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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Column: quarentine is morally wrong

Blog: eh, maybe we can try it sometimes, as long as we know it will be limited

Does any terrible policy pop up as terrible on its face, or do they evolve? Given the tilt of this blog, I'm surprised to see an endorsement for opening the door.

good point look at the attempted forced quarantine of General Flynn!
the american left & media still have not updated their priors?

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Okay, generally agree, but let's face it, the US is quite FULL (is it materially more than most other countries? I've lived in 3 others, and I'd bet money on "yes", but admittedly it's speculative) of citizens who don't give a shit about their fellow citizens. They're quite happy going about their lives endangering others with the excuse of "personal rights." Fuck them.

in our middleclass neighborhood peeps are managing pretty well outside. socially distancing, lotta masks, lotta babies , lotta dogs and now in the evening, wolves

Absolutely! And I'm right there with them.

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How many of them see themselves as endangering others and not just making the risk/reward trade off they believe themselves entitled to?

instead of risk/reward
think efficacy
nobody has ever made the bold assertion that they are entitled to
shut down most of a countries economy for months.

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The next man's liberty stops at the end of my nose. His virus does not.

Speaking with Ronald Coase, we have to be careful in defining rights: Do I have a right to remain virus free or does the next man have the right to spread his virus. Since we can't haggle over this as individuals, we want the regime that distorts least. That, in turn depends on the severity of the virus and the spreading behavior of individuals. This speaks fir the forcible isolation of superspreaders of the current virus.

If this is all too much of a gray area for you, Karen, here's a hint: one of these is a negative right and the other is a positive right.

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Dismalist, Good point. Does the person with a communicable skin disease have a right to go swimming in the pool and infect others.

We often have compacts to limit our rights--they're called laws--so that we all may preserve our right to live or live safely. We both gain the liberty to be free of each other's diseases by agreeing to laws and following them.

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Human beings have had the right to assault your nose and person with the unintentional transmission of their shedding bacteria / viruses / spittle for millenniums. You cannot escape the organic world. This is silly.

In other words, the infection disease expert and epidemiologist years of research amount to nothing compared to the blathering of the ignorant

The "infectious disease expert" (medical errors major cause of death) and the epidemiologist, a theoretical statistics maven, are not only qualified but morally capable of directing the activities of everyone else? They're not "blathering" themselves? There's a dearth of genuine knowledge in this situation, especially amongst the experts.

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"The governments of open societies now find themselves in the precarious position of having to decide what their citizens can and cannot do. And of course it’s not easy for citizens either—we are not used to governments curtailing our personal freedom. With the negative social and economic effects mounting, maintaining the social distancing marathon in open societies is going to be a challenge...

"In order for governments to promote public health effectively, they must ensure their citizens abide by the orders, without turning their open societies into police states. Insight into how people interpret and respond to laws can help governments walk this tightrope.

"One factor governments would be wise to pay attention to is legitimacy—the degree to which citizens trust that their government protects their general interests and does so in a way that is fair, appropriate, and unbiased."

Article then goes on to describe how hard legitimacy will be in this climate of fake news, polarization, and identity politics.

https://behavioralscientist.org/how-to-lock-down-an-open-society/

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If you want people to stay in quarantine you'll have to pay them. Of course, we can't have that, so in two or three months they'll start leaving their homes to go find work.

Having shuttered a quarter to a third of the economy, the Big Line is coming down so I'm not surprised to see this issue being discussed.

Quarantine shouldn't last for more than a month. If it's worse than that, then it's hospitalization. And sure, there's no reason the Federal government couldn't pay for quarantines. It wouldn't be a particularly large portion of the population.

The Federal government is already paying those who were paid less than $15 an hour to quarantine. Unless they are illegals working in slaughterhouses.

Note Tyler confused quarantine with isolation.

Quarantine is for populations who might be infected, but probably aren't.

Isolation is for those infected.

Conservatives are calling for forcing the working poor who are possibly infected to work for $10 an hour spreading disease to higher income people so businesses profit.

"Note Tyler confused quarantine with isolation.

Quarantine is for populations who might be infected, but probably aren't.

Isolation is for those infected."

No, you're confused.

quarantine =impose isolation on (a person, animal, or place); put in quarantine.

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Mulp - I doubt that grow all of the food that you consume, given the apparent amount of time that you spend here spouting inane nonsense. There are therefore, quite a few people likely earning about $10 per hour who you want working at food plants, warehouses, retailers, takeout restaurants, etc. so that you have food to eat.

I will also heartily invite you to lower your own lifestyle to a bare minimum and then pay the rest of your earnings to a charitable fund with the goal of making sure that none of the working poor have to work again.

Aren't those essential services still open and running, with safety and hygiene procedures in place? That's what's happening in competently governed countries. We're not, like, running out of food...

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Surely this is, to some extent, a quantitative judgment (as you allude to in the 2nd half of our addendum #1). If the disease were so contagious/deadly that a sick person staying with their family was, in expectation, equivalent to one or more negligent homicides (of people outside the family who is not consenting to the increased risk) then it would absolutely be right and necessary to violate the rights of the sick and their family - in order to prevent the much greater infringement upon the rights of individuals in the larger community.

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And then there is Taiwan, doing better than any of those with less coercive methods.

Taiwan has centralized quarantine facilities

I know someone wrote an article trying to claim this. The article was trying to win support for centralized quarantine, so being able to cite Taiwan was advantageous. This Reuters article, however, indicates that most quarantines are at home: "Taiwan has 86,000 people in quarantine, mostly at home but also in hotels for those who don’t live on the island." [https://www.reuters.com/article/us-health-coronavirus-taiwan-quarantine/taiwans-carrot-and-stick-approach-to-virus-fight-wins-praise-but-strains-showing-idUSKBN21E0EE].

Japan has only quarantined visitors for 14 days if they have the virus.

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A writer at The Dispatch has proposed "Real Quarantine" as well: https://thedispatch.com/p/what-if-we-tried-a-real-quarantine

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Scoring points off Taiwan? Almost all countries bordering China have done well, just as likely because they've been through it before, are homogenous, and island easily sealed off, etc. Much to Tyler's point.

Taiwan is not all that that socially homogeneous. There are distinct ethnic groups and different languages.

