She is said to have refused to stop being a cook and this led to infection of people in a New York maternity hospital consequently she was re-arrested by the health officers and taken back to quarantine in 1915 till her death in 1938. This sparked a lot of human rights issues concerning quarantine as never before.
The typhoid pandemic in New York went hand in hand with the poliomyelitis pandemic that began in 1916. The health officers began to separate parents from their children in chagrin of many. This saw the wealthier families provide isolation rooms and treatment for their children right at home. However, in November of the same year when the pandemic subsided, it was after well above 2,300 lives claimed by the pandemic, a vast majority being the young.
It was not long until the world war brought with it another challenge of prostitution and consequent spread of venereal diseases. Between 1917 and 1919 the American authorities kept in quarantine to the tune of 30,000 prostitutes as an attempt to curb this menace. The quarantine was passed by the U.S.A. congress hence had all the support of the legal arm. This was another incarceration in the American history that sparked a lot of revolt and repulsion from human rights propagators. The most memorable incidence is when Allan Brandt referred to this incarceration as “the most concerted attack on civil liberties in the name of public health in American history.”
Later on in 1944 the Public Health Service Act was well scripted and passed for implementation and saw the establishment of quarantine authority in the federal government. This authority was mandated with the control of all the U.S.A. quarantine facilities and stations from 1921. In the succeeding year, the mayor of Baltimore passed another rather bizarre quarantine instruction for all the patients who resented being given penicillin treatment, though this did not affect many people since many patients willingly accepted the treatment. In 1949 a similar quarantine situation is experienced when Seattle introduced the locked ward system for the Tuberculosis patients who obstinately resented treatment. Incidentally 88% of them were alcoholics.
The system of locked ward quickly spread to other cities. This type of detention was to re-appear in the 1990s when New York City detained well above 200 people who were obstinate towards taking voluntary treatment of TB. This was a control measure in combating a multi-drug resistant TB. The patients were confined to the highly secured and controlled wards of the hospital for approximately six months.
1967 saw a major change in the manner of handling quarantine issues when the U.S.A. Department of Health, Education and Welfare handed over the duty of quarantine to National Communicable Disease Center which later cam e to be known as Centers for Disease Control and Prevention (CDC) till date. This gave CDC the capacity to carry out research as it conducted the quarantine so as to help prevent future occurrence of the pandemic as well as control the spread at the moment.
The USA has made great strides in the control of most infections that hitherto led to quarantine. The remaining concern was an eventual need for quarantine in the near or far future. In 2001, in the experience of the 9/11 terrorist attacks, the U.S.A. health authorities drafted an act which came to be known as the Model State Emergency health Act. This was after the CDC advised and requested for such an Act. The Act in a nutshell mandates the state and authorizes it to quarantine an individual in the occurrence of a bioterrorist attack using a fatal microorganism like smallpox and anthrax etc. By July 2002 this legislation had gotten an approval in nineteen states and had consequently been introduced and implemented in seventeen states therefore.
The most recent of the outbreaks or outbreak scares was in 2003 case of Severe Acute Respiratory Syndrome (SARS). This was experienced in Asia and Canada being the closest to us. Health officials in the affected areas approved of quarantine and isolation as a means to mitigating the pandemic. In April of the same year, President George W. Bush adds SARS to the list of the diseases that can warrant use of quarantine as a means and process of mitigation.
At the moment, the Division of Global Migration and Quarantine which is a branch of the CDC is directly concerned with any matters relating to quarantine in the U.S.A.
It manages the eight national facilities for quarantine in Chicago, Honolulu, New York, Los Angeles, Miami, Seattle, Atlanta and San Francisco. It is worth noting that selected city health officials have the authority to quarantine or if need be isolate patients or potential victims to a deadly infection.
In the list of the infections or diseases that can warrant isolation or quarantine in the U.S.A. are cholera, Marburg viruses, and viral hemorrhagic fevers such as the Ebola, diphtheria, plague, infectious tuberculosis, smallpox, SARS and yellow fever. These may be rare in the health situation of the U.S. citizens as at now due to the advanced medical care and hygiene conditions but they are not totally ruled out.
Shortcomings of quarantine
The real essence of quarantine or isolation is to help stop the spread of a disease or infection that has been detected. However, in the noble process of doing so there are fundamental disadvantages that come with it.
In the period that one is in isolation, the individual loses the basic human rights like movement, association religion, access to information and so on and so forth. At times the protection of these basic rights in the isolation units is way below even the protection of the same in the correction departments. For instance the right to willingly and voluntarily participate in a research is usually deprived. Prisoners will have the choice to participate in a biomedical research or not, yet those in isolation cannot make that choice. The level of the research conducted among the prisoners will of necessity be approved and controlled by Department of Health and Human Service. The department will ensure that no prisoner is coerced into participation in any research, which is not the case in the quarantine facilities since those in isolation are the experimental pieces by default.
The second issue is that quarantine produces the desired results and show effectiveness in very limited or few selected circumstances. As Richard Schabas stipulates, there are three rep requisite conditions for a quarantine to effectively work. i). Patients must have indicative symptoms of a communicable disease that cam possibly be spread at its early phase. This however is not possible to detect or obviously see in many diseases. ii). In order for a quarantine to work effectively in a region, there must be identification of practically all the individuals with the infection. This is not possible since one cannot restrict the movement of a whole street or all office workers of a given block. iii). Voluntary compliance is of great necessity for a quarantine to work with efficiency. This was seen in Canada during the SARS pandemic when the citizens refused to comply with the government requirements for quarantine. Richard further notes that the screening and restrictions at the airport cannot be effective since the importation of the infections happens when the carriers cross over when the infection is still at the incubation stages.
Quarantine could also work counter to the objective of the airline industries. This will place a heavy load upon the airlines that are already reeling under taxation burden. For instance a plane can carry hundreds of passengers at a go hence this will make it impossible to carry out an effective and reliable quarantine.
While isolating the infected from the healthy population, isolation still has social repercussions. It alienates individual liberty, it destabilizes the relation between the isolated individual and the society at large, it can lead to alteration of and weakening of family bonds, it also distances the individual social gains and weakens the social codes in general.
Quarantine can also be used against human rights and as an excuse to abuse or deprive human rights to an individual. The most commonly known and well understood is the case of Typhoid Mary. Quarantine was used as an excuse to keep her in isolation for numerous years as she was subjected to series of medical experimentation, journalists and reporters flocked her life and she was generally put lie in a prison. It should be remembered that she was actually arrested by the New York health officers and put in quarantine against her wish.
Another case of abuse of quarantine was hen Chick Gin, a Chinese business died of bubonic plague in the Chinese quarter of San Francisco. The authority cordoned off the place immediately.