Something's in the air: liberties in the face of SARS and other infectious diseases - Singapore

Reason, August, 2003 by Declan McCullagh

Reactions to the 1918 epidemic provide a cautionary tale. State governments across the U.S. responded by levying quarantines and imposing mask laws. In San Francisco, the city sterilized public telephones and drinking fountains. It also required people to wear gauze masks in all public places, giving rise to the far-too-optimistic slogan: "Wear a Mask and Save Your Life! A Mask is 99% Proof Against Influenza." In November, city sirens wailed to signal that it was safe to remove the masks-an announcement that was terribly premature, as thousands more people came down with influenza the following month.

In Philadelphia, city officials made the fatal mistake of sending mixed signals. While one agency was warning against public coughing, sneezing, and spitting, the Department of Health and Charities was informing the public that influenza would not spread outside the military. Then, over a matter of weeks, nearly 13,000 people died. Too late, the city government ordered schools, churches, theaters, and other public gathering places closed. Elsewhere, "openfaced sneezers" were fined and the District of Columbia imposed blanket quarantines that restricted residents to their homes.

The history of quarantine dates back at least to the Bible's Leviticus 13, which describes a seven-day period of isolation that priests must impose when an infection is apparent. Quarantine literally means a period of 40 days, which cities along the Mediterranean shipping routes imposed during the plague of the 15th century. English common law recognized that a government must take aggressive steps to limit the spread of plague, a concept that was adopted by the American colonies and the young Republic. In the 1849 case Smith v. Turner, the Supreme Court described early efforts at quarantine in New York: "Never did the pestilence rage more violently than in the summer of 1798. The State was in despair. The rising hopes of the metropolis began to fade. The opinion was gaming ground, that the cause of this annual disease was indigenous, and that all precautions against its importation were useless....The whole country was roused. A cordon sanitaire was thrown around the city." At times, Bedloe's Island-where th e Statute of Liberty is today--and Ellis Island have been used for quarantines.

And today? Under current federal law, 42 U.S.C. 264, the Surgeon General has broad power to "make and enforce" any rules that may be necessary to prevent the spread of communicable diseases. The law makes for fascinating--if disquieting--reading.

It gives federal officials the authority to appoint quarantine officers, establish quarantine stations, and detain Americans "reasonably believed to be infected" with a communicable disease. Anyone violating a quarantine order can be punished by a fine of up to $1,000 and a one-year prison term. The law applies only to a list of deadly and easily communicable diseases that the president may amend at will, which Bush did in his executive order that added SARS to the list.