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There is a very different social ethos in Taiwan. Where the US is highly attached to the myth of the individual; the Chinese have a social order myths. The differences in guiding mythologies produces different successes and failures. If I had to pick countries where the reigning mythologies would prevent a coherent response to C19 the US and the UK would be near the top of the list. It's not something that the US can do well.

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Of course, we would never quarantine essential workers, not unless there is an army of them to replace those quarantined. Cowen's version of free enterprise is only free for those in the top quintile, who have the freedom to self-quarantine and still collect an income. The pandemic is is shining a bright light on what we have created: an economy benefiting the few while the few rely on the many low paid workers to make the lives of the few comfortable. Cowen would argue that the many benefit from the few, who are the innovators who produce and deliver the essential medical supplies during times of health emergencies. As Annie Lowrey writes, economics 101 doesn't dictate the plight of essential workers, it was a choice made by the few who benefit from the arrangement. https://www.theatlantic.com/ideas/archive/2020/05/why-are-americas-most-essential-workers-so-poorly-treated/611575/

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Some people have been separated from their families for months by travel bans with no end in sight. Separating families for two weeks for a centralized quarantine is a mild imposition by comparison.

I'm not saying I support forced central quarantine (it is a severe imposition on liberty and there should be a high burden of proof to show that it is effective before we undertake it). But I am pointing out that "American notions of individual rights" are not as expansive, or at least not nearly as evenly distributed, as we pretend they are. Most of us Americans are happy with severe impositions on the freedom of people at the margins of society even as we fiercely resist relatively milder impositions on freedom that could affect us personally.

Also, many of the above-mentioned Asian countries are now lifting their lockdowns and travel restrictions, or in some cases like South Korea and Hong Kong, only implemented mild ones to begin with. It's not at all clear to me that we will come out of this virus with more "freedom" than South Korea or Hong Kong, and attributing our failures at fighting the coronavirus to "freedom" is just a comforting story to distract from our lack of competence, essentially the 2020 version of "the terrorists hate us because of our freedom."

If you want civil rights under a state's charter, then you have to be a member in good standing of that state. I'm not a member in good standing of the state of South Korea, so I don't get to enjoy the civil rights of the South Koreans. I don't see what I'm supposed to outraged about here.

Individual rights come from people's innate moral value, not from the charter of some state.

That is not a serious statement.

I guess the Founders weren't serious people then, and the US should just revert back to being a British colony.

Civil rights require a civis, and you've got to be a member. The founders started a new civis and membership was restricted to free, former subjects of the British Crown. They didn't found a United States of the World.

The Constitution is a pact between the US sovereign and its citizens. It doesn't apply to non-citizens of the sovereign. If the sovereign wants to give rights to refugees wash up here, great. If it doesn't, too bad.

These are policy questions within the province of the state. Nobody is talking about theoretical, metaphysical rights except non-serious people.

For the record, you mean the Bill of Rights, not the Constitution per se. And by intent (citizen=anyone here when the Bill of Rights was written) and 200 years of precedent, most rights enshrined in the Bill of Rights apply to all people, regardless of their citizenship status.

Regardless of this basic fact, you also confuse civil and political rights.

Things like the right to life and freedom from torture (you know, hallmark civil rights). These are, by precedent in international law (including precedent respected by the US state) and treaties (to which the US state is signatory), applicable to non-citizens who do not enjoy political rights.

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The “sovereign” being the people, not the government which was instituted by the sovereigns to protect their rights

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Are you saying people don't have an innate moral value?

If all your rights are given to you by the state, then there is no point to talking about freedom, rights, or anything like that. The state can never violate individual rights because the state defines what they are and who has them.

In the U.S., the right not to be held without charges comes from the Constitution, not the state.

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I think my esteemed parents have innate moral value. I have no reason to think you don't have innate moral value. I think Jeffrey Dahmer squandered his innate moral value. But we're in the realm of secular policy and what to do about a contagious virus, not an academic discussion of theoretical rights which any number of people will disagree over.

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"Most of us Americans are happy with severe impositions on the freedom of people at the margins of society even as we fiercely resist relatively milder impositions on freedom that could affect us personally."

Yes, well, forcible quarantine is likely to impose on those that are not "at the margins of society". Thus, the question whether they will be politically viable.

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Issues with your stance here are:

- the ability to see your family as and when you choose across borders is not a human, or even a civil right, accepted by most states. I couldnt for instance, meet a "girlfriend in Canada" and then swan off to Canada as I please on the basis of my right to family life. It is, and is accepted to be, the case that the ability to travel between states is a discretionary allowance that is almost unlimited by any rights concerns and language.

So it's fundamentally inappropriate to talk of travel bans as an abrogation of a right. There's no right or pre-existing freedom there to begin with! And people who've chosen to make international families in this knowledge knew the deal up front.

- a quarantine is a much greater restriction of life than not seeing family members (which can be done via Skype anyway), and it would fall on larger numbers.

This is just not the time to push the Overton Window on the global society by trying to smuggle in the normalisation of discretionary privileges as rights.

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The assertion that "current Covid-19 tests do not have a high rate of false positives" seems inappropriate. As I am sure that Tyler knows, it is the negative predictive value that is relevant, not the test specificity. If the actual infection rate is low, then even with a test specificity of 99.5%, it may be that most of those persons with positive tests do not have infection. Maybe Cowan can step through an example in one of his columns?

for all intents and purposes PCR false positives do not exist. TC's example of 1% is not even in the universe of plausible, tho it obv makes for some frightening straw man forced quarantine #s

Nonsense. Even if the technology is fool proof, the humans in the process are not. It is quite possible your sample to get swapped with a control sample. It is possible for the recording technician to input the data wrong. It is quite possible for poor sample handling to result in contamination of many samples.

And less we think these are too unlikely, that last one is literally one of the things that made the initially CDC test fail.

You cannot both tell me a 1% FP rate is not plausible and that the CDC test was flawed. The latter necessarily implies the other.

As far as the actual technology, ehh, from what I understand it comes down to the sequence homology between this and other viral genomes. I am not convinced that we even know all the endemic viral infections that are typically asymptomatic so we very well might have some hitherto unknown virus that is infecting a small fraction of the population but is not pathogenic. I would be surprised about 1%, but having something else tag the primers is certainly possible and I am humble enough to know that I do not know all the viral members of human flora.

