There have been many unfortunate moments in America’s quarantine history, from the forced confinement of Typhoid Mary to the barbed wire strung around parts of San Francisco’s Chinatown in the midst of an outbreak of bubonic plague. But quarantine in the time of coronavirus will likely have no barbed wire moments. Still, even the possibility of forced quarantines have provoked fear among many.
Recently a friend of mine and his wife were forced to quarantine in Shanghai. It was late February and they were returning from Europe back to their home in Shanghai. The city they were traveling from had yet to report a single confirmed case of Covid-19 — though they would do so just a day later — but upon their return, they agreed to two weeks of voluntary isolation in their homes. This experience was much like what many of us are doing here in New York — they went for walks and bought their groceries, but they stayed home most of the time. They were required to take their temperature twice a day and upload the results to an app so authorities could monitor their health from afar. Roughly 90% of people infected with Covid-19 experience a fever as one of the symptoms.
Three days later, all that changed. My friends received calls from the police, the Shanghai Center for Disease Control (CDC) and their district CDC telling them a passenger on their flight had tested positive for infection and my friend and his wife were to be moved to a controlled quarantine location. This is different from self-quarantine, where you are asked not to leave your home, even to go out for food. With controlled quarantine measures, you are taken from your home and taken to a secure location for monitoring.
A day later, my friend and his wife were taken by van to a three star hotel in the city, which had been taken over by authorities for quarantined individuals — not dissimilar to the quarantine motels set up in Washington State as the outbreak unfolded there. With suitcases in hand, they were taken to two separate rooms on the same floor and told they would be separated for the duration of their quarantine. Food would be brought to them three times a day and left in front of their doors. And once a day, their trash would be cleared and their room disinfected.
With access to the internet and cell service, life on the inside was not all that different than life on the outside. They woke up, exercised, ate breakfast, and went on with their day, working remotely from a table in their rooms. They kept a video feed on with each other throughout the day so they could check in and group chat with friends. And they were even allowed to receive care packages with fresh fruit, wine, and other items that made life much more manageable, like warmer clothes, comfortable linens, and books to pass the time. While perhaps not enjoyable, in this case quarantine was most definitely liveable.
Their story will hopefully bring relief to those who are afraid of what quarantine might bring. But despite the good news inherent in their story, there is still reason for a judicious amount concern. Quarantine was bearable for my friends because their government was prepared. They tested the traveller who was initially infected, traced all his contacts, and had a plan in place for quarantine. Rules for quarantine were given to my friends at the hotel’s front door, along with a thermometer, soap, and even a bucket with dissolving disinfectant tablets that they were to use after going to the bathroom to prevent ongoing infection.
Would that be our experience here? The answer is unclear. Already our healthcare leaders and health systems are scrambling to keep up with a surge in demand. In places where we have set up similar quarantine facilities there have been reports of inadequate controls to keep those who may be infected in place. Each of us have a responsibility to ourselves and each other to stay as safe and healthy as possible, even if it means we are inconvenienced and forced out of our daily routines. Only by alleviating the pressure on our health system now can we free up resources to ensure that our response to this outbreak and the support for those infected is as smooth and efficient as it was for my friends.