We address the issue of whether, why and under what conditions, quarantine and isolation are morally justified, with a particular focus on measures implemented in the developing world. We argue that the benefits of quarantine and isolation justify some level of coercion or compulsion by the state, but that the state should be able to provide the strongest justification possible for implementing such measures. While a constrained form of consequentialism might provide a justification for such public (...) health interventions, we argue that a stronger justification is provided by a principle of State Enforced Easy Rescue: a state may permissibly compel individuals to engage in activities that entail a small cost to them but a large benefit to others, because individuals have a moral duty of easy rescue to engage in those activities. The principle of State Enforced Easy Rescue gives rise to an Obligation Enforcement Requirement: the state should create the conditions such that submitting to coercive or compulsive measures becomes a fundamental moral duty of individuals, i.e. a duty of easy rescue. When the state can create such conditions, it has the strongest justification possible for implementing coercive or compulsive measures, because individuals have a moral duty to temporarily relinquish the rights that such measures would infringe. Our argument has significant implications for how public health emergencies in the developing world should be tackled. Where isolation and quarantine measures are necessary, states or the international community have a moral obligation to provide certain benefits to those quarantined or isolated. (shrink)

Concerns about emerging and re-emerging infectious diseases have given a new lease of life to quarantinist measures: a series of time-honoured techniques for controlling the spread of infectious diseases through breaking the chain of human contagion. Since such measures typically infringe individual rights or privacy their use is subject to legal regulations and gives rise to ethical and political worries and suspicions. Yet in some circumstances they can be very effective. After considering some case studies that show how epidemics are (...) unique, fluid and affected by a multitude of contingent factors, it is argued that the legal and ethical guidelines may not always be the best approach to discipline the use of quarantinist measures. An alternative model based on ex-post political accountability for reasonableness is proposed. This model restores the centrality of political decision and expert judgement in situations characterized by high risk, uncertainty and contingency. It is argued that such alternative model affords quicker and more flexible responses to serious outbreaks of infections, while providing adequate protection against abuses. (shrink)

Although researchers have investigated the impact of social isolation on well-being, the recent quarantines due to COVID-19 resulted in a social isolation environment that was unique to any examined in the past. Because sleep is one of the endogenous drives that impacts short and long-term health and well-being, it is important to consider how social isolation during the COVID-19 government-mandated quarantines affected sleep and sleep habits. A number of researchers have addressed this question during the last 2 (...) years by examining several concepts related to possible changes in sleep during the quarantines. To best understand these recent results, the current mini review provides a background on the pre-pandemic literature on the effects of social isolation and loneliness with a focus on sleep and then summarizes the recent literature on sleep and sleep habits. In general, sleep was negatively impacted for many people during the pandemics but not all. One group that seemed to benefit from the pandemic in terms of sleep patterns, were younger people who could more easily adapt their sleep times to match their internal chronobiology. Given the potential broad impact of sleep on health and well-being, better understanding how social isolation impacts sleep is an important consideration for individuals, work organizations, and governments. (shrink)

This article aimed to explore issues of concern related to quarantine, its social consequences and influences, challenging its effects on human behavioral expressions during social isolation. The advent of the coronavirus disease 2019 (COVID-19) pandemic impacted human lives in multifarious ways, threatening the meaning of normalcy. Quarantine, lockdown, isolation, and other terms reflecting conditions limiting human freedoms have become synonymous in importance to safety, security, and survival. To understand human defiance in the face of maintaining limited (...) mobility during the COVID-19 pandemic, reimagining situations of “unfreedoms” is explained as thinking of changes to inspire and improve the meaning of living lives meaningfully. During the pandemic, issues regarding healthcare practices and social behaviors focused much attention on interactive challenges that enhance ways to mitigate the spread of contagious diseases. Illuminating these issues, discussing concerns and highlighting recommendations to engage in alternative approaches and practices, heightens the declaration of efficiency of quarantine outcomes and effectiveness. Implications are proposed with the hope that they may lead the way forward in exercising contemporary healthcare practices. (shrink)

The highly contagious 2019 novel coronavirus disease (COVID-19) outbreak has not only impacted health systems, economies, and governments, it has also rapidly grown into a global health crisis, which is now threatening the lives of millions of people globally. While, on one hand, medical institutions are critically attempting to find a cure, on the other hand, governments have introduced striking measures and policies to curtail the rapid spread of the disease. Although COVID-19 has achieved pandemic status and is predominantly viewed (...) as a biomedical issue, it is argued that it should also be treated as a psychological crisis. This paper also reviews the literature to examine and comment on the detrimental effects of isolation, which has been enforced as one of the primary preventative measures to manage the spread of COVID-19. This paper further outlines key recommendations that should be addressed across different levels to buffer against the known adverse effects of isolation, which is especially relevant for the current COVID-19 situation, where a large proportion of the global population is isolated, confined, and/or quarantined. (shrink)