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But they do exist. HIV is a common PCR test, and false positives matter a lot. If you use an HIV test in a setting where just 0.2% of people have HIV, then 71% of your tests are wrong, and 28% of your tests are right. Even with a false positive rate of just 0.5%. The problem is your false positive rate is far higher than your prevalence rate.

The prevalence of covid is around that of HIV.

Our government cannot even count a ballot. And now we're expecting gov employees to manage testing where every real postive test yields 3 false positive tests? The same gov employees that cannot handle a simple request for unemployment help. The same gov employees that cannot keep old people safe in highly regulated senior living facilities?

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Testing is primarily not done by "the government," and since we're meant to accept that private enterprise is both infallible and here to save us from government bureaucrats, I guess this comment doesn't apply?

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"for all intents and purposes PCR false positives do not exist" said a man who hasn't spent much time in the lab.

But putting utter implausibility aside: how do you know?

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No real dog in this fight but thought I would pass this along that the UK government seems to believe the Roche test is 100% accurate;
https://www.telegraph.co.uk/news/2020/05/13/exclusive-first-coronavirus-antibody-test-given-approval-public/

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FDR separated Japanese Americans living on the west coast from their communities because he thought they were a danger to their neighbors' health and well being.

...look back on that as a horrible event.

Yes. And It is amazing that we continually fail to learn from our past mistakes.

Who have we — correction, who are we currently forcibly separating from their communities? No one. Apart from criminals and the insane. (Don’t say migrants, because they voluntarily self separate from their original communities.)

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"We have found it necessary to take measures of increasing stringency, not only against enemy aliens and suspicious characters of other nationalities, but also against British subjects who may become a danger or a nuisance should the war be transported to the United Kingdom. I know there are a great many people affected by the orders which we have made who are the passionate enemies of Nazi Germany. I am very sorry for them, but we cannot, at the present time and under the present stress, draw all the distinctions which we should like to do. If parachute landings were attempted and fierce fighting attendant upon them followed, these unfortunate people would be far better out of the way, for their own sakes as well as for ours. "

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Yes, that is the same example I have been thinking about. Courts have defined "isolation" as restricting the movement of persons who are known to be infected with a contagious disease. "Quarantine" is the term used by courts to describe restricting the movements of persons who are known or reasonably believed to have had contact with a person infected with a contagious disease. Generally, the federal government has powers to isolate or quarantine at the federal borders and states within their borders as part of general police powers. As far as due process is concerned, the common denominator is that the required proof and the decision is based at the individual level rather than merely a class of persons. That was the problem of incarcerating Japanese based merely on ancestry and not on a specific showing of security risk of an individual. It is also the essence of the concept of "discrimination".

Compare this with "stay-at-home" or "lockdown" orders which again require no showing of risk at the individual level. This is the essence of substantive and procedural due process. Locking up all persons in Akron, Ohio, for example, would be problematic as it paints with a too-broad brush.

One of the big dangers here is that generally the person (the "execiutive") who decides who should be locked up is the same person who decides when there is an "emergency" that warrants it. It seems to me that one of the lessons here is that, like the War Powers Act, there should be more consensus and buy-in on when we are "at war" against these invisible enemies. This would also preclude a lot of the petty political finger-pointing we now are experiencing.

"Compare this with "stay-at-home" or "lockdown" orders which again require no showing of risk at the individual level."

But there is no unqualified right to freedom of movement. Try exercising your freedom of movement in the middle of riot zone, right after a serious crime has been committed in your immediate vicinity (police are probably going to want you to stay put for a few hours so they can at least ID you and talk to you) or on one of those Arizona highways that has a Border Patrol checkpoint on it.

It sometimes comes into conflict with uncontroversial state powers which, as you noted, include general police powers to protect public health and safety. Not being a constitutional lawyer, I don't know how this balancing is done by the courts but an obvious place to start would be whether less coercive methods are available. If we had an unlimited supply of fast-acting and accurate covid-19 tests, restrictions on freedom of movement would be largely unnecessary but that's unfortunately not the world we live in right now.

Of course, no constitutional right is absolute. I can't, for example, yell "fire" merely for my amusement in a crowded theater and expect to be protected by the First Amendment. Nor do I have the freedom to enter military installations at will.

But, these are not good examples of the present situation, nor is your example of a riot zone. The latter is qualitatitvely and quantitatively much different than a lockdown or order that I can't leave my own home. I see a big difference between not being able to enter a limited space and an order that I must be confined in a limited space.

Again, what I suggest is appropriate is that there be far stricter limits on the ability of an executive to define and declare an "emergency" and that same person to then order everyone for months (not *hours*) that they can't move about. This is a recipe for authoritarian disaster.

To repeat--when need something like the War Powers Act (but better enforced) to require more consent and buy-in to these types of dictates.

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"why aren't we talking about forced quarantines"
-If
Dr, Cowen is not opposed to all small number, limited duration quarantine procedures, such as say holding Typhoid Mary out of socializing."
then
he is not opposed to pretty much all of the current quarantine guidelines &practices.
-"That is very different from the “mass dragnet” to be directed against American society under current proposals."

curious who is making mass dragnet forced quarantine proposals for the u.s. (besides the media link)?

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Interesting graphic on how the states are doing.

https://www.axios.com/coronavirus-cases-map-high-risk-states-8ceeaa05-cc07-4e8b-b9f4-df3a3315f143.html

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Forced quarantine seems more important with high population density and especially multi family blocks with shared ventilation. Neither are so common in the US.

Could we just do voluntary quarantine? Because we're not.

It seems to be an obvious mitigation technique we could be doing right now that takes advantage of a surplus we have right now (hotel rooms). If someone has a positive test, they get put up for two weeks.

It's especially useful right now with things shut down, because we wouldn't have to double-dip to pay for their lost income (doing that already).

I would bet that 95% of people would be ok with this voluntary approach - of course if they live alone then hotel rooms wouldn't be needed. The key though is not that people stay in, but that visitors are limited to only essential medical services who have proper PPE.

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"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. "

I suspect there's a lot of partisan hypocrisy on this issue. Personally, I support forcible quarantines including the removal of the person from their family.

Much like I supported detention of illegals on the border even if it meant separation from their children.

But I'm sure you have people that Support A and not B or vice versa. Mostly on mood affiliation grounds.

