- ATLANTA (AP) - Sobered by the recent alarm over bioterrorism and anthrax,
state officials have begun using the Q-word: quarantine.
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- The public-health tactic has been revisited
as officials consider roping off homes, blocks or even entire cities to
keep a potentially dangerous agent from spreading.
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- Health leaders stress that it would take
an emergency - such as a wide release of smallpox in a sprawling airport
- to trigger a quarantine, which would restrict potentially exposed people
to a tightly controlled area.
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- But at least 20 states and the federal
Centers for Disease Control and Prevention are reviewing their quarantine
laws, trying to determine exactly who has the authority to call one - and
who would enforce it.
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- "We realize the Q-word is pretty
loaded with emotion," said Dr. Marty Cetron, deputy director of the
CDC's quarantine division. "The struggle to balance individual liberty
with the public good is not something we take lightly."
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- The anthrax attacks in the fall killed
five people, but anthrax isn't contagious. If terrorists released deadly
smallpox, plague or Ebola virus, quarantines could be critical to prevent
thousands of deaths, experts said.
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- In the shadow of the new threat, some
states are revisiting their quarantine laws for the first time in decades
- and finding that they are vague and woefully outdated, if not unconstitutional.
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- Under some existing laws, "you'd
probably end up with large amounts of confusion and indecision," said
Lawrence Gostin, a Georgetown University public health professor. "And
you're losing critical time. You're causing confusion and panic in the
population."
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- Rushing to help states that wanted to
be more prepared after Sept. 11, the CDC asked Georgetown and Johns Hopkins
universities to write a sample law that legislatures could use as a pattern.
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- The latest version includes detailed
instructions for handling a quarantine, declared by a state's top health
officer. It directs the government to use the "least restrictive means
necessary" to keep a killer germ from spreading.
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- And it takes pains to make sure the quarantined
people - whether it's an office building or an entire neighborhood - get
enough food, decent clothing and good medical care.
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- Health officials say it represents a
huge shift in the purpose of the quarantine itself - focusing on caring
for the people who may have been exposed instead of just shutting them
off from the population.
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- Still, health officials admit they're
fighting fears produced at the mere mention of quarantine - images of armed
guards swarming around hospitals, with infected patients left helpless
inside.
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- But huge advances in public health since
the old days of quarantines, particularly in the study of infectious disease,
should reassure people that such a doomsday scenario is the smallest of
possibilities, the CDC says.
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- "The public is a lot smarter than
people think," said Dr. David Fleming, CDC's deputy director for science
and public health. "This is common sense."
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- What's not as clear is exactly who would
enforce a quarantine. CDC lawyers have told state health officers that
the law allows lots of options, from local police departments to a state
National Guard regiment to the U.S. military.
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- It all depends on the danger of the outbreak,
how soon it's detected and how widely the germs are believed to have spread,
Cetron said.
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- The uncertainty has arisen partly because
quarantining is a fairly rusty process. Mass quarantines haven't been seen
in the United States for decades.
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- If there's one thing health experts learned
from anthrax, it is that the public demands clear information from an authoritative
government figure in the event of a bioterrorism crisis, said Gostin, who
wrote the sample law.
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- "There should be very clear communication
to the public," he said. "Failing that, you could have hysteria,
confusion and even civil disobedience. You can't overestimate the importance
of calm."
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- Copyright © 2002 Nando Media http://www.nandotimes.com/healthscience/story/231036p-2220353c.html
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