Psychosocial Effects of Quarantine - Research Paper Example

 Psychosocial Effects of Quarantine Prove the psychosocial effects of quarantine do not outweigh the benefits 1. Introduction When having to introduce measures for confronting specific social and health problems, governors are likely to prefer practices, which have been proved quite effective in the past. In other words, methods, which have been tested in similar cases, are preferred instead of new ones, especially when the safety or the health of the public is threatened. Quarantine is a practice used for ensuring the protection of the public health when there are signs that one or more persons have been exposed to a severe disease. At this point, the following issues appear: is quarantine always feasible? As explained below, the requirements of quarantine are many, a fact which may lead to the limitation of the use of the particular tool for protecting public health. Furthermore, the psychosocial effects of quarantine are important. These issues are discussed in this paper. The research on the existing historical data and the studies related to quarantine has proved that the effects of quarantine do not overweight its benefits. For this reason, quarantine is still used in countries worldwide for securing public health, even if the implementation of the particular measure can be, under certain terms, quite difficult, as analytically explained below. The most important finding of the study is the following one: the psychosocial effects of quarantine, as identified by researchers working in the particular field, do not overweigh the measure’s benefits. It is for this reason that quarantine is still preferred when the expansion of a disease has to be prevented within a nation or in the context of the international community. On the other hand, it has been made clear that the control of quarantine, meaning the appropriate use of its terms, is often difficult, especially when this measure is used for facing emergent health risks. 2. Quarantine – description and effects 2.1 Use of quarantine In order to evaluate the effects of quarantine, especially their relation to the measure’s benefits, it would be necessary to understand the use of quarantine as a tool for promoting the public health. In accordance with the definition of quarantine included in the study of Stambaugh (2008) the quarantine can be described as ‘the separation and restriction of movement of persons, who, while not yet ill, have been exposed to an infectious agent and therefore maybe become infectious’ (Stambaugh 2008, p.2). In accordance with the above definition the use of quarantine aims to help towards the prevention of the expansion of diseases; it is also explained that quarantine, as described above, is a valuable tool for governments worldwide when having to face such risks. In other words, quarantine is considered as being independent from the local social ethics and culture; it is implied that quarantine is likely to be used in societies with different traditions and beliefs and for this reason its psychosocial effects may be differentiated, an issue that should be further discussed. In any case, the value of quarantine is significant, a view, which is supported by the following fact: quarantine, as a tool for controlling the expansion of diseases, has been used in USA ‘since 1796, when the 4th Congress passed a law regulating the use of this measure across the country’ (Stambaugh 2008, p.2). The use of quarantine is also made clear through the study of Jones (2011); in accordance with the above researcher, the quarantine can be characterized as ‘the separation of individuals who have been exposed to an infection but are not yet ill from others who have not been exposed to the transmissible infection’ (Jones 2011, p.2). In this definition also, as in that of Stambaugh presented above, it is made clear that quarantine focuses on the isolation of those individuals who have been exposed to an infection from others, so that the expansion of a disease to be prevented. In other words, quarantine cannot be used for treating a disease, only for keeping the disease controlled so that time is allocated for studying the disease’s characteristics, aiming to identifying the appropriate treatment. In this context, quarantine can be particularly useful in cases where the disease involved is rather new and the information available for the characteristics of the specific disease is limited. Moreover, quarantine can be particularly useful when the risk for rapid expansion for a disease is rather high and quarantine is considered as the most appropriate tool for limiting this risk. For example, in airports quarantine can be particularly useful for preventing the expansion of a disease out of a country. In educational settings also the quarantine could help to protect the pupils/ students from a potential infection from viruses that can threaten their life. In accordance with the above quarantine is related to a geographical area, meaning that it can be used for controlling the expansion of a disease across a population or across countries. The use of quarantine through the decades, as described through the data presented below, proves that the effectiveness of quarantine can be sometimes questioned, especially when the criteria set for the involvement of this measure in the protection of public health are not clear or are not feasible – taking into consideration the local social ethics but also the performance of this measure in similar cases in the past. At this point the following issue should be discussed: is the use of quarantine always aligned with the local social ethics? The findings of the research developed in the particular field lead to the assumption that the use of quarantine may not be justifiable within a particular social framework, for instance in countries where the infection of certain diseases is considered as a sign of committing a crime, meaning the countries based on the Islamic law. In this context, using the quarantine for protecting the public health may put destroy a person’s life, a fact which cannot be accepted especially when the indications for the infection of the person from a disease are quite limited or not adequate for justifying the isolation of the person as quarantine requires. Another important characteristic of the use of quarantine in countries worldwide has been the inequality, meaning the differences in isolating poor people compared to the rich people when indications for the potential existence of a disease exist. In the