Two big non-mood affiliation differences that spring to mind are that one scenario is about protecting public health while the other is not, and (I'd argue more importantly) one lasts for two weeks and the other is indefinite. Duration is very important for something like this: separating a family for two weeks is unpleasant but does no lasting harm; separating a family for an indefinite period creates a ton of uncertainty and permanent damage.

> separating a family for an indefinite period creates a ton of uncertainty and permanent damage.

Of course, at any time you could say "I'm done" and you and your kids get reunited and can go on your way back home. Nobody is forcing the separation.

The separation is only mandated while waiting for something you aren't entitled too.

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Lockdown was supposed to last for two weeks, too. No one's going to believe that now about forced quarantine.

Stop being daft. You get quarantined while you are contagious. People don't do that longer than 2 weeks.

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The intent of the family separation policy was to deliberately separate parents from children as a form of punishment for the parents. Centralized isolation involves something very different in terms of scope and intent.

If you present families with a choice of either the entire family isolating for 2 to 4 weeks -- no going out even for groceries or medicine -- or the infected person isolating in a decent enough facility until they are no longer contagious, a lot of people would choose the latter option for practical reasons. One group that wouldn't would be single parents taking care of children at home and it would be reasonable to make an exception for that group.

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"They are a form of detainment without due process".

Indiana's quarantine statute provides for all sorts of due process rights and protections. Ind. Code 16-41-9-1.5. I expect other states provide similar rights.

The laws are on the books and are almost certainly constitutional, but they have been largely unnecessary and uninvoked so long the public has forgotten how necessary they might be.

In 2016, the ACLU filed a class action lawsuit against the State of Connecticut on behalf of several residents "who were ordered to stay inside apartments and homes for up to three weeks in fall 2014, with police officers posted outside their residences." (NYT)

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It seems to me that a policy of forced isolation and quarantine would be a huge disincentive to submit to testing and to cooperate in any test and trace efforts.

Had to scroll way too far down for this.

Thanks

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+1, that is a good point. But to Skeptical's previous comments, is that because we are a Low Trust society.

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Suppose you tested positive. What would you do?

1. Stay at home for 14 days or until you get a solid negative?
2. Go out but keep your distance.
3. Pretend nothing happened and go about as usual.
4. Go full psycho and run out and try to infect more people rather than fewer.

If, say 75% of people did #1 and #2 and very few people would go for the evil #4, mass testing with voluntary compliance could still reduce Rt below 1 and shorten the virus's time on earth.

Great point. Forced quarantine could actually be counterproductive if it discouraged people in (2) from getting tested. People might also be discouraged from getting tested or letting officials know about their close contacts if they worried about subjecting their close contacts to forced quarantine.

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Depending on how sensitive R is to a number of factors, 75% my be far too low to do much good. And even a small number of #4, as has been witnessed with HIV, Ebola, and most other major communicable diseases, is going to have an outsized impact.

This is frankly part of what makes my utterly baffled by the repeated roasting of Trump and his partisans. I don't care if the man is evil, incompetent, or responsible for all the past failures of Covid response and neither does the virus. We will certainly need a sizeable fraction of the 30% of the population that are rock solid Trump supporters to work with rather than against containment measures.

Because some of the things my ID guys are saying is that we will need north of 90% compliance rates with isolation and testing to have a chance. That is certainly less than was observed in Taiwan, South Korea, and Singapore.

Pandemic responses are not morality plays. Being right about Trumps responsibility, when to get back to work, and all the rest will be pretty much meaningless if it alienates enough people to allow Covid get back on an exponential growth curve. Yet I see far too many people in positions of authority and with broad reach of voice spending their time doing things that alienate people we need to win this.

We don't just need generic Trump supporters on board. We need Creationists. We need flagrant Racists (down to the KKK and Nation of Islam). We need xenophobes. We need illegal immigrants.

Unless the numbers get more forgiving with new data, this is not something where even 3/4ths super majority in compliance will be sufficient. Anybody who is serious about making testing and isolation work needs to have a plan to get buy-in from over 90% of the population, and I am seeing precious few people who are even moving in the right direction.

Resist opening then until tests are plentiful. They want the economy opened faster because they are hoping a V recovery will save them in the election.

Anyway how about test positive you get two weeks paid time off split and your employer gets a bonus too? Employer wins, employee wins.

Regardless you don't need cooperation on a large scale. If an area becomes free of virus, you don't need to be testing everyone in it, periodic tests of random volunteers can confirm the virus has returned to the area.

Again, their motives are immaterial to the effect. If they are willing to defy lockdown orders or to rescind them where they hold the power, we need something to either persuade them to change their mind or a plan that works even with going for a V-shaped recovery. And that needs to be something that speaks to the culture and their value systems (not yours or mine).

An area being free of this virus will not lead to a drop in testing requirements unless we go for the full Taiwan and require full quarantine when moving between regions. With the modern economy, it is exceedingly hard to do basic things, like providing meat and vegetables to the table, without potentially moving infected people across whatever boundaries you draw.

Random cross sectional testing only works if your randomly selected set of test subjects comply. If a non-random subset of the sample refuses to comply (e.g. a religious group, a political faction, members of an industry, or members of a hate group) then the virus can spread in that subset and detection is only possible once the outbreak grows large enough to spill over into the general population.

If anyone is serious about test and trace then we will need very high rates of compliance. We will actually need higher rates of compliance from people with densely connected subgroups prone to high risk behaviors.

The more dangerous you think the baseline behaviors of Trump supporters are, the higher compliance rate the math says you need from Trump supporters to contain the virus.

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Also #4 may not be a major factor if people are otherwise careful. If everyone goes to the store in a mask and washes hands but psychopathic #4 guy doesn't, he may not get to infect many. I don't think R0 is higher than 5 or 6 for this disease.

A purposeful spreader has to get the virus then decide to get tested. I suspect the kook element simply will not care and act reckless and not bother being tested. If they aren't tested they won't know when they are positive and won't know when to purposefully try spreading it more.

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What is the modeling for family structure?

One of the major benefits of quarantine is that it protects fellow family members in your own house. Who wouldn't want that? Well, maybe young couples, where the other partner isn't at much risk, or has already gotten it. It still seems selfish if you actually care about the person.

If you are single, being in a quarantine facility means you have someone watching you so you don't die on the floor alone.

