Welcome to Just Between Us, The Huntington News’ two-way interview podcast.
Northeastern law professor Wendy sits down with Maya Homan to discuss the legality of public health policy and how to balance disease prevention with human rights.
Maya Homan: With the recent outbreak of novel Coronavirus, now dubbed Covid 19 by the World Health Organization, tensions are rising worldwide. As of February 12, there were just 13 confirmed cases in the U.S., one of which occurred in Massachusetts. In response to the outbreak, the U.S. government has implemented several public health measures. These include banning non-citizens who have been to China recently from entering the U.S. and quarantining citizens who are returning from China. I sat down with Northeastern law professor Wendy Parmet to discuss quarantine, human rights and the stigma surrounding infectious diseases.
Homan: How is the U.S. been responding?
Professor Wendy Parmet: By and large, measured, President Trump has imposed the travel ban of non-nationals who are coming from China, which I think is somewhat disturbing, basing it on passport to a degree. We’ve had the broadest, most extensive use of quarantine that we’ve had in a very long time. I mean, for the moment it doesn’t seem like the conditions are particularly harsh or that people are being mistreated. I don’t think we know everything yet that’s going on around the country.
Homan: And what are some of the legal implications that come with quarantining people?
Parmet: Well, I’m not exactly sure what you mean by legal implications. I mean, quarantine is an extraordinary power. It’s a power where the government can say, “we are confining you and detaining you. You haven’t actually done anything, right? You haven’t broken a law. We’re not giving you a trial. We’re just detaining you.” And it could be for a very short time, it can be for a very long time. So it’s actually a very extraordinary power. It’s a very old power. It’s a power that has historically been abused and misused in very deeply troubling ways. So, I think it’s really critical that the quarantine power always be looked at carefully, that its use always be limited and prudent to what is absolutely necessary to protect the public’s health.
Parmet: There are issues of constitutional law, there are issues of policy, you know, the constitutionality of various forms of quarantine. The rights of people quarantined have not been fully examined. They’ve been examined a lot by scholars, but not by courts in the modern era. And one of the issues outside the constitutionality — so when people talk about quarantine, they often confuse and conflate voluntary quarantine from legally imposed quarantine. One of the things you want to do as a policy matter is get people to agree, voluntarily, to keep themselves apart if they may have been exposed or if they may have been contagious.
Parmet: One of the things that I worry about is that we tend to rely a lot on legal orders and we spend a lot less time thinking about what can we do to make it more feasible for people to quarantine themselves. I’ll give you one example; in 2003 during the SARS outbreak, many jurisdictions, non-U.S. jurisdictions, which experienced the outbreak (it didn’t come to the U.S. then) passed laws to provide compensation for lost wages for people who were quarantined. And the idea is if you want people to stay home and not go to work if they may have been exposed, one of the things you want to do to increase the compliance rate is to provide people with income, otherwise people— it’s great to tell people to stay home, but if they’re gonna lose the rent and be evicted. So I think that there’s a lot of things we could do as a matter of policy that would improve compliance. But there’s been very little effort in the U.S. to do that. We don’t have compensation. We don’t have guaranteed sick coverage. We don’t even have laws that protect people who are quarantined from losing their job from being quarantined. Right now the quarantines are limited and although they’re more expensive than we’ve ever had, there are people coming back from China so they’re not affecting a vast wide swath of the population. It seems too that it’s people who can afford transit Pacific flights. You’re not necessarily affecting people— if people can travel back and forth across the Pacific, they’re probably not the people who are going to have their life destroyed if they miss one day at work, but if the need for quarantine was broader, then I think you really start having problems if you don’t make quarantine palatable and plausible for people.
Homan: And does kind of the stigma of infectious diseases play into that at all?
Parmet: Well, the stigma of infectious diseases plays into the stigma around quarantine, it plays into all of this. Sometimes it explains why, historically, quarantines have been applied and very problematic and discriminatory ways. And there’s just a tremendous stigma about infectious disease. The stigma is sort of running through everything when you think about responses to infectious diseases and how you respond to them, you’ve got to recognize that the stigma is significant, that the danger that the stigma is going to attach to certain already-marginalized populations is very high, that quarantine can be both responsive to the stigma and can exacerbate the stigma. These are all things we need to be mindful of.
Homan: I’ve been hearing a lot about Asian Americans experiencing more racism after the coronavirus outbreak.
Parmet: That happened during SARS. And that’s happened before, in 2009 when the Adnan virus first came, the initial response, many Americans blamed Mexicans for the virus. So there was a lot of stigma directed towards people who were perceived to be Mexican origin. Historically, diseases are usually blamed on some minority population, and it’s kind of always been that way. And so, again, the stigma of disease kind of mixes toxically intersection with preexisting stigma and makes things worse.
Homan: Wendy Parmet is a Professor of Public Policy and Urban Affairs at Northeastern School of Law, she also serves as the director of the Center for Health Policy and law. Reporting from Northeastern University in Boston. I’m Maya Homan.
This transcript has been edited for clarity.