Due to the COVID-19 pandemic, cities and states adopted social distancing, social isolation, or quarantine measurements to slow the transmission of the disease. Negative mental health outcomes including depression and anxiety have been associated with social distancing or social isolation. The purpose of the present study was to examine changes in psychological health and physical activity over an 8 week period under social distancing policies during the COVID-19 pandemic.Methods: Ninety individuals participated in this study. Qualifying participants answered (...) questions using an online survey regarding their loneliness, depressive symptoms, anxiety symptoms, mood state, and physical activity over four time points each lasting two weeks.Results: Symptoms of depression and state anxiety were increased in the population when compared to nationwide statistics from before the COVID-19 pandemic. Time point 2, ~1 month into social isolation, showed the most significant effects on mental health. During this time point, 100% of the participants showed symptoms of depression. There were no significant changes in physical activity over the 8 weeks. Loneliness, depressive symptoms, fatigue, and mood state were negatively associated with participation in physical activity. Vigor and state anxiety were associated with participation in physical activity.Conclusion: Social isolation and social distancing practices have had a negative effect on depression, anxiety, and mood over time. It appeared that depressive symptoms and total mood disturbance was elevated during time point two. Depressive symptoms were much higher than average compared to previous epidemiological data. Physical activity amount did not change over time but was associated with poor mental health. (shrink)

SARS and monkeypox have given the public health community a unique opportunity to examine the use of quarantine measures. Until recently, the word “quarantine”was not used in polite conversation, and evoked unsavory images. The recent SARS epidemic illustrated the important role of quarantine and isolation as a public health response to communicable disease.As public health officials in Toronto began to take control of the SARS epidemic, a second wave of the disease emerged. In the first SARS (...) epidemic, approximately 8,200 individuals were isolated. There were approximately 82 probable cases, 66 suspect cases, and 24 deaths. On May 22, 2003, SARS II emerged. In total, approximately 13,000 people were quarantined. SARS II saw the onset of difficult questions being asked about the control and spread of SARS.The province of Ontario establishes the public health policies and legislative framework for the entire province. (shrink)

SARS and monkeypox have given the public health community a unique opportunity to examine the use of quarantine measures. Until recently, the word “quarantine”was not used in polite conversation, and evoked unsavory images. The recent SARS epidemic illustrated the important role of quarantine and isolation as a public health response to communicable disease.As public health officials in Toronto began to take control of the SARS epidemic, a second wave of the disease emerged. In the first SARS (...) epidemic, approximately 8,200 individuals were isolated. There were approximately 82 probable cases, 66 suspect cases, and 24 deaths. On May 22, 2003, SARS II emerged. In total, approximately 13,000 people were quarantined. SARS II saw the onset of difficult questions being asked about the control and spread of SARS.The province of Ontario establishes the public health policies and legislative framework for the entire province. (shrink)

Quarantine and isolation at extended length, although considered as highly effective countermeasures for the novel coronavirus which started at the end of 2019, can have great impact on individual's mental health, especially emotional state. The present research recruited 5,115 participants from the general public across 32 provinces and autonomous regions in China in an online survey study, about 20 days after the lockdown of the epicenter, to investigate the relationship between the length of the quarantine and negative (...) affect, as well as the mediating roles of negative cognition, and the moderating roles of dispositional optimism, tolerance of uncertainty, social support, and healthy behavior. The results showed that: Worry and anticipation mediated the relationship between quarantine length and depression and anxiety; Dispositional optimism moderated the path coefficients of quarantine length to worry, worry to anxiety, and anticipation to depression; Tolerance of uncertainty moderated the path coefficient of worry to anxiety; Social support moderated the path coefficient of anticipation to anxiety. In conclusion, during quarantine, dispositional optimism, uncertainty tolerance, and social support can buffer the direct or indirect effects of quarantine length on depression and anxiety. These findings could have profound implications on the societal responses to COVID-19 and future pandemics. (shrink)

The incident in May-June 2007 involving a U.S. citizen traveling internationally while infected with drug-resistant tuberculosis involved the U.S. federal government's application of its quarantine and isolation powers. The incident and the isolation order raised numerous important issues for public health governance, law, and ethics. This article explores many of these issues by examining how the exercise of quarantine powers provides a powerful lens through which to understand how societies respond to and attempt to govern threats (...) posed by dangerous, contagious pathogens. The article considers historical aspects of governmental power to quarantine and isolate individuals and groups; analyzes the current state of quarantine and isolation law in the United States in light of the recent incident with drug-resistant tuberculosis; and explores global aspects of public health governance and law highlighted by this incident. (shrink)

In late March 2020 in response to the COVID-19 pandemic, Australia introduced mandatory 14-day supervised quarantine at hotels and other designated facilities for all international arrivals. From July 2020, most states and territories introduced a fixed charge for quarantine of up to $3220 per adult. The introduction of the fee was rationalised on the basis that Australians had been allowed sufficient time to return and there was a need to recover some of the cost associated with administering the (...) program. Drawing on an empirical study of 58 returned Australian citizens and residents quarantined between March 2020 and January 2021, this paper aims to explore how people experienced paying for hotel quarantine, particularly with respect to fairness and relatedly, the principle of reciprocity. Reciprocity requires that the state has an obligation to assist individuals in discharging their duty to comply with public health measures and avoid disproportionate burdens accruing to populations or individuals. Though participants had varying opinions on whether they thought it fair to be charged for their quarantine, for many, the fee constituted a significant burden and source of stress. Given the undertaking of quarantine is primarily for the benefit of the public good, we argue the financial cost imposed on individuals does not meet the demands of reciprocity. It is imperative that future quarantine and isolation arrangements consider seriously the need to minimise burdens of individuals subject to such measures, and that fees do not become a new norm in public health and infectious disease control. (shrink)