"If you are single, being in a quarantine facility means you have someone watching you so you don't die on the floor alone."

That doesn't seem to be how this disease progresses. You develop trouble breathing and have time either to get to the hospital yourself or call 911 for an ambulance to take you there.

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Having thought about this overnight, I'm much less confident in this comment. Lots of people don't give a crap. If some guy is juggling 5 women, he doesn't want quarantine cramping his style, and he can easily justify in his own head why the risk doesn't matter.

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I think it will depend on how you are treated. Few people 'want' to infect anyone, much less friends/family, but most also have obligations.

The *huge* advantage of targeted/involuntary quarantines is that the rest of society can help the person and their family, instead of burning savings/resources too.

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It would be absurd to talk about forced quarantine before we at least have voluntary quarantine in place. Create a system where people can be put up in hotels, free of charge, with room service and a modest daily stipend, first. Include people with mild symptoms, positive Covid tests and no symptoms, and close contacts of people with positive tests. Give tests to people in quarantine, so that they can leave if found to be negative. Many, many people would choose this option purely to protect their family from the illness, or even as a break from looking after small kids. Once this is in place, then we can have the discussion about how mandatory to make it.

There are voluntary quarantine centers where I live. I am not sure of all of the details or if they are available to everyone, but I know they exist.

Cool. Where is that?

Northern Indiana, the one I am thinking of particularly is a Motel 6 being run or paid for by, I believe, the city of South Bend.

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Seems fairly permissive in who can go there.

https://www.southbendtribune.com/news/local/roseland-council-reacts-to-coronavirus-isolation-center-at-hotel-imposes-new-regulations/article_6138cc4a-800b-11ea-95e9-b72e05f5d68b.html

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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.

funny, a century ago it was common for the states to do 'generational quarantine' (i.e. forced sterilization) if the gov't thought you'd have stupid kids, enacted by the states and endorsed by the Supreme Court in a case I don't believe has ever been overturned.

A bit more recently, I recall NJ's gov. Christie trying to force a doctor who returned from treating ebola to live in a tent in a hospital's parking lot. The courts ruled she could just stay at home.

People who talk about Constitutional more often than not are really talking about stuff they are used too versus stuff they aren't.

Hmm

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.

So he seems to be saying they are wrong, but not illegal, but the courts today may rule them illegal

No.

He’s saying that he’s not saying they’re illegal. This is not the same as saying they’re not illegal.

People need to get better at reading comprehension

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The notion of externalities serves to define the proper role of government. The externalities of infection are serious. Serious enough? How much will we pay?
The Supreme Court has already upheld the authority of compulsory vaccination laws.
https://en.wikipedia.org/wiki/Jacobson_v._Massachusetts

Quarantine has the same issues. Probably there are better tools that lock'em up -- give them nice quarters, food, entertainment, etc., but do it. If it were smallpox, there would be little hesitation.

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Here is Matthew Yglesias plugging Tabarrok's plan for the government to commit $70 billion on new vaccines as a means to the end of creating the capacity to produce them. https://www.vox.com/2020/5/13/21248157/testing-quarantine-masks-stimulus There are some things only the government can do, and Tabarrok knows it.

$70 billion is a bargain if it brings the vaccine a week earlier.

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I agree with this column on the whole, although I don't think it's that controversial --- I don't think many people would seriously advocate forced quarantine in the US. To make it more interesting, we should start with this thought experiment: what if the virus had the same transmission properties, but the fatality rate was 30%? What about if it was as infectious as measles and as deadly as ebola? As the outmoded joke goes, do we know what we are, or are we just haggling?

Thats my thoughts. If death rate was much higher i'd be a fan of quarantines for all. At likely sub .5% then it seems its a bad idea. Something greater than 2% would get me into the forced quarantine camp. With same spread ability as this

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Progressives love to point to East Asian countries (incl. Vietnam and Singapore) as examples of well-run government, but any politician that would try to move this country even slightly in that direction in any capacity (immigration, crime, civil service) would immediately be called a fascist by these same people.

Noah Smith is probably the best example of a commentator like this.

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There are more important things to discuss before forced quarantines.

1. The coronavirus is not going away. It is a new fact of life.
2. The coronavirus is not as deadly as first feared.
3. Therefore, we have to learn to live with it.
4. Opening back up the economy and social life is appropriate. The current shutdowns cost more than they save.
5. However, we still must not overwhelm our medical facilities.
6. Government from federal on down should lead us down this path.
7. Testing, contact tracing, social distancing, and quarantine should all be supported.
8. And people will still die from this disease just like from cancer, heart disease, car crashes, police shootings, etc.
9. Maybe someday there will be very effective treatments and a good vaccine but we can't wait for that.

Completely agree, and everything here should be obvious.
But some people will never lose their delusions, like Boonton here who is still speak\ing of "shorten[ing] the virus's time on earth."

Once again, there is one, and only one, virus causing a serious illness that we have been able to eradicate, namely smallpox. And it took two hundred years after the invention of a vaccine for this illness to end its time on earth. And this virus of smallpox had many characteristics that made it easy to eradicate: people infected with it where completely immunized for life, which is probably not the case for coronavirus (though a short-term immunity at least is extremely likely). And this was a DNA virus, which has much less mutations than an RNA virus.

The only delusional people here are those like you who think that this virus becoming endemic will not mean an end to service sector oriented civilization as we know.
Say goodbye to big cities, restaurants, clubs, mass gatherings, in-person education and offices if this is the case. And that's just the beginning.

That's absurd. Human history of dealing with more virulent infectious diseases tells us that.

Humanity has never dealt with any infection more virulent than this that is simulatenously:
a) droplet transmitted
b) can reinfect

Also, humanity has never dealt with a severe infection on a global scale since the service sector became more than half of the economy.

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4. Opening back up the economy and social life is appropriate. The current shutdowns cost more than they save.

and

7. Testing, contact tracing, social distancing, and quarantine should all be supported.

These are the two things that are in tension with each other. Testing and tracing are not necessarily practical when you have a large number of new cases every day. And "social distancing" does, in fact, mean that certain aspects of economic and social life will be disrupted for the foreseeable future. I've seen this meme going around that "social distancing" is good but "we need to reopen the economy" and no one explains what exactly they mean by the second and how it is consistent with the first. The economy was never actually closed to begin with (where do you think those fresh fruits and vegetables at your local supermarket come from?) -- parts of it were in order to maximize the possibility of people putting social distancing into practice.

