Page - 562 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

VULNERABLE562 Mandatory Quarantine Is a Less Restrictive Alternative For many countries, a reasonably available alternative to total border closures would be to temporarily quarantine all people entering a coun- try. This policy option compels all incoming travellers to isolate for the maximum incubation period of COVID-19 (for example, 14 days)14 so that potentially asymptomatic and pre-symptomatic cases can safely be identified without the risk of spreading the SARS-CoV-2 virus to oth- ers. This option builds on a proven intervention—quarantine15—and is non-discriminatory in terms of race, ethnicity, sex, gender, citizenship, residency, and other factors (although, of course, the downstream con- sequences of quarantine disproportionately affect people facing condi- tions of marginalization, including poverty, homelessness, disability, racism, and xenophobia). This means that temporarily quarantining all travellers coming into a country would likely meet the Article 43 condi- tions, in that this measure is supported by science, proportionate to the risks involved, and respectful of human rights. Would temporarily quarantining all incoming travellers for 14 days be equally as effective as completely closing the border? Probably, at least so long as quarantine measures were fully imple- mented and enforced. Indeed, previous studies highlight that the vast majority of citizens in democratic societies comply with pub- lic health orders when they make logical sense, when their value is properly explained, and when they have the means to safely do so.16 Governments can additionally promote compliance by requiring travellers to have credible quarantine plans, sequestering travellers without credible plans to government-run quarantine sites, randomly auditing compliance, zealously prosecuting violators, bringing public attention to prosecutions, and advertising steep punishments for vio- lating quarantine orders. Not every government has the bureaucratic capacity to imple- ment this more nuanced border measure. But most wealthier coun- tries should have the needed capacity, and all countries can attempt 14. Stephen A Lauer et al, “The Incubation Period of Coronavirus Disease 2019 (COVID-19) from Publicly Reported Confirmed Cases: Estimation and Application” (2020) 172:9 Annals of Internal Medicine 577. 15. Barbara Nussbaumer-Streit et al, “Quarantine Alone or in Combination With Other Public Health Measures to Control COVID-19: A Rapid Review” (2020) 4 Cochrane Database of Systematic Reviews. 16. R K Webster et al, “How to Improve Adherence with Quarantine: Rapid Review of the Evidence” (2020) 182 Public Health 163.