Health Expert Explains What You Need to Know About Quarantines

[Matt] As the novel coronavirus

continues to spread around the world,

officials are turning to increasingly

extreme measures to slow it down.

[Norah] Ramy Inocencio is in China

reporting on a city quarantined.

[Reporter] And all trains and planes

out of that city halted.

[Reporter] Deserted streets telling the story

of a country on lockdown.

While we haven't gone that far in the U.S.,

officials here are encouraging people to stay at home

and to cancel classes and public gatherings.

But are we also heading toward mass quarantines,

and would they even work here?

To find out more, we spoke to Lawrence Gostin.

He's a professor of global health law

at Georgetown University.

I think to start, it would be helpful to define

exactly what a quarantine is.

Quarantine is when you're not known to be infected,

but you've been exposed to somebody who is infected.

So you, say you just shook hands

with somebody that had COVID.

You don't necessarily have it,

but we will quarantine you for the longest

period of incubation of the disease,

and in this case, that's 14 days.

Mass quarantine is when we guard entry and exit

from a city or a town, and we confine

everybody within those borders.

Self-quarantine or isolation is

completely different than mass quarantine.

In the United States during COVID, we've seen

the largest federal quarantine in recent history.

Some have been evacuees from Wuhan,

but some have been people who were rescued

off of the Grand Princess just docked now

in Oakland, and also Diamond Princess

out of Japan, and then we evacuated

our citizens back to the United States.

So we haven't seen anything like that in recent history.

We've only seen self-quarantine or isolation

in the United States, and I can see this

increasing exponentially.

But people shelter in place, mostly in

their apartments and their homes.

That can be either voluntary, or it might be

that you were ordered by force of order,

but either way, it applies to individuals.

That's what self-quarantine or isolation is.

And how does that compare to something

like social distancing?

Social distancing is quite different.

We use social distancing irrespective

of whether you've been infected or exposed to a disease.

At that stage, we're on to what public health people

call mitigation, and all that means is

that we're trying to slow the spread of the infection.

And so, social distancing measures are things

like school closures, postponing or canceling

large gatherings, things like political rallies.

It's just a measure where we try to separate

the population so that they're not

really being exposed to one another,

they're not mingling in crowded spaces.

What we wanna do is we wanna buy ourselves some time.

So looking specifically at what happened in Wuhan,

in your opinion, does that look

to have been a successful quarantine,

and maybe what metrics do you look at when

determining if it was, in fact, successful?

You have to remember this was a mass quarantine

that affected 60 million people.

It was unprecedented.

I was very worried about it, because it

congregated a lot of people together in Wuhan.

But recently, the World Health Organization

has praised China.

They've said that the rest of the world

should use the China model.

I have grave doubts about that,

because it's true that cases have gone down in China,

but they've also gone down in South Korea,

so I don't know that you need those draconian measures.

But, you know, let's even assume

for the moment that it was effective.

There's still a big cost.

We all know about the economic cost,

the stock markets are going down,

supply chains are disrupted, work environments

and workers are disrupted, but there are

also enormous human rights implications.

It's a balance.

We have to balance public health with

civil liberties and human rights.

People have asked me, Could we have

a mass quarantine or a lockdown in the United States?

Could we lock down New York City?

And I think it's inconceivable in the United States,

even though we are seeing it in another

liberal democracy, which is Italy.

Americans wouldn't accept the degree

of social control that was needed

in China or the intrusive surveillance.

We need to be sensible.

So what, then, should our overall goal be here?

And I think this would be a good opportunity

to talk about what we mean by flattening the curve.

What we need to do is tried-and-true

public health measures.

We need to really ramp up our diagnostic testing.

We also need to test not patients,

but in random samples in the community,

so that we can see what's going on silently

but below the radar, 'cause I suspect

we have a lot of silent transmission going on.

We're gonna need, then, to isolate people who are sick,

quarantine those who've been exposed.

I think we're gonna probably need to do

school closures and closures and cancellations

of public events.

Those are the kinds of things we need to do,

and if we could do those kinds of social distancing,

isolation, keeping people away from one another,

we would flatten the curve.

In other words, instead of cases going

up, up, up, up, up, we would bend it

to flatten it out a bit, and that buys us time,

because days, weeks matter.

It buys us time to actually use our public health tools,

but it also buys us time to develop

effective, specific treatments, and then,

ultimately, it buys us a little more time

to get what is the Holy Grail,

which is a vaccine, but that probably won't be

for another year to a year and a half.

In your opinion, is it still possible

for us in the United States to prevent

a kind of worst-case scenario with this outbreak?

I think if we rapidly do a surge response,

surge funding, and do the kinds of measures

we've been talking about, like isolation,

social distancing, more testing, contact tracing,

I think we stand a reasonable chance

of bringing the numbers down.

We do have good public health agencies,

and we need to use them with science-based,

evidence-based approaches in a proportionate way.

Thank you very much for joining us today.

Okay, thank you, take care.