Sweden is "technically nearly everything is open, people are just choosing to stay apart."

They are being hit hard with deaths. Maybe it's the same deaths everyone else will get, just earlier.

Their economy is doing a little better now. It looks like that won't last, but it says "economists project" so who knows.
https://www.ft.com/content/93105160-dcb4-4721-9e58-a7b262cd4b6e

For people who recommend a Sweden approach, I'd like to see some kind of quantitative argument; like, "we've lost X lives but saved $Y billion dollars, and given other ways of mitigating death that's a good trade."

They are being hit hard with deaths. Maybe it's the same deaths everyone else will get, just earlier.

If we are trusting the experts, it is the deaths that we will experience later.

"Flatten the Curve" was never about stopping deaths, it was spreading them out and NOT overflowing the hospitals.

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"Therefore, we have to learn to live with it."

Learning to live with it doesn't mean "going back to normal".
It means identifying the minimum subset of (still significant) changes to the structures of our lives so that the Rt is kept < 1 most of the time.

Anyone thinking that society can return to normal if this virus becomes widespread and endemic is a delusional moron.
It may well be the case that it actually becomes endemic but that just means end of life as we know it.

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As a non American I'd have to say this anti quarantine movement that the US has is very reflective of the blind libertarianism inherent in your culture. I'm suprised you guys aren't championing the use of firearms to defend yourself against the evil quarantiners taking away your prescious human rights. Get over it and stop being so dramatic, you're just being asked to stay home for awhile to stop the spread of a dangerous virus.

I agree that most Americans haven't really through through rights in any intelligent way. The Lockean foundations of inalienable rights are ridiculous. Most Americans have not considered alternative ways of thinking about society, like the Confucian emphasis on duties and social harmony. Of course these alternatives have their own problems...

"The Lockean foundations of inalienable rights are ridiculous": they certainly are, as is obvious to the intelligent schoolboy. The fact that Americans are blind to the fact implies that whatever madrassas you use for your young are rather effective.

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Anyone who actually knows this country, understands that states, and even cities, such as Texas and California are as about as different as any two countries in the world. Some cities went to immediate self-quarantine and stayed there, such as San Francisco. I know boring, not in the media, not a gun in sight. Don't believe everything you see on CNN.

Texas and California aren't that different. Smoggy air, good Mexican food, bustling business environments, etc. Minus the humdity, Houston is basically Los Angeles. The media wants you to think they are so different. Or Putin does, goes another view.

Bob makes a good point.

Also, for all that "sorting" is a real phenomenon, at the level of states we find that about 30% to 40% of people vote for the opposite party even in a "deep blue" or "deep red" state.

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Thanks, Tyler. I will attach your column to my presentation of an Amparo recourse to protect my constitutional rights from a forcible quarantine of old people here in Santiago, Chile. Earlier today, the President (Ph.D. Economics, Harvard U, an old colleague and friend) ordered that starting this Friday it will be applied to people over 75 (since 3/22 it has been applied to people over 80). It's wrong but I will be arguing that in Chile it's illegal because age, as a gross proxy for susceptible to infection, is arbitrary discrimination and in addition infection per se does not imply a demand for public health resources (it depends on the severity of the disease caused by coronavirus, comorbidities, and other factors). The government has panicked on the expectation that the demand for resources will increase sharply in the next two weeks.

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Forced quarantining would be reasonable for something like the black death or the John Ringo H5N1. COVID-19 is not nearly severe enough to justify such measures.

COVID-19 was not even nearly severe enough to justify closing schools for two weeks.

But it's an election year, brother.

Can't spell pandemic without Dem panic.

So "Dem panic" shut literally the entire world down, generally before the US closed up?

He's actually used this one a couple times. It's adorable.

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if you hear forced quarantine think harvard sociology
we bet there was something in the fine print of roemers testing proposal
about forced quarantines?

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As someone who fairly frequently asks for more than he thinks he can get, I would never consider something that far outside the box.

We'll be lucky, very lucky, if we can manage the carrot. Pay people to quarantine.

Never mind the stick.

A reason we might want to think more seriously about these options:

"This is an important thread on the emerging evidence that large outbreaks and excess mortality do NOT produce meaningful herd immunity. If *everyone* with abs in Madrid are immune (11%), it would drop an R0 of 2.5 to Rt~2.25"

https://twitter.com/BillHanage/status/1260678233890213891?s=19

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BTW, file under testing is hard:

"Bloomberg: The coronavirus test from Abbott Laboratories used at the White House to get rapid answers to whether someone is infected may miss as many as half of positive cases, according to a report from New York University."

https://t.co/zl9xn0O0K7

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Forced quarantine will not happen, I think, because, as Dr. Cowen keeps saying, our regulatory apparatus doesn’t work. In this instance, its that the state has lost its commitment to a monopoly on violence, a sine qua non of a functioning state. Most people, upon being informed that they pose a risk to others, will voluntarily quarantine for a reasonable period. The ones who won’t, the assholes that is, appear anecdotally to include a lot of open carry/ stand your ground types, and are being goaded on by the usual purveyors of free floating anger. A functioning state would already have made a show of responding in some dramatic way to incidents like store clerks being attacked for asking customers to wear masks; the better to make plain that there will be consequences for violating reasonable limits on anti-social actions and that the state will not back down. There are not likely to be such consequences and the state will back down so forced quarantine is not really on the table except for blog commenters to have something to flame one another about.

I think you are mixing groups in a way that significantly detracts from the coherence of your point. The people protesting stay at home orders are not people who have tested positive for the virus. These are two different groups, who also don't seem to have any overlap with those attacking clerks about masks, that is a third distinct group.

Well, they are the same people, but the causality runs the other way.

https://www.dailymail.co.uk/news/article-8316571/More-70-people-Wisconsin-test-positive-coronavirus-attending-large-gathering.html

Well, this article does not say that people who went to the protest became infected it's just innuendo.

But of course people who go to protest could become infected or spread the disease.

That is a separate issue from people with the virus protesting being asked to stay home.

It is all part and parcel of one question:

Do we pull together as a nation to defeat this virus? Or do we fetishize transient desires as more important "freedoms?"

"I can't get my hair done!"

