Page - 436 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE436 In the context of COVID-19, orders are currently in place under public health and emergency legislation to close certain public spaces, require physical distancing, and enforce self-isolation in the case of known or suspected infections.3 The most frequent penalties employed so far have been monetary fines,4 although court orders, police involvement, enforced isolation, and detention are also pos- sible in more serious cases.5 Although the health risk to the majority of infected non-elderly individuals, particularly those in good health, may be relatively low, the needs to safeguard the community and to maintain a functioning health care system have been judged to be important objectives that justify restriction on the civil liberties of the whole community. One of the challenges that has emerged is the proper response in the case of people whose behaviour suggests that their failure to comply with public health orders is because of mental illness. Some of the ways this question arises are illustrated by the following scenarios: • A person known by the staff of a homeless shelter to have a chronic psychotic disorder is refusing to follow hygiene and distancing directives. The person is barred from the shelter to protect other residents and staff. • A person who is known to have a serious mental illness is showing signs of infection. The person denies their evident symptoms and refuses mental health treatment, as well as testing and self-isolation. • A person with depression and a serious substance use disor- der is awaiting test results for suspected infection but does not self-isolate. 3. Emergency  Management  and  Civil  Protection  Act, RSO 1990, c E.9; Organized  Public  Events,  Certain  Gatherings, O Reg 52/20; Closure of Outdoor Recreational Amenities, O Reg 104/20. 4. Josh Pringle “43 tickets issued to people in closed Ottawa parks, non-essen- tial businesses over the weekend”, CTV News (6 April 2020), online: <ottawa. ctvnews.ca/43-tickets-issued-to-people-in-closed-ottawa-parks-non-essential- businesses-over-the-weekend-1.4884703>. 5. Holly Mckenzie-Sutter “Mounties could enter homes to enforce Quarantine Act orders if Canadians don’t self-isolate”, Globe  and  Mail  (10 April 2020), online: <www. theglobeandmail.com/canada/article-rcmp-warns-it-will-enforce-the-quaran- tine-act-if-canadians-dont-self/>; Isaac Olson, “Québec City police arrest COVID- 19 patient for defying quarantine”, CBC News (20 March 2020), online: <www. cbc.ca/news/canada/montreal/quebec-city-police-arrest-covid-19-1.5505349>.