Dramatic events involving dangerous microbes often focus attention on isolation and quarantine as policy instruments. The incident in May-June 2007 involving Andrew Speaker and drug-resistant tuberculosis joins other communicable disease crises that have forced contemplation or actual application of quarantine powers. Implementation of quarantine powers, which encompasses authority for both isolation and quarantine actions, is important not only for the handling of a specific event but also because the use of such authority provides a (...) window on broader issues of public health and the legal rules, ethical principles, and governance systems that support it. Debates about quarantine powers reflect political and social attitudes about public health that often tell us more about this policy endeavor than acts of isolation and quarantine themselves. (shrink)

Northeastern University School of Law, 400 Huntington Avenue, Boston, MA 02115, USA. Tel.: 617 363 2019; Fax: 617 373 5056; Email: w.parmet{at}neu.edu ' + u + '@' + d + ' '//--> Abstract This paper looks at the American law of quarantine in light of the teachings of John Stuart Mill, whose harm principle has often been used to justify the practice of isolating and/or quarantining individuals to prevent the spread of an infectious disease. The paper shows that despite (...) important parallels between quarantine law and both the authorizing and prohibitive aspects of Mill's harm principle, the contemporary law of quarantine does not reflect either Mill's concern for the potential abuse of executive authority nor his recognition that quarantine is only ethically justified when the broader public health policy environment in which quarantine is applied is itself ethically sound. CiteULike Connotea Del.icio.us What's this? (shrink)

Most countries are facing the societal challenging need for a new quarantine period due to the increasing number of COVID-19 infections, indicating a second or even third wave of disease. The COVID-19 pandemic has brought to the surface existential issues that are typically less present in people's focal attention. The first aim of this study was to identify some of these existential struggles such as increased feelings of loneliness, death obsession, and preoccupation with God. Secondly, we explored the association (...) of these factors with the increased fear of coronavirus during the quarantine. Data was collected from 1,340 Romanian adults using a cross-sectional web-based survey design in the midst of the national lockdown period of COVID-19. Participants completed measures of COVID-19 related loneliness, death obsession, and preoccupation with God twice; first, thinking about the period before the pandemic, and second, for the current situation during the quarantine. Then, they completed a fear of COVID-19 measure. Participants perceived an increase in the feelings of loneliness, death obsession, and preoccupation with God during the confinement. Furthermore, gender, knowing someone diagnosed with COVID-19, loneliness, death obsession, and preoccupation with God predicted fear of COVID-19. Interestingly, days in isolation did not predict fear of COVID-19 nor were associated with feelings of loneliness. In line with existential positive psychology, these results highlight the importance of policies and interventions targeting the experience of loneliness, spiritual beliefs, and particularly those aimed to promote death acceptance, in order to alleviate intense fear of COVID-19. (shrink)

The study investigated the influence of resilience and dispositional optimism on, first, emotional distress and, second, the intention to self-isolate, experienced by people with a lower and higher illness risk, during the lockdown imposed in Spain during the first COVID-19 wave. These effects were investigated against the background of the Health Belief Model. A convenience sample of N = 325 participants completed an online survey including an ad-hoc questionnaire measuring the HBM core factors: Perceived health threat, and perceived quarantine (...) benefits and costs. Self-efficacy and perceived social pressure were also measured. Based on reviews regarding pandemic outbreaks, quarantine benefits were conceptualized as the perceived effectiveness and solidary contribution of self-isolating in line with the quarantine protocols. Quarantine “psychosocial” costs were conceptualized as a composite of perceived boredom, loneliness, and economic concerns. Findings revealed an asymmetrical pattern of results so that people at higher risk were more distressed by the perceived severity of getting infected whereas people at lower risk were more distressed by the psychosocial costs. Moreover, resilience and optimism were more “protective” against distress within the lower and higher risk groups, respectively. In addition, quarantine benefits and self-efficacy promoted the intention to self-isolate within both groups. However, optimism hindered such intention. This finding is discussed in the light of links between dispositional optimism and optimistic bias; the underestimation of experiencing negative events, which can relax the perceived health risk. Based on these findings, communication campaigns should prioritize information about the effectiveness of the implemented preventive behaviors rather than the costs of not implementing them, and be cautionary in encouraging excessive optimism. (shrink)

Coronavirus disease 2019, as an infectious disease, is now prevalent in many countries around the world, which has recently led many governments to home quarantine and impose penalties for violating quarantine. Concerns and stress caused by lockdown and social isolation led to personal and interactive reactions in some families, which are also culturally important to address. This study was administrated to study the psychological well-being and the effect of home quarantine on marital satisfaction and parental burnout (...) from parenting responsibilities during the prevalence of COVID-19 in Iranian parents. A total of 213 parents voluntarily participated in the online survey in the period of February to mid-April 2020 and completed the 5-item index of the well-being of the World Health Organization, the Kansas Marital Satisfaction Scale, and the Parental Burnout Assessment. The results showed that the effect of home quarantine on MS and PB was not significant in parents. The interactive effect of home quarantine and gender was not significant on MS and PB. In addition, the mothers significantly reported higher PB than the fathers, but the fathers had higher scores in MS and psychological well-being. The effect of some demographic factors on the studied variables was also significant. Supportive resources in family-based culture may play an essential role to reduce the negative effects of stressful situations on family interactions. (shrink)