Unlike most here, I am impressed by your sophisticated arguments like this one.

I just try to aim for simple truths.

It is a simple truth that if herd immunity is not free or easy, we must pull together and win by the harder road.

We have to put in the work.

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Uncharacteristically direct and impassioned article from TC. Closing sentence cannot possibly be sincere. The rightness or wrongness of our pandemic strategy consists in its impact on human welfare, currently best measured in lives saved and GDP among other metrics. And why write with such apparent fervor against a strategy which is not being considered in the first place?

Straussian reading is that the author's purpose is to signal boost enforced central quarantine as an alternative to current strategy, and point up the relative weaknesses of arguments against it. Or at least to shine a light on the West's moral qualms about the measure and see if there is any there there (to which the author seems to answer in the negative).

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Or: why talk about forcible quarantine at all? (Or: how are we able to talk responsibly about forcible quarantines?)

Unless I misread rival accounts in today's Google news feeds, Los Angeles County, CA, is CONTINUING its standing "stay-at-home" order for several more weeks WHILE it is "re-opening" its beaches in mid-May. Does or would any discussion of "forcible quarantine" make any sense when a locale "enforces" such mixed messaging?

BTW: who would be tasked with enforcing a "forcible quarantine"? State National Guard forces? the US military? (Martial law could yet be imposed state-by-state or on a national basis before all of this plays out, I suppose. [The American Bar Assn. has entertained scenarios for martial law imposition, at least as recently as its August 2001 national convention in Chicago. The scenarios assumed only outbreaks of bio-terrorism.])

We are talking about forced isolation of an individual. Most states already have these laws on the books from a century or more ago but I believe the enforcement is simple: someone from the health department or sheriff's department gives you a piece of paper saying you are subject to a quarantine order, tells you where you need to go, what to bring, what you can't do, etc. and for how long. Violating that order can subject you to a fine and possibly a misdemeanor criminal charge, just like if you fail to show up for jury duty.

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Now that I think about it, sequestering jurors during a trial is a fairly rigorous form of isolation. It has fallen out of favor in recent years but the OJ jurors were sequestered for several months and it used to be relatively common for high profile trials in general. There seems to be a trend in which unpleasant but nevertheless common, temporary restrictions on personal freedom that used to be widely understood as part of the price to be paid for living in the U.S. are now seen as violations of the basic principles of the constitution. Of course, every generation has its blind spots and perhaps we were wrong to ever think sequestering jurors or quarantining people with infectious diseases was acceptable. But someone should at least be challenged to make the argument.

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I don’t think anyone disagrees that mandatory quarantines are undesirable. Whether they are “wrong” depends very much on the counterfactual, at least for a consequentialist.

And even from a deontological perspective it need not be wrong. If we frame it as a civic duty, why is it necessarily wrong? Yes, imprisonment without due process is wrong. It is also wrong to forcibly take young people away from their lives, homes and families for months or years and exposing them to extreme danger. But call it conscription and that changes things. Then whether or not it is wrong depends perhaps on whether the war itself is wrong.

We don’t know that, and I suspect there are workable options short of this. But if there aren’t then hand wringing about individual freedoms won’t get us very far.

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I think this post is not serious. (See my comment supporting Dismalist above; I won't repeat that part here, except to say it deals with the compact we have called laws and why we create the to create a greater liberty).

So, let me ask:

Can someone deny me my livelihood and income because I test positive? (Hint: Like Tyler, I framed it this way so you would be sympathetic to me because that would be denying me the right to earn an income.) Of course, that would mean an employer should not be able to deny employment to an employee who tests positive.

Or, how about this:

Should a person be denied the right to fly in an airplane, or attend a stadium event, or attend his church because he tests positive? OMG, you'll be taking away the right to travel, to assemble, and practice religion if you do,

Do you observe what is common to this: framing a choice as denying (losing) liberty.

Immediately, you give me sympathy (maybe not all of you, cause I know some may not like me, but the true believers in libertarian principals might).

So, what is common to both of these examples that you are missing.

Here it is: I have private information about my health and I am not disclosing it to you for your disadvantage and my gain.

Once I disclose that health information that is relevant to your health or safety, you would not willingly wish to associate with me without gloves and PPE. If all individuals now have that information, they will not interact with you. What is that called: Quarantine. The word quarantine had as its origin an Italian word that described the practice of keeping infected ships offshore from Venice for a month or so before they could enter the port.

I think it makes a difference whether it's permanent or temporary. If you're condemned to a leper colony for life that seems a lot more severe to me than 2 weeks (or 6 weeks) of quarantine.

Presumably you're fine with it if they first tell you it's 2 weeks, and then it's 4 weeks, and then it's 8 weeks, and then it's going to be determined by a phased-in system using pretty color-coded charts with absolutely no specific rules for how to get from one phase to another or what happens in each phase, and then they tell you it's going to last until they have "effective treatment," and then once that happens they tell you it's going to take until we have a "clinically proven vaccine that demonstrates bulletproof results."

That sound good to you? I bet that sounds good to you.

Do you smell the straw
from International Pants
Strawman argument.
If not,
That loss of smell
Might be the first sign of covid.

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The Cuban success against AIDS is Greg Cochran's go-to example of how medical authorities in the U.S are idiots.
https://westhunt.wordpress.com/2014/10/20/the-experts/

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The history of civil liberties and quarantines is pretty straightforward - forced quarantines are permitted as long as they are not done in a way that expressly targets a group on ethnic lines. In 1917 a woman was restricted to her home for smallpox exposure. Note that was just exposure, not infection. She sued claiming ‘false imprisonment.’ and lost. I think there's no case of anyone winning a similar lawsuit.
On the other hand, San Francisco tried to quarantine just Chinese people and businesses in 1900 after a Chinese man died of bubonic plague and that quarantine was lifted by the courts, saying it was done 'with an unequal hand.'
So there are civil rights issues that win in courts, but they are equal-treatment issues. And they don't always win - 30,000 prostitutes were put in jail to curb VD in 1917 and it was upheld as it was deemed reasonable to assume they were all infected.

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>Why aren’t we talking about forcible quarantine more?

Because we are not five years old.

You're missing a point, many people "score points" by mentioning countries that have had success, but it was using forcible quarantine and that is not usually mentioned.

