Tuesday, July 11, 2006

Guard to Enforce Quarantine --- Time to Scram?

Lindsay Beyerstein argues in her piece "You and Whose Army? Flu and Quarantine" on the blog Majikthises that military quarantine would probably spread the flu as citizens flee to escape quarantine. Her feeling for the situation is put in a useful --- if rhetorical --- question: "Wouldn't you get out of town if you heard that your county was about to be locked down by the National Guard?"

To be sure, I would be taken aback to hear that the National Guard had been called to Philadelphia for any reason. Still, is it credible that the Guard could be asked to enforce a quarantine?

One Step at a Time Please

Let's put this possibility into perspective. What is likely to happen in an 1918-level H5N1 pandemic before a city or state calls on the National Guard?

Naturally, influenza would have to be established in the community. That's a given. For sure, this means that the local government would have taken all of the easy steps it could take. Schools would have been asked to close. Most public gatherings would have been banned --- first on a voluntary basis, then --- if necessary --- by municipal order.

Hospitals would have been reorganized on the principles of triage. Flu patients would be sent to facilities set up in schools and public buildings. Great efforts would have been taken to keep hospitals as free as possible of the influenza virus. Some hospitals would have failed (and essentially gone into meltdown), but many hospitals would succeed in keeping infections under control.

Public transportation would continue to work, although there would be problems. Many regular travelers would avoid public transportation as much as possible. Buses and subways would run, but absenteeism would cause frequent and worrisome interruptions. More people than usual would want to drive, but gas lines would be long and supplies uncertain. Self-quarantining would be common. Many parents would turn to home schooling --- one of the wisest actions at their disposal.

These are events that are almost certain to take place long before any situation could evolve where a state or municipal official could imagine calling in the National Guard.

But When the Guard is Called?

If and when the National Guard is called upon, it will almost certainly be for
  1. Prevention of looting
  2. Protection of the distribution of food and water
  3. Protection of the channels of distribution, especially trucking and warehousing
  4. Assistance with sanitation, including mortuary functions
As a Philaldelphian, I would welcome these services. Moreover, I do not think that it is sensible to expect any others.

Forced Quarantines --- Just Not in the Cards

During their two hundred and thirty years, US governments (city, state, and federal) have done their share of stupid things. Nevertheless, forced quarantines should not be on anyone's short list of the stupid things that our governments are likely to do in the event of an influenza pandemic.

To be sure there are government blunders and blind spots that we should worry about. For starters, we should be worried that our public water facilities have their hands tied by short-sighted regulations that would force them to shut down water supplies because of arbitrary standards which would be impossible to meet in a pandemic. Such feasible disasters --- and the actions we can take to forestall them --- are topics for later posts.

Back to the Original Question

How would I respond to Beyerstein's rhetorical question? If I heard that the National Guard was imposing a quarantine on Philadelphia, what would I think? One can never say for sure, but my best guess is that I would think that the report must be wrong. I suppose that I would be a little worried, but I also believe that I would be reasonably confident that a correction would soon be announced.

Forced quarantine is infeasible (and largely irrelevant) under any scenario one can credibly imagine. If the Guard is on the way, it's on the way for reasons that are much more practical than quarantine. We should be relieved upon its arrival.


Blogger gs3gs3 said...

why should a quarantine be silly/useless in a severe pandemic ? You state it as fact, but give no argument.
Also a curfew could be necessary.
But the national guard can't control all cities, local guards have to be formed.

10:08 AM  

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