study of Ciottone (2006) it is explained that, traditionally, quarantine was more likely to be used against poor people and not so much against rich people and this fact has been related to the failure of the authorities to control the expansion of certain diseases, like HIV or tuberculosis (Ciottone 2006, p.452). This problem indicates rather the failure of governments to promote equality among citizens but also the inability of the public agents involved in these schemes to treat equally persons of different financial status. From another point of view, currently the use of quarantine can be judged using various sources, such data on epidemics or the consultation of experts (M’ikanatha, N. & Lynfield 2007, p.467); this means that the decision of authorities for using quarantine can be justified using appropriate material. Moreover, if the use of quarantine in a particular case has not been sufficiently reviewed, the cancellation of the measure could be suggested using appropriately supported justifications. At the same time, the availability of material and experts for checking the potential effectiveness of quarantine if being involved in the control of a disease helps to ensure equality – meaning the equality between poor and rich when their isolation in the context of quarantine has to be decided. In other words, the improvement of the techniques used for implementing quarantine can lead to the increase of the measure’s effectiveness and fairness, especially in social environments where such measures are partially opposed with the existing ethics or where these measures can lead to severe social conflicts. The specific fact is highlighted in the study of M’ikanatha & Lynfield (2007, p.467). In the above study emphasis is given to the relationship between quarantine and law, as this relationship can be identified in USA. It is explained that in the particular country, the use of quarantine is closely monitored by the law and cannot be decided out of the context that law sets in regard to the particular measure. In this way, the alignment of quarantine with the existing social ethics is ensured; also, the oppositions of the public towards the particular measures can be controlled, considering the quarantine not as a way for punishing the social behavior or choices of people but rather as a means for ensuring the protection of both the public and the individual towards a particular disease. Indeed, the public is expected to be better protected if individuals exposed to a severe disease are isolated; on the other hand, being isolated people who have been exposed to diseases are likely to recover faster being able to return to their daily life. 2.2 Historical data on quarantine cases In accordance with Riegelman (2009) the history of quarantine is rather long. It is explained that quarantine has been quite popular in USA during the 19th century for confronting the expansion of tuberculosis (Riegelman 2009, p.74). In the 20th century, the quarantine has been considered as the most effective tool for preventing the expansion of SARS. It is also made clear that because of its psychosocial effects, quarantine has been often negatively criticized as of its role as a tool securing public health. The most common dispute related to the use of quarantine refers to its opposition to the rights of individuals. On the other hand, through quarantine the rights of the public are promoted. The above differentiation in the role of quarantine within a particular society is reflected in the following fact: quarantine is not always used when signs for the expansion of a disease exist. The potential use of other measures, with similar targets, is primarily checked. Then, quarantine is likely to be used only when no other measure for protecting the public health is available. In the past, quarantine was considered as the most effective tool for confronting cases where the public health was under threat – in opposition with today where alternative measures for protecting the public health are also likely to be used when similar issues appear. In 1918, quarantine was chosen as the most appropriate measure for confronting the expansion of influenza pandemic in USA (Craddock, Giles-Vernick,& Gunn, 2010, p.199). Earlier, in 1818, the legislator in Louisiana had ordered the quarantine in order to face the rapid expansion of a fever epidemic across the particular region (La Roche 1855, p.543). In China, the appearance of SARS in 2003 led the authorities to order the use of quarantine for confronting the expansion of the disease across the country – but also in the international community (Eccles & Weber 2009). The use of quarantine in the above country proved that quarantine is not necessarily applicable on all cases related to a specific disease; in fact, the authorities in China have decided to use quarantine only for isolating’ those individuals who had contacted symptomatic SARS cases’ (Eccles & Weber 2009, p.217). 2.3 Psychosocial effects of quarantine As noted above, the use of quarantine as a tool for protecting public health is based on specific criteria. However, these criteria are not always appropriate in terms of the needs of a particular case. As a result the effects of quarantine can be severe – meaning the level of influence of the local society but also of the individual(s) involved. The psychosocial effects of quarantine can be understood if referring to the characteristics of the relevant projects: quarantine focuses on the isolation of the individual or the group of people that were exposed to severe risks of infection from a specific disease. At this point it would be necessary to review the structure/ characteristics of such projects, meaning the projects involved in the implementation of quarantine for preventing the expansion of a particular disease. In the context of quarantine, an individual or a group of persons are asked to abandon their current social environment/ family for a particular period of time – in order to gather data important for understanding the health needs and threats of local people. Being isolated from his social environment, an individual is likely to be stigmatized, meaning that even if it is proved that the above person was not infected by the disease, still he would be remembered for being involved in the particular case. On the other hand, not all people face in the same way their isolation, meaning that each person is likely to perceived differently the restriction of movement/ living as set by the authorities in the context of a quarantine plan. At the same time, quarantine could threaten the personal life or the work of an individual – for instance, in cases where quarantine is imposed in a period where important decisions on personal life or work are to be made. Being absent from work for a particular period because of quarantine can have severe effects on a person’s work; apart from the cancellation of important plans in the work, the continuation of the isolation of the person, this time in the workplace, after the end of the quarantine period is always possible. 