What If We Tried a Real Quarantine?

Voluntary social distancing has helped, but governments have ignored the most powerful tool they have.

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With more and more states coming out of lockdown, the “end game” for COVID seems to be in sight. The worst wave of death is (maybe) over. Surely life can go back to normal?

Unfortunately, this hope is likely to be in vain. To the extent that the threat of COVID is receding around the world, it is because of a massive (and mostly voluntary) campaign of social distancing, in many places helped along by the arrival of warmer weather. When social life returns to normal, or when the weather begins to cool in the fall, it’s quite likely that COVID will come roaring back. Thus far, no highly effective treatment options have been found, and a safe vaccine remains a long way off. It is likely, then, that the fall of 2020 will see another outbreak. Many states and school systems are already planning how to manage frequent, episodic closures, on the assumption that further outbreaks will occur.

Unfortunately, most Western governments have left their most powerful tool on the shelf. Every country that has beaten COVID has done it the same way: with centralized quarantine. If we want to avoid a second round of lockdowns, panic, and disruption to life, there is only one path forward: to adopt a functional system of centralized quarantine, as humans before us have done for millennia.

Before we get into what centralized quarantine might look like today, it’s worth walking through the history of this strategy. In Leviticus 13 and 14, Moses gave the people of Israel instructions on how to deal with outbreaks of infectious diseases (in this case, a skin condition; widely translated as leprosy, it is actually very unlikely that the disease described was true “leprosy.”). The instructions are a Bronze Age version of “test and quarantine.” Detailed diagnostic criteria are listed for experts to use to provide a diagnosis. Any cases that meet a very low standard for a “possible positive” were then isolated from the rest of the community in a secure location until they completed a certain window of time without symptoms.

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  1. Avatar photo
    Kevin Johnson

    Fascinating piece with stuff we don’t see elsewhere. How about an expert response to his points? Perhaps Lyman could then respond. I really enjoyed him on The Remnant as well. Thanks.

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    Nick M

    Lots of people pointing out the obvious issue about asymptomatic transmission, which is of course true - if people infected with Covid-19 couldn't transmit the virus until they showed symptoms, we simply wouldn't be in this situation. Look at the Ebola epidemic that threatened the U.S. in 2014 - we did almost precisely what the author recommends, and it worked really well, because Ebola generally can't be transmitted by an asymptomatic person. Symptomatic people really are not the issue here - I haven't heard of virtually anyone, at least in the last two months or so, who came down with significant Covid-19 symptoms but nonetheless decided to carry on as normal anyway - for symptomatic people, voluntary quarantine has seemed to work just fine.

    But this article misses another big piece of the picture as well: what about mild cases or cases that may be Covid-19 but may not? Due to testing limitations, the author suggests forced quarantine for anyone even suspected of being infected, which in practice would mean we'd have to quarantine anyone who came down with the flu, the common cold, or even seasonal allergies given the similarity in symptoms. How would this even work in practice for those who didn't want to voluntarily quarantine? Would people be forced to "rat out" their neighbors or family members if they heard them sniffle?

    The only way to effectively impose a centralized quarantine is the South Korean model of massive testing combined with intrusive tracking and monitoring of the infected. And that may well be where the U.S. ends up too, eventually. But to suggest that somehow the U.S. should have done this from the beginning, when we DIDN'T have enough tests and DIDN'T have really any capability of contact tracing on a large scale, is nonsensical.

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    JDW

    I think a lot of you are missing the point. Yes the net used to scoop up potential infected is not perfect. Still if a person tests positive, you can quickly gather up people the person is in frequent contact with such as family and possibly co-workers. They can be tested. Repeated uses of this approach will greatly reduce the spread.

    I'm not as gung ho though to stop social distancing. I think even if we reopen businesses that efforts should be made to reduce the risk as much as possible. Things such as max capacity, waiting in cars instead of waiting rooms, wearing masks when feasible, etc.. are all good ideas. I've backed the lockdown but only as a temporary measure so the government can get ready. We have limited tests but if we use them on those mentioned above we already are ahead of the game.

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    Michelle O

    My only disagreement with you is that we wouldn't see SWAT/heavy police action. I think several incidents in the last couple months proves that false.