Human space exploration requires massive budgets every fiscal year. Especially under severe financial constraint conditions, governments are forced to justify to society why spending so much tax revenue for human space exploration is worth the cost. The value of human space exploration might be estimated in many ways, but its social significance and cost-effectiveness are two key ways to gauge that worth. Since these measures should be applied country by country because sociopolitical conditions differ in each country and must be (...) taken into consideration, the study on the social significance of human space exploration must take the coloration of a case-study. This paper, focusing on the case of Japan with surveying Japanese literary and national documents as well as taking its sociopolitical conditions into account, examines the social significance of human space exploration. -/- First, we give an overview of the circumstances surrounding Japan's human space exploration program. Derived from the statements of such relevant parties as scholars, journalists, policy makers, and astronauts, this overview indicates that the main concerns about human space exploration in Japan are its social significance and cost-effectiveness (Section 1). Next, an overview of behavioral science—an essential field for human space exploration (referred to in this paper as space behavioral science) that provides support for astronauts—is presented from the perspective of stress research in isolated and confined environments (Section 2). We then give two examples of where such knowledge from space behavioral science research has been applied to terrestrial isolated and confined environments. One is JAXA’s support in 2009 for people who were vulnerable to infection by a new strain of flu and accordingly placed in an isolated and confined facility under the Infectious Disease Law and the Quarantine Law. The other is NASA's support in 2010 for Chilean mine workers who were trapped 700 m underground after a mining accident (Section 3). Based on these case studies, we illustrate the further social utility of such knowledge through a discussion of potential applications in other situations in Japan. Focusing on Japan for its geographical and social features in being an earthquake-prone archipelago and having the world's preeminent aging society, we show that refugees living in evacuation centers and people in an elderly-elderly homecare situation pose socially problematic situations specific to Japan. We then argue that space behavioral scientific knowledge can be applied to support people under these and other isolated and confined environments in various ways (Section 4). Finally, we demonstrate that such an application can be understood as an ethical contribution to Japanese society and that this contribution can be embedded in Japan's space policy (Section 5). We conclude that human space exploration can be a socially significant and cost-effective endeavor that is worthy of tax revenue expenditures because space behavioral science is highly likely to provide unique and useful knowledge to help address various social problems concerning terrestrial isolated and confined environments and support people in sufferings there. (shrink)

COVID 19 closed the people in their homes but for a small part of the society the period of isolation has passed in a learning and office environment. What are the effects of the social isolation on people – we will find out. How the environment – parents, friends, society, colleagues, influences on the successful dealing with stress and how it helps personal sustainability, we will know in the future. During the research we will see the dynamics in (...) the resilience levels of the cadets before, during and after the quarantine. The results will show us how the military environment helps the cadets to deal with the negative sides of the social isolation. The development of resilience will be monitored as an ability of selfregulation in a moments of crisis. (shrink)

Public health policies often require individuals to make personal sacrifices for the sake of protecting other individuals or the community at large. Such requirements can be more or less demanding for individuals. This paper examines the implications of demandingness for public health ethics and policy. It focuses on three possible public health policies that pose requirements that are differently demanding: vaccination policies, policy to contain antimicrobial resistance, and quarantine and isolation policies. Assuming the validity of the ‘demandingness objection’ (...) in ethics, we argue that states should try to pose requirements that individuals would have an independent moral obligation to fulfil, and therefore that are not too demanding. In such cases, coercive measures are ethically justified, especially if the interventions also entail some benefits to the individuals; this is, for example, the case of vaccination policies. When public health policies need to require individuals to do something that is too demanding to constitute an independent moral obligation, states have an obligation to either provide incentives to give individuals non-moral reasons to fulfil a certain requirement – as in the case of policies that limit antibiotic prescriptions – or to compensate individuals for being forced to do something that is too demanding to constitute an independent moral obligation – as in the case of quarantine and isolation policies. (shrink)

In 2020, after the first Covid-19 lockdown, several countries implemented a policy of contact tracing and self-isolating for individuals who crossed borders or came into contact with infected people. To enforce these restrictions, some states imposed very harsh monetary penalties for people who violated them. Behind these harsh fines lies an instrumental rationale. They allow the state to avoid implementing a system of labor-intensive and costly surveillance and enforcement. In this article I argue that such severe penalties are extremely unjust. (...) In order not to expose citizens to the risk of being excessively fined, governmental institutions should instead intensify controls. I argue that they owe it to their citizens to increase the surveillance of compliance with self-isolation obligations. (shrink)

This article investigates the role of Big Data in situations of psychological stress such as during the recent pandemic caused by the COVID-19 health crisis. Quarantine measures, which are necessary to mitigate pandemic risk, are causing severe stress symptoms to the human body including mental health. We highlight the most common impact factors and the uncertainty connected with COVID-19, quarantine measures, and the role of Big Data, namely, how Big Data can help alleviate or mitigate these effects by (...) comparing the status quo of current technology capabilities with the potential effects of an increase of digitalization on mental health. We find that, while Big Data helps in the pre-assessment of potentially endangered persons, it also proves to be an efficient tool in alleviating the negative psychological effects of quarantine. We find evidence of the positive effects of Big Data on human health conditions by assessing the effect of internet use on mental health in 173 countries. We found positive effects in 110 countries with 90 significant results. However, increased use of digital media and exclusive exposure to digital connectivity causes negative long-term effects such as a decline in social empathy, which creates a form of psychological isolation, causing symptoms of acute stress disorder. (shrink)