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Why use force when you could use money instead? Pay out $10k to stay in quarantine until you test negative and 95% of Americans will voluntarily consent. We currently have 20k new cases/day, so this policy would cost 200 million/day or 6 billion/month - quite affordable for the COVID budget.

Plausible, but there would seem to be significant moral hazard issues.

...as well as positive externalities. Every one who goes through the cycle is contributing to herd immunity.

A good point. But, your probably looking at a lot more than 6 billion a month. Of course it doesn't have to be 10k.

There's also the "overshooting herd immunity" issue.

I guess if the testing capacity was there it would probably be an effective, although incredibly expensive and probably pretty dangerous, way of getting all of the potential patients to come to you.

Even tripling it to $20 billion/month sound that bad... at least when you compare it to the $2-5 trillion in on-the-books federal spending, an additional $2-4 trillion from the federal reserve (side note: on top of the ~$1 trillion dollar bailout it did in 4Q19), and additional trillions in lost tax revenue at all levels of government. Not to mention multiple trillions in lost GDP.

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Three more COVID-19 deaths in Fresno County as total cases rise above 1,000

----
So far we are running behind auto and gunshot deaths.

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The difference between the U.S.and the Asian countries is that citizens in the U.S.have guns, so these problems can sort themselves out on their own.

To think I came her for intelligent discourse. Oh well, back to ft.com.

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I don't think the comparison with HIV/AIDS quarantine is very apt. Coercive quarantine for those carrying SARS2 will last 2 weeks? (Mine, on returning to china was 14 days, enforced by an alarm on my door). What's the end point of a HIV quarantine?

I do think we should be cautious about measures that compromise the rights and freedoms of individuals, but that has to be weighed against the public good. The question should be looked at from the perspective of how many people will be affected vs. how effective it would actually be at achieving its goals, and compared to other approaches.

I agree that challenge trials (using well-informed volunteers) are less of an ethical problem than coercive quarantine, and should receive more widespread support.

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161502/
SARS-Cov-2 infection: response of human immune system
---
We have a well colored ball. It is a spherical coiled RNA sequence.
It is a difficult penetration, it can react faster than our response immuno globulins. We need a two sided attack vector, it will out run a single color attack on its surface. A well colored sphere has spin and can scoot. The docs know in this article that the proper immuno globulins are late to be delivered by the white blood cells. Our system does not expect well colored balls at the skin layer.

The neat thing about the theory, it does not need to know the environment process, it just needs to know the ypical sequence at equilibrium and it can identify disequibriated sequences by relative changes in concentration or three identified process axis.

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Yeah. What we need is viral tracking so that if one person gets another sick, they can file charges for assault and battery. If one person gets another sick and that person dies, then it's murder. The main problem with this in the US is that the US has all too many people who think murder is just AOK.

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"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." Of course they are. And yes, I know that is a small thing, and furthermore quarantine may not even be effective.

The general point is this: you cannot over the longer run have a society based on such inflexible rules of adjustment.

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"This is one of the reasons why I believed then, and do believe still, that the shutting up houses thus by force, and restraining, or rather imprisoning, people in their own houses, as I said above, was of little or no service in the whole. Nay, I am of opinion it was rather hurtful, having forced those desperate people to wander abroad with the plague upon them, who would otherwise have died quietly in their beds."

A Journal of the Plague Year, Daniel Defoe

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Straussian for MAGA? “Give me profit or give me death.”

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Your assertion that cv-19 testing has low false positives is wrong. See Dr. Andrew Kaufman's research showing as high as 80% false positives. The test is looking for exosomes, not "virus".

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This is another example of ideology over common sense. Really it's not that hard

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I I’ll note that the people I know who had plans of traveling to Taiwan, Japan, etc for more than a week or two have mostly not voluntarily changed their plans (though many flights were canceled) reasoning that it’s better to be there - even with the risk of sitting in the plane and then being quarantined, than here.

Not exactly apples to apples, but a form of revealed preference.

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In the context of a flatten the curve/preserve health care infrastructure strategy, how much additional good would forced quarantining do above recommending that the person minimize contact with people?

Would Typhoid Mary have been Typhoid Mary if she had proper unemployment insurance?

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A friend who works in commercial construction had direct contact with a coworker who tested positive though asymptomatic. My friend was told to self-isolate for two weeks before who could come back to work, though he has shown no symptoms and has not tested positive. I wonder if this "pseudo forced quarantine" is fairly common, especially among medium-to-large employers with significant downside risk to their labor force and/or reputation. I'm not sure what the enforcement mechanisms are in every case, i.e. if it's just an honor system, whether one has to legally attest to following the self-isolation guidelines, submit to follow up testing at end of the period, require a physician's note to return to work, or some combination of the above. Based on rules/guidance issued by entities like DOL and SHRM, it appears something akin to "forced quarantine" is happening to broadly, but to varying degrees, in the private realm.

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Traditionally in the US quarantines were done at home, generally with the entire household quarantined, but maybe allowing for non-sick adults to take lodging elsewhere temporarily, especially if they were working people on whose income the family depended. Back in my father's early childhood (in the 1920s) his sisters fell ill with diphtheria and their house was quarantined. My grandfather however, who was not sick, was allowed to continue to go to work as long as he stayed elsewhere and had only distant contact with the household members (his wife and sons) who were not ill, in the backyard.

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Good luck forcibly quarantining 150 million cats, now that it's been show they can spread it too.

There is shockingly little evidence that "extreme lockdown, no non-essential work" actually saves any lives relative to "voluntary social distancing, only high-risk businesses shut down" so count me skeptical.

It's been shown that cats can contract the illness from humans, not the other way around.

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I'll want to come back and read the 161 comments.

Mine: If quarantining a ship is morally OK, why not quarantining a million people? I really don't see the difference. But maybe you are against quarantine generally, being somewhat libertarianly foolish.

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Strausianism is such an immature game for little boys. I hope it makes you feel oh so smart using your decoder ring.

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Mandatory quarantine is one thing. Difficult to do in the US. Voluntary quarantine (protect your family! Spend two weeks in a hotel with free room service) is something else. Many would go. We don’t need perfect compliance. Make it culturally normal and generally pleasant and you will increase compliance.

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There isn't much point in discussing coercive if your not yet able to provide good information on recommended voluntary quarantine, nor have organized the practical aspect of voluntary quarantines.

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