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      LtColZ

      I agree, Michelle. Full disclosure, I have pretty fundamental disagreements with his premise, but even if I did agree with him, I’d have to suggest that when it comes to fines (as with taxes) it seems from how he approaches this that he doesn’t understand quite how they work.

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        Michelle O

        I suppose I shouldn't have said "only disagreement." I meant, only big hole I noticed in the first read. I shuddered on hearing this argument the first time on The Remnant podcast. But I appreciate the argument being laid out in more detail. I think it's at least as worth considering as anything else right now. Personally, I could lock down forever. But then, I'm quite fortunate. Something different must be done or we'll lock ourselves back down to the Bronze Age.

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  5. PM

    I support Quarantine. It doesn't negate the need for testing. I would imagine that most experience people acting responsibly and people acting irresponsibly. The irresponsible are COVID-19's best friend. I have literally had a few people (young) go out of their way to come up and touch me just because.

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    Teresa

    Even If we accept that quarantine is one of the most effective techniques, why not just put more enforcement behind home quarantine of all those who test positive and their close contacts. You could still do fines for non-compliance. Have groceries, medications and supplies delivered. Have a daily nurse visit or Telehealth visit. Maybe one could offer hotels for those who wish to separate themselves from their own families to lessen the risk of transmitting it to them. Track cell phones or use some other kind of tracking technology. I would much rather quarantine in my own home, personally. Also, I think it’s more consistent with personal liberty.

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      J.Seravalli

      I agree but some folks might actually prefer the hotel route, especially in large cities where people live in less than 1000 square feet of space. It is quite demanding of roommates or family to have to sanitize the place daily unless the sick person has his/her own bedroom, bathroom. This is even happening in NY, NJ where hospital workers are having to camp out on the garage or send the family away while they are dealing with the crisis

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    Mark Wm L

    I've enjoyed Mr. Stone's writings and interviews on podcasts, learning much from him. I found the mention of Leviticus incredibly interesting. Aside from not addressing the asymptomatic aspect of COVID-19, I'm not sure I understand why symptomatic people who isolate themselves in their homes need to be removed and moved to a hotel full of symptomatic people?

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      Soniak21

      Seems like the main benefit would be allowing sick people to isolate from people in their own households. I'm sure it would be great to have that option if you live with someone who's elderly or vulnerable.

      The reason this piece doesn't really land right is that the author gives the idea such a buildup, as if it's both more original and more impactful than it really is. Yes, quarantine centers for mildly sick people are a good idea, and they'd help. But they'd be a smallish piece of the puzzle when the bigger problem is that lots of people are still out there spreading germs without knowing it.

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    Brian Ruff

    Lots of truth to be had in this article, but certainly some holes. I won't reiterate the discussion about symptomless patients already raging here, but instead focus on another part of the piece:

    "Put simply, the “flatten the curve” approach was focused entirely on the medical problem facing patients, doctors, and hospitals: How can we ensure COVID patients don’t die? Simple: Space out when they arrive at the hospital, so we never get overwhelmed."

    This gives the impression Mr. Stone is proceeding from an assumption that this was the strategy of our national leadership from the outset. (Maybe I'm reading that into the article, to be fair.) I don't think our epidemiologists ignored a strategy with so deep a history. I suspect that because of our sluggish acceptance of the seriousness of this disease and the problem of symptomless transmission, our scientific leadership knew that any attempt at centralized quarantine was boned. The "red dawn" email threads bear that out.

    Even so, once we can get a handle on knowing who is carrying this virus and who isn't, implementing a centralized quarantine strategy is enormously logical. This is a great breakdown of how that could happen.

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    rlritt

    I think this a great idea. If Trump wanted to do a great thing, he could provide all his hotels as quarantine centers. Receiving of course compensation. It would certainly keep the economy on track and be cheaper than unemployment. People in quarantine would have to be promised their old jobs afterwards.

    I just don't know how you would get people to comply. Lot's who have it, test negative. Lots of people who have it, don't get tested at all. Also, some human rights advocates would see it as punitive. And there would be court battles. Finally, it is no respecter of wealth and fame. Can you see confining Tom Hanks or Mayor Cuomo in a quarantine facility?

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  10. Tiffany

    Is there any chance that this will happen or is it mostly an ideal scenario that isn’t likely to be proposed?

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