2.4 Ways to overcome negative effects of quarantine In accordance with the issues discussed above, the negative effects of quarantine can be many; however, the limitation of these effects is feasible, especially in case where appropriate measures have been developed in advance, i.e. before the implementation of the relevant quarantine – plans. In this context, the following strategies are considered as appropriate for controlling the effects of quarantine within a particular society: a) a quarantine plan should be promoted by the government rather than the local authorities – ensuring the fairness and the equality of the measure, as perceived by the local population (Craddock, Giles-Vernick & Gunn, 2010), b) a quarantine plan should be carefully designed; in this way, the effects of the plan on the life of individuals could be reviewed more analytically, allowing the introduction of appropriate practices for ensuring fairness when promoting the quarantine plan (Eccles & Weber 2009), c) the emergent use of quarantine as a tool for preventing the expansion of a disease should be avoided; however, because the risk for the appearance of diseases that need to be treated within a short period of time is increased, the potential use of quarantine as a tool for responding to emergent threats of the public health should be periodically reviewed by governments worldwide (Eccles & Weber 2009), d) the use of quarantine as a tool for protecting the public health should be made clear to the public; the media and the press could help to explain to the people the role of quarantine and the terms of its use. In this way, people could become aware of the following fact: quarantine is likely to be used not only when the chances for an infection are many but also when there are limited chances for such infection to exist (Craddock, Giles-Vernick & Gunn, 2010). In other words, quarantine is a prevention tool, being used even in cases where the risks for the existence of a disease are limited, a fact which should be clearly to the people in countries where such plans are going to be used. 2.5 Why the effects of quarantine do not outweigh the benefits. Despite its negative effects, quarantine seems to be preferred as a measure for securing the public health. The reason is the following: the negative effects of quarantine do not outweigh its benefits. Indeed, through quarantine the following targets are likely to be achieved: a) the expansion of severe diseases is controlled; in fact, the effectiveness of quarantine in such cases seems to be high, as proved through the historical data presented above, b) the risks for social conflicts due to the expansion of severe diseases are decreased; indeed, severe diseases are likely to cause turbulences within societies, especially where the means for the confrontation of these diseases are limited; in other words, quarantine can help to keep balance and piece in society when indications for diseases that cause severe health problems exist (Stambaugh 2008), c) quarantine can also help to keep a balance in regard to a country’s costs on public health; without the use of quarantine the expansion of a disease can be quite rapid, leading to the radical increase of the costs of public health, either in the short or the long term (Eccles & Weber 2009). In other words, the negative effects of quarantine are likely to involve in a particular individual/ group of persons while the benefits of quarantine are likely to involve in the entire society, a fact that leads to the assumption that the negative effects of quarantine cannot, in no case, outweigh its benefits (M’ikanatha, N. & Lynfield 2007). 3. Conclusion The development of measures for protecting the interests of the public – meaning the health or the rights of individuals within a specific region – needs to be based on appropriate criteria. The above fact has been made clear through the case of quarantine. The specific tool for protecting the public health is quite effective, especially regarding its benefits for the public. The use of the above tool may come to opposition with certain rights of individuals, meaning specifically the right to live and move with no restrictions within a particular country. However, it has been proved that the negative effects of quarantine, as presented above, do not overweigh the measure’s benefits, even if these benefits are related to the interests of the public in general and not to the rights of each individual. The performance of quarantine in the past, as identified through the research on relevant cases, has proved that quarantine has helped governors to control the expansion of severe diseases no matter the local social ethics and culture. For this reason it is suggested that quarantine should be considered as an effective tool for securing the health of the public under the terms that measures are taken so that the fairness and the equality of the practices involved to be ensured. References Balint, J. & Strosberg, M. (2006) Ethics and epidemics. Oxford: Emerald Group Publishing Ciottone, G. (2006) Disaster medicine. Oxford: Elsevier Health Sciences Craddock, S., Giles-Vernick, T. & Gunn, J. (2010) Influenza and Public Health: Learning from Past Pandemics. London: Earthscan Eccles, R. & Weber, O. (2009) Common Cold. New York: Springer Jones, N. (2011) Quarantine and Isolation: Selected Legal Issues Relating to Employment. Darby, PA: DIANE Publishing Kuhse, H. & Singer, P. (2009) A Companion to Bioethics. Hoboken: John Wiley and Sons La Roche, R. (1855) Yellow fever, considered in its historical, pathological, etiological, and therapeutical relations. Oxford: Oxford University – Digitized: Sep 4, 2006 M’ikanatha, N. & Lynfield, R. (2007) Infectious Disease Surveillance. Oxford: Wiley-Blackwell Riegelman, R. (2009) Public health 101: healthy people--healthy populations. London: Jones & Bartlett Learning Stambaugh, H. (2008) Quarantine facilities for arriving air travelers: identification of planning needs and costs. Washington: Transportation Research Board Read More