There is an underdeveloped potential for using neuroscience as a particular input in the process of law-making. This paper examines one such instance in the area of public health law. Neuroscience could play an important role in elucidating and strengthening the relevance of the conditions underlying and re-enforcing our ability to cooperate in balancing the benefits and burdens necessary to achieve particular goods; for instance, the protection of public health in an outbreak of pandemic influenza. In particular, I shall focus (...) on how a better understanding of the neurobiological basis of reciprocity could be used to help increase support and compliance with public heath laws—especially those involving restrictive measures (such as quarantine and isolation). (shrink)

The Coronavirus Disease 2019 pandemic, now a global health crisis, has surprised health authorities around the world. Recent studies suggest that the measures taken to curb the spread of the COVID-19 outbreak have generated issues throughout the population. Thus, it is necessary to establish and identify the possible risk factors related to the psychosocial and psychophysiological strain during the COVID-19 outbreak. The present extensive literature review assesses the social, psychological, and physiological consequences of COVID-19, reviewing the impact of quarantine (...) measures, isolation, vast human loss, social and financial consequences in the family’s economies, and its impact on the psychological health of the population. We also discussed the effect of psychophysiological factors, considering the impact of physical inactivity and modifications in nutritional habits, at psychological and physiological levels. The present review includes an actualized to date bibliography, articles for which were methodologically analyzed to verify they met the standards of quality and scientific accuracy. Authors understand the pandemic as a multifactorial event for which only a profound and extensive analysis would lead to better compression and efficient intervention in the near future. (shrink)

Responses to public health emergencies can entail difficult decisions about restricting individual liberties to prevent the spread of disease. The quintessential example is quarantine. While isolating sick patients tends not to provoke much concern, quarantine of healthy people who only might be infected often is controversial. In fact, as the experience with severe acute respiratory syndrome (SARS) shows, the vast majority of those placed under quarantine typically don't become ill. Efforts to enforce involuntary quarantine through military (...) or police powers also can backfire, stoking both panic and disease spread. Yet quarantine is part of a limited arsenal of options when effective treatment or prophylaxis is not available, and some evidence suggests it can be effective, especially when it is voluntary, home-based and accompanied by extensive outreach, communication and education efforts. Even assuming that quarantine is medically effective, however, it still must be ethically justified because it creates harms for many of those affected. Moreover, ethical principles of reciprocity, transparency, non-discrimination and accountability should guide any implementation of quarantine. (shrink)

Old habits die slowly. Hence there is little surprise that attorneys fashioning the Model State Emergency Health Powers Act preserved much of their own standard operating procedure. This model statute was designed for the worst of times—for horrific scenarios in which terrorism, infectious disease, or natural calamity threaten to derail the machinery of civilization while snuffing out thousands or even millions of human lives. Such grave threats seem to justify grave measures aimed at restoring order and maximizing survival. So, the (...) model statute bestows sweeping power on state governors and public health officials, allowing them to seize private property, obtain clinical services through impressment, and enact quarantine and isolation measures without the usual due process. Yet amid all these drastic measures, certain standards persist. (shrink)

The authors argue that in preventing and controlling the pandemic of Covid‐19, we should have taken an offensive or proactive strategy rather than a defensive or reactionary one because the former type of approach can bring about more health benefits and fewer harms than can the latter. The offensive or proactive approach consists of two parts: The first part is to preemptively establish a barrier between a novel virus and humans in order to prevent the spillover of the virus into (...) humans, and the second part is that, when a spillover fails to be prevented, we should take public interventions, such as contact tracing, social distancing, and quarantine and isolation, as early as when there are several dozens or one hundred or more cases that manifest symptoms with an unknown etiology in order to prevent an epidemic that is still limited to relatively small groups from developing into an outbreak. (shrink)

While the global threat of Ebola Virus Disease in 2014 was concentrated in several West African countries, its effects have been felt in many developed countries including the United States. Initial, select patients with EVD, largely among American health care workers volunteering in affected regions, were subsequently transported back to the states for isolation and treatment in high-level medical facilities. This included Emory University Hospital, which sits adjacent to the federal Centers for Disease Control and Prevention in Atlanta, Georgia.The (...) first domestic case of EVD occurred in late September in Dallas, Texas. Additional exposures of two HCWs generated an array of legal issues for state and local public health authorities, hospitals, and providers. Consideration of these issues led to extensive discussion among lawyers, public health practitioners, and other attendees at a late-breaking session on EVD and Legal Preparedness at the 2014 National Public Health Law conference. In this commentary, session presenters from CDC and Emory University share their expert perspectives on legal and policy issues underlying state and local powers to quarantine and isolate persons exposed to or infected with Ebola, as well as facets of hospital preparedness underlying the successful treatment of patients with EVD. (shrink)

