COVID-19 and the ethics of quarantine: a lesson from the Eyam plague
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SCIENTIFIC CONTRIBUTION
COVID‑19 and the ethics of quarantine: a lesson from the Eyam plague Giovanni Spitale1
© The Author(s) 2020
Abstract The recent outbreak of the SARS-CoV-2 coronavirus is posing many different challenges to local communities, directly affected by the pandemic, and to the global community, trying to find how to respond to this threat in a larger scale. The history of the Eyam Plague, read in light of Ross Upshur’s Four Principles for the Justification of Public Health Intervention, and of the Siracusa Principles on the Limitation and Derogation Provisions in the International Covenant on Civil and Political Rights, could provide useful guidance in navigating the complex ethical issues that arise when quarantine measures need to be put in place. Keywords History of medicine · History of epidemiology · Eyam · Plague · SARS-CoV-2 · COVID-19 · Public health ethics
Introduction The recent outbreak of the SARS-CoV-2 coronavirus is not an exclusively medical issue. The history of medicine and contemporary reflection clearly teach how an epidemic may have deep and sometimes radical social implications (Cohn 2002). After all, it is sufficient to keep an eye on the news of the day to recognise the fact: in addition to information on the progress of the disease, on the efforts of the scientific community to find a cure, or on the conditions of cities under quarantine, since the beginning of the outbreak newspapers from all over the West reported unfriendly, suspicious and sometimes openly racist attitudes towards people of Asian origin (Hussain 2020; Iqbal 2020; Lindrea and Gillett 2020; Ling 2020). The Twitter hashtag #JeNeSuisPasUnVirus, "I am not a virus" has become—the pun is not intentional, but hard to avoid—viral, used by thousands of users around the world to raise the level of public attention on the upsurge of xenophobia, "justified" (quotes are a must) by the fear of contagion. As the outbreak progresses and hits new countries, accompanied by its toll of panic, the same irrational dynamics could easily regard people with different origins. * Giovanni Spitale [email protected] 1
Institute of Biomedical Ethics and History of Medicine, University of Zurich, Winterthurerstrasse 30, 8006 Zurich, Switzerland
After the initial phase of virus entry into a new country, other divisions emerged, in this case not based on ethnicity but between different social groups, accompanied by the same load of suspicion and distrust. In the USA face masks have been resemantized from personal protective equipment to political symbols and statements, visually marking the division between “smug liberals” and “reckless republicans” (Lizza and Lippman 2020; Vetterkind 2020). In Italy, during the hardest phase of the lockdown, categories allowed to leave their houses, like dog owners, have been heavily stigmatized by so-called “balcony watchdogs”, and multiple sources have reported dogs killed by poisoned bites (BresciaToday 2020; Berton 2020; La Gazzetta del Mezzogiorno 2020). It seems that, togethe
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