIV-AIDS. It is not generally a policy that is endorsed in polite society, and not because everyone is such an expert in Cuban public health data and epidemiological calculations. People oppose the policy because it was morally wrong.

And what about uncertainty? Is it really a safe bet that America’s quarantine policy would be executed successfully and save many lives? What if scientists are on the verge of discovering a cure or treatment that will lower the Covid-19 death rate significantly? Individual rights also protect society from the possibly disastrous consequences of its own ignorance.

Here are a few points that did not fit into the column:

1. I am not opposed to all small number, limited duration quarantine procedures, such as say holding Typhoid Mary out of socializing.  This same point also means that a society that starts coercive quarantine very early might be able to stamp out the virus by coercing relatively small numbers of people.  (It is not yet clear that the supposed successes have achieved this, by the way.)  That is very different from the “mass dragnet” to be directed against American society under current proposals.

2. I am familiar with the broad outlines of American quarantine law and past practice.  I don’t see that history as necessarily authorizing how a current proposal would have to operate, and on such a scale.  In any case, I am saying that such coercive quarantines would be wrong, not that they would be illegal.  I believe it is a genuinely open question how current courts would rule on these matters.

3. From my perch from a distance, it seems to me that Human Challenge Trials for vaccines are more controversial than is mass forced quarantine.  I could be wrong, and I would gladly pursue any leads on the current debate you might have for me.  Who are the philosophers or biomedical ethicists or legal scholars who have spoken out against such policies?


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