Objective:This study explored the psychological and academic effects of studying online from the home vis-à-vis host country during the coronavirus disease 2019 (COVID-19) pandemic in the experience of international students at the University of Warsaw, Poland.Methods:A total of 357 international students from 62 countries (236 in the host country and 121 in the home country) completed an online questionnaire survey 2 months after transition to online learning. We studied students' levels of loneliness, life and academic satisfaction, acculturative stress, academic adjustment, (...) performance, loyalty, and perceptions of the online learning experience.Results:The country-of-residence variable had no statistically significant effects on most psychological and academic variables. Significant effects were observed only for two academic variables. Specifically, students who returned to the home country found online communication with other students more contributing to their online learning experience and exhibited higher academic adjustment than students who remained in the host country. This suggests the positive influence of (peer and familial) support on online learning experience from the home country. Furthermore, a significant difference in experiencing acculturative stress occurred for students in quarantine/self-isolation in the host country, which expands prior literature on the disruptive effects of social distancing on students' mental health. Finally, this study confirmed the expected increased levels of loneliness among self-isolating students in both countries, hence extending prior results to the home- and host-country contexts. No relationship between self-isolation and students' life or academic satisfaction was found, which is explained by the specific nature of the learning-from-home experience. (shrink)

There is a fine balance between civil liberties and protection of the public’s health.Legislators, especially those in the western United States, are concerned about selling the Model State Act because of the loss of civil liberties. State constitutions give governors broad powers, such as declaring martial law and giving public health leaders the authority to act. State laws should consider issues such as property rights; taking of businesses and supplies; quarantine and isolation; due process; coordination among states, counties (...) and cities; communication systems; conscription of doctors and nurses; and compensation. When two mock emergency response drills were held in New Mexico, concerns arose regarding opening records associated with dams, national laboratories, waste repositories, and three air force bases. (shrink)

There is a fine balance between civil liberties and protection of the public’s health.Legislators, especially those in the western United States, are concerned about selling the Model State Act because of the loss of civil liberties. State constitutions give governors broad powers, such as declaring martial law and giving public health leaders the authority to act. State laws should consider issues such as property rights; taking of businesses and supplies; quarantine and isolation; due process; coordination among states, counties (...) and cities; communication systems; conscription of doctors and nurses; and compensation. When two mock emergency response drills were held in New Mexico, concerns arose regarding opening records associated with dams, national laboratories, waste repositories, and three air force bases. (shrink)

In the recent literature a number of free will skeptics, skeptics who believe that punishment is justified only if deserved, have argued for these two points: first, that the free will realist who would justify punishment has the burden of establishing to a high level of certainty - perhaps beyond a reasonable doubt, but certainly at least by clear and convincing evidence - that any person to be punished acted freely in breaking the law; and, second, that that level of (...) evidence is simply not there. In this paper I make two parallel points against a quarantine theory of criminal justice. First, the free will skeptic who would justify universal criminal quarantine is also faced with a burden of proof, the burden to establish to a similarly high level that no human being ever acts freely. Second, there is not sufficient evidence for that conclusion either. I believe that the quandary that this creates for criminal justice can be resolved by distinguishing the methods associated with a particular approach from the approach itself: if our choice is between the methods of punishment and the methods of quarantine, the methods that constitute punishment are, I would argue, morally preferable to those that constitute quarantine. (shrink)

Since the outbreak of COVID-19, reaction quarantine, social distancing, and economic crises have posed a greater risk to physical and psychological health. Such derogatory mental health stigma is associated with adverse outcomes in the student population. The purpose of the current study is to provide a timely evaluation of the COVID-19 pandemic and its adverse effects on students’ psychological well-being to sustain economic sustainability. A thorough review of the literature and current studies, significant emphasis of socio-demographic indicators, interpretation of (...) physical symptoms, home quarantine activities, and COVID-19 unique stressors were extracted. Data were collected through electronic surveys from 640 university students at local and foreign universities. The findings revealed substantial adverse effects resulting in varying levels of stress, symptoms of depression, and specific discomfort in the case. Among COVID-19 stressors, financial instability, unpredictability toward future/career, and media exposure have been described as common factors that cause poor psychological well-being and weaken economic sustainability. COVID-19, quarantine, self-isolation, and onerous interventions primarily weaken university students’ mental health. The emphasis on this vulnerable category, however, is substantially absent from the literature. This research addresses the urgent need to develop possible solutions and preventive measures to promote economic sustainability by ensuring students’ psychological well-being. (shrink)

Medical quarantines often threaten the civil rights of the persons whom they confine. This might happen in two ways. First, quarantines might inflict harsh conditions on their occupants; and, second, quarantines might be imposed in an arbitrary or indeed discriminatory manner. These concerns, moreover, are anything but fantastic. Infectious diseases, particularly in epidemic forms, commonly trigger retributive and discriminatory instincts, so that actual quarantines often impose inhumane, stigmatizing, or even penal treatment upon persons who are confined based on caprice or (...) even prejudice.But quarantines that impose no gratuitous hardships and that are applied pursuant to orderly and non-discriminatory procedures are theoretically possible and also practically available. And such well-run quarantines, especially when they are employed to combat epidemic diseases, cannot plausibly be said to violate the civil rights of the quarantined. Even the staunchest civil libertarian must accept that one person's liberty may be restricted when this is necessary for preventing harm to another. (shrink)

