Quarantine, isolation and lockdown protocols have been key strategies in the global assault on the coronavirus that has killed more than 1,700 people since December despite mixed reviews on their value.
Quarantine involves separation of those who have been exposed until confirmation of the presence or absence of the disease. Isolation separates the confirmed cases from the populace to avoid further transmissions. A lockdown is aimed at halting movement of all individuals within the concerned area, regardless of whether individuals are exposed, ill, or not.
Michael Ryan, who leads the World Health Organization’s emergencies program, is urging global leaders to carefully strike balances between the common good and the rights of individuals.
“There is no zero risk in the world for anything,” Ryan said at a news conference Monday. “We need an approach that allows us to function as a society. … We need to be extremely measured in what we do.”
It’s been more than two weeks since the U.S. began implementing 14-day quarantines. Japan has quarantined a cruise ship off Yokohama, and now the U.S. and other countries are removing their citizens and bringing them home – to more quarantines.
Ogbonnaya Omenka, an assistant professor and public health specialist at Butler University’s College of Pharmacy and Health Sciences, told USA TODAY that the U.S. decision to directly oversee the isolation and quarantine processes of Americans makes sense from an intervention perspective.
“These approaches may prevent the wider spread of the disease temporarily,” he said, adding that “they are not guaranteed to stop further transmissions” or deaths.
China ordered massive lockdowns
China has led the way. Last month, President Xi Jinping ordered entire cities locked down to slow the outbreak. Wuhan, a city of 11 million people that has been the epicenter, was among several cities and about 60 million people that remained locked down Monday.
The government is doubling down, too. This week it ordered lockdowns expanded to include residential communities within urban and rural areas of the region. The government also closed non-essential public places and banned public gatherings and the use of private vehicles.
China efforts draw uneasy support
Tedros Adhanom Ghebreyesus, WHO’s director general, says the government’s efforts to contain the outbreak at its source “appear to have bought the world time.” But Lawrence Gostin, director of the WHO Collaborating Center on Public Health Law & Human Rights, warns that such lockdowns can drive an epidemic underground, provoking fear and panic. “Trapping more than 50 million people together in a hot zone of contagion will lead to cross-infection, fear, and social isolation,” he wrote in the Health Affairs blog.
US quarantine measures
Any U.S. citizen returning to the U.S. from China’s Hubei Province is subject to up to 14 days of mandatory quarantine to ensure they are provided proper medical care and health screening. Any U.S. citizen returning to the U.S. who has been in the rest of mainland China within the previous 14 days will undergo proactive entry health screening at a select number of ports of entry and up to 14 days of monitored self-quarantine to ensure they have not contracted the virus and do not pose a public health risk.
Diamond Princess quarantine
The Diamond Princess was carrying 2,666 guests and 1,045 crew when it was quarantined in Japan after 10 cases of coronavirus were reported Feb. 4. The totals included 380 Americans. Two charter flights for American passengers landed at military bases in California and Texas overnight, but they face a new 14-day quarantine period to ensure they are free of the coronavirus.
Why the US broke the quarantine
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said the quarantine process on the ship failed. “I mean, I’d like to sugarcoat it and try to be diplomatic about it, but it failed,” he told USA TODAY. “Something went awry in the process of the quarantining on that ship.”
Omenka said the U.S. decision made sense in terms of synchronization of response, “especially when there is no available cure or universal treatment for the disease.”
The future is unclear
Almost 72,000 cases of the new virus have been confirmed, all but a few hundred of them in mainland China. Those few hundred are scattered across more than two dozen nations. Fifteen cases have been confirmed in the U.S., but health officials say dozens more Americans apparently have the virus on the ship.
WHO has declared a global health emergency, but Ryan stressed that the spread of the disease outside China has been minimal.
“This is a very serious outbreak and it has the potential to grow,” Ryan said. “But outside Hubei (province) this infection is affecting a tiny, tiny, tiny proportion of people. We need to be extremely measured in what we do.”
Contributing: David Oliver