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.
It is true that such practices very likely save lives, sometimes many lives. A recent working paper from three economists noted that “a policy that uses tests to quarantine infected people has very large social benefits.” One reason the pandemic has been so deadly in Italy, for example, is the high rate of family transmission in the northern part of the country.
So it is possible that tens or hundreds of thousands of American lives could be saved by the forced removal of people from their homes. Still, it would not be the right thing to do.
Consider the scale and scope of the coercion that could be required. The situation could suddenly improve, but a common estimate is that 40% to 60% of the American public might end up infected. It is an open question how many of those cases the authorities will catch, or if the virus could be shut down altogether. Nevertheless, at least 150 million Americans could be subject to a forced-quarantine regime.
And since family members may wish to care for the sick, any coerced quarantine of a single person will very often be a depredation against more than just that person. Given America’s dismal record with nursing-home fatalities, does anyone really expect that quarantine dormitories or temporary hospital facilities will be such great places for caregiving? Forcible quarantines might save many lives in the future — but only by imposing a de facto death sentence on some people now.
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.
When exactly do these people get to return to their families? No one currently knows exactly how long the risk of contagion lasts.
And it’s not just the violation of individual rights. A policy of forcible detainment would put Americans at each other’s throats. It would reinforce the view that all Americans should own guns and be ready to use them. The very fear of such forthcoming detainments would compound polarization, encourage belief in pseudoscience and all but guarantee that millions of Americans will avoid COVID-19 testing altogether.
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.
It is a commonplace observation that a policy of forced quarantine is not culturally suited for an individualistic society such as the U.S. That is a point worth making, but I am struck by the cowardice implicit in this perspective. Who among us will speak up for individual rights? And why do we find it necessary to tiptoe around this topic? Much as I disagree, I’m actually more impressed by those willing to take a stand in favor of a policy of coerced quarantine.
In the meantime, in judging pandemic policies, there are more considerations than just lives saved and effect on GDP. The most important is a strong and defensible notion of right and wrong.