Background: The purpose of the current study was to assess the prevalence of sleep disturbances among Chinese people during the COVID-19 pandemic in a large national survey, analyze the relationship between sleep disturbances and mental health status, and explore the influencing factors of the relationship between sleep disturbances and mental health status.Methods: An online survey was accessed by 19,740 people throughout China from February 14 to 21, 2020. The survey included the Depression Anxiety Stress Scale-21 to measure psychological distress and (...) two questions about sleep disturbances. Logistic regression analyses and moderation analysis were performed.Results: Among the 14,505 respondents included in analyses, 3,783 reported sleep disturbances at least 3 days during the past week. Sleep disturbances increased the risk of depression, anxiety, and stress. Gender, age, education, occupation, frequency of attending to epidemic information, nervousness about supplies, receiving provisions of living necessities from the service department during the outbreak, number of correct responses to questions about the epidemic, and isolation/quarantine affected the risk of mental health problems among participants experiencing sleep disturbances. A moderation analysis found that sleep problems were more likely to affect depression, anxiety, and stress scores in men than women during the COVID-19 outbreak.Conclusion: During the COVID-19 outbreak, 26.08% people surveyed experienced sleep disturbances, and the presence of sleep disturbances was positively related to depression, anxiety, and stress, especially among front-line anti-epidemic workers, younger people, people living in isolation/quarantine, people with a college or greater education, and males. (shrink)

Objective: This main aim of the study is to explore COVID-19 pandemic problems from the perspective of public health-clinical care ethics through online mediareports in Turkey. Method: This research was designed as a descriptive and qualitative study that assesses COVID-19 through online media reports on critics between the periods of March 11, 2020 and April 2 2020 as a quantitative as number of reports and qualitative study, across Turkey. Reports were from Turkish Medical Association websites which included newspaper reports. Study (...) data were presented as statistically and qualitative data case and headlines. No ethical or ofTicial permission was sought as the study was conducted through open access internet news sites. Results: This online reports analysis retrieved about 6723 articles about the COVID-19. According to study data, information about COVID-19 were themed as follows: general deTiciencies in taking action and isolation, lack of isolation, passengers and transport vehicles not quarantined ; insufTicient diagnostic tests, decision to test after healthcare professionals become infected, lack of equipment, lack of evaluation outbreak countries [Table 2]. Conclusion and Suggestions: COVID-19 is a pandemic and is a global public health problem that concerns every individual and needs to be handled carefully. This requires a multi-faceted preparation and education. In this context, healthcare professionals should be well trained in this aspect and have all the necessary equipment throughout the process. Additionally, it should work systematically with the cooperation of all health organizations, the Ministry of Health, local governments and of course the media, in order to inform society, fairly distribute the resources and to implement the safety measures effectively. BrieTly, lack of transparency, insufTicient information, limited resources, lack of public health protection measures such as partial quarantine decision, partial implementation of the scientiTic board's re c ommenda ti on s fo r e c on omi c rea s on s, and contradiction of the explanations are revealed as serious ethical problems. (shrink)

Judged by the key measures of morbidity and mortality, the United States has been very fortunate in the Ebola outbreak so far. We have had a limited number of cases and only a few fatalities. As of this writing, all of the health care workers who became infected in the United States have recovered, and none of the other nonhealth care contacts of Ebola patients has become infected. Yet by almost any other measure, the response to Ebola in the United (...) States has been a disaster. Among other things, there has been a wealth of misinformation, politicization of public health, public panic, and unnecessary quarantine. There is plenty of blame to go around. But one often overlooked factor that complicated the response to Ebola is American public health law. (shrink)

Medical quarantines often threaten the civil rights of the persons whom they confine. This might happen in two ways. First, quarantines might inflict harsh conditions on their occupants; and, second, quarantines might be imposed in an arbitrary or indeed discriminatory manner. These concerns, moreover, are anything but fantastic. Infectious diseases, particularly in epidemic forms, commonly trigger retributive and discriminatory instincts, so that actual quarantines often impose inhumane, stigmatizing, or even penal treatment upon persons who are confined based on caprice or (...) even prejudice.But quarantines that impose no gratuitous hardships and that are applied pursuant to orderly and non-discriminatory procedures are theoretically possible and also practically available. And such well-run quarantines, especially when they are employed to combat epidemic diseases, cannot plausibly be said to violate the civil rights of the quarantined. Even the staunchest civil libertarian must accept that one person's liberty may be restricted when this is necessary for preventing harm to another. (shrink)

The declaration of the COVID-19 pandemic by the World Health Organization on March 11, 2020, led to unprecedented events. All regions of the world participated in implementing preventive health measures such as physical distancing, travel restrictions, self-isolation, quarantines, and facility closures. The pandemic started global disruption of socio-economic systems, covering the postponement or cancellation of public events, supply shortages, schools and universities’ closure, evacuation of foreign citizens, a rise in unemployment and inflation, misinformation, the anti-vaccine movement, and incidents of (...) discrimination toward people affected by or suspected of having coronavirus disease. Attempts have been made to protect the oldest age group at risk, but in many cases, this has led to over-restriction and age discrimination. The rationale for working on the Research Topic "Socio-economic systems in the post-pandemic world: Design thinking, strategic planning, management, and public policy" was the need to start reflecting on resilience and lessons learned from this public health event that revealed the global unpreparedness in critical areas. Also, the pandemic triggered both top-down and bottom-up responses that needed more in-depth analyzes. This Research Topic covers interdisciplinary contributions addressing new thinking, challenges, and transformations required for post-pandemic global, national, regional, and local realities. The presented Research Topic combines studies focused on recognizing the actions and interventions leading to the recovery of socio-economic systems during the tail end and after the pandemic. The studies delivered recommendations regarding, among others, the care of vulnerable, planning socio-economic restart, and imagining the "new normal.". (shrink)

On 11 March 2020, the World Health Organization declared a pandemic of the COVID-19 coronavirus disease that was first recognized in China in late 2019. Among the primary effects caused by the pandemic, there was the dissemination of health preventive measures such as physical distancing, travel restrictions, self-isolation, quarantines, and facility closures. This includes the global disruption of socio-economic systems including the postponement or cancellation of various public events (e.g., sporting, cultural, or religious), supply shortages and fears of the (...) same, schools and universities closure, evacuation of foreign citizens, a rise of unemployment, changes in the international aid schemes, misinformation, and incidents of discrimination toward people affected by or suspected of having the COVID-19 disease. The pandemic has brought to the fore unpreparedness in critical areas that require attention, amid prospects and challenges. Moreover, considerable reorganization efforts are required with implications for assets, resources, norms, and value systems. COVID-19 is challenging the concept of globalization and stimulating responses at the levels of local and regional socio-economic systems that lead to the mobilization of assets that have been unrecognized earlier on, such as various forms of economic capital, social capital, cultural capital, human capital, and creative capital. For example, through digital channels, local groups are forming to create schemes of support for physical and mental wellbeing. These emerging exchanges lead to various social and technological innovations by building on skills and assets that are less important in the free-market economy, such as empathy, skills for crafts, making and fixing; locally grown microgreens; and micromanufacturing. Isolation and local living are also making it much harder to ignore the civic responsibilities towards communities, meant as individuals, vulnerable groups, and local businesses. Whilst the pandemic is limiting physical participation, this challenging time is uncovering alternative ways of mutual support, which may create long-term benefits for socio-economic systems, including environmental and biodiversity protection, reduction of the air pollution, and climate action. The pandemic’s threat to public health will hopefully be overcome with implications for disruption for an extended period that we are unable to forecast at this stage. It is key to focus on studies recognizing the activities and interventions leading to the recovery of socio-economic systems after the pandemic. Reflecting and planning on how societies and economies will go back to “business as usual” requires new forms of communication and cooperation, imaginative design thinking, new styles of management, as well as new tools and forms of participation in various public policies. Many questions related to the care of the vulnerable, economic restart, and the risk of future pandemics, to mention but a few, are already occupying the academic, scientific, experts, and activist communities, who have started to imagine the “new normal.”. (shrink)

Through a rhetorical analysis of fragments of language used by United States public health experts, victims, and advocates during the early periods of polio, HIV and COVID-19, this project shows how constitutive rhetoric within infectious disease discourse articulates the subject position of potential victim for different publics. The author finds that the analyzed discourse simultaneously calls forth a negative identity that asks people to not become something and also asks for actions to prevent disease spread – and, in doing so, (...) the awakening of potential victim reveals hegemonic assumptions about whose bodies are valued and whose are not. (shrink)

By reconsidering the theme of isolation in the philosophy of technology, and by drawing upon recent developments in social ontology, Lawson provides an account of technology that will be of interest and value to those working in a variety of different fields. Technology and Isolation includes chapters on the philosophy, history, sociology and economics of technology, and contributes to such diverse topics as the historical emergence of the term 'technology', the sociality of technology, the role of technology in (...) social acceleration, the relationship between Marx and Heidegger, and the relationship between technology and those with autism. The central contribution of the book is to provide a new ontology of technology. In so doing, Lawson argues that much of the distinct character of technology can be explained or understood in terms of the dynamic that emerges from technology's peculiar constitutional mix of isolatable and non-isolatable components. (shrink)

This fictionalized script traces the contours of the conversation that seeks to fathom the crisis unleashed by the outbreak and global spread of the coronavirus and the ensuing anxieties created in our current social living. The scenario of deepened isolation of the self from the other is considered, and it is proposed that isolation, while an unavoidable requirement, does not mean it is some mental lassitude but rather may be seen as an enthusiastic concern toward recovering physical and (...) mental wellbeing of the larger communities concerned to control the possible avenues of transmission of the contagion. The conversation meanders around the issue of quarantine, its attraction or otherwise, and who benefits from this restriction, its effects on one’s mental constitution, etc. Philosophers have been known to isolate themselves in other contexts and situations give us a taste of what is to come in the dialogue to resist the calamity of the coronavirus and its grim effects that engulf the entire humanity. (shrink)

This issue’s “Legal Briefing” column covers recent legal developments involving coerced treatment and involuntary confinement for contagious disease. Recent high profile court cases involving measles, tuberculosis, human immunodeficiency virus, and especially Ebola, have thrust this topic back into the bioethics and public spotlights. This has reignited debates over how best to balance individual liberty and public health. For example, the Presidential Commission for the Study of Bioethical Issues has officially requested public comments, held open hearings, and published a 90-page report (...) on “ethical considerations and implications” raised by “U.S. public policies that restrict association or movement (such as quarantine).” Broadly related articles have been published in previous issues of JCE. We categorize recent legal developments on coerced treatment and involuntary confinement into the following six categories: 1. Most Public Health Confinement Is Voluntary 2. Legal Requirements for Involuntary Confinement 3. New State Laws Authorizing Involuntary Confinement 4. Quarantine Must Be as Least Restrictive as Necessary 5. Isolation Is Justified Only as a Last Resort 6. Coerced Treatment after Persistent Noncompliance. (shrink)