TB Andy has made
quite a splash in the news this week by flying to
Europe, flying around Europe, flying to Canada, and then crossing the border back
into the U.S. - all while he had a very drug resistant form of tuberculosis (TB).
He has been condemned for exposing several other people to the
disease, but he has responded by arguing that his doctors told him it was
safe for him to travel (the CDC denies this). Unfortunately, the focus on
whether Andy is or isn't to blame for his actions misses the more important
point - that neither the U.S. nor the international health system is set up to
respond to and contain a pandemic.
CDC officials knew about TB Andy's
condition before his trip, yet they did not place him on the no-fly list, nor did they
detain him for treatment. In fact, if Andy has told the truth, they may
have even ok'd his trip.
After Andy arrived in Rome, the CDC
tracked him down, but instead of immediately informing their Italian
counterparts of his condition, they waited to do so until he was already on a
flight to Prague. Furthermore, the Italians have admitted that even if
they had known of Andy's condition, they would have only offered him treatment -
to detain him would have been a violation of his rights under Italian
law.
Then, Andy was able to fly back to Canada - despite the CDC having finally taken the step
of putting Andy on the U.S. No Fly List. Once in Canada, Andy casually
drove past unalarmed border officials, and back into the U.S.
Now, we got lucky with Andy - he has
a bad form of TB, but he's not particularly symptomatic, and he probably wasn't very contagious.
That said, we may someday have to deal with a disease carrier that
carries a truly scary bug. The Bird Flu could take down millions. Certain forms
of Ebola have a better than 90% mortality rate. The Black Death
killed over 1/3 the population of Europe. If someone carrying a
newly mutated contagious disease acts like TB Andy, our current disease response
system will fail to prevent them from spreading their infection worldwide.
Western
society has recently proven willing to sacrifice important freedoms and
protections in order to protect itself from terrorism. Yet, when it comes
to detaining people with dangerous diseases, we have shown a strange reluctance
to infringe upon individual rights - even when that individual has shown a
reckless disregard for the safety of his fellow man.
There is a man named Robert Daniels who has spent 8 months
locked in a hospital room because he has a particularly virulent strain of
TB. He was detained after he exposed several other people to the disease
by failing to take his medication and by
refusing to wear a mask in public. Yet, instead of condemning him for
behavior that was at best reckless, and at worst criminally negligent, many commentators
have expressed concern for him - and some of them argue that his constitutional rights
are being violated and that he should be freed. Similar concerns are
now being raised with regard to TB Andy (who is
also now detained). Likewise, there is still significant opposition to jailing HIV positive
individuals who have unprotected sex with uninfected people - even when the HIV
positive individual fails to inform their partner of their HIV status.
We
need to re-think our approach to dealing with dangerous diseases.
A naturally occurring pandemic could kill hundreds of thousands or millions of people
in the U.S. alone - the only terrorist attack that could equal it would be
an attack with biological weaponry (i.e. the man-made equivalent of
a natural pandemic). In either case, health authorities would
be completely justified in detaining as many people as necessary to control the
spread of the disease (until, of course, scientists discovered a vaccine or
cure). In a worst case scenario, it might even be necessary to declare martial
law and invoke a shoot-on-sight order to keep people in their homes and to prevent the
disease from spreading.
In order to prevent conditions from preceding to
this point, however, we need to be prepared whenever possible to stop the spread
of dangerous diseases while there are only a few infected individuals.
Anyone with a particularly contagious lethal disease should be detained for
treatment immediately - and not released until they are incapable of spreading
the disease to others. Those with rare, but normally non-lethal or
non-contagious diseases should be evaluated based on the risk of their disease
mutating into a more dangerous form. If this seems likely to be a
possibility, then they should be given the chance to take appropriate steps to
prevent the spread of their disease (i.e. by wearing face masks and following a
treatment plan). If they fail to follow these steps, however, then they
should also be detained until they are incapable of spreading the disease.
In order to improve our chances of quickly identifying new
diseases and preventing their spread, we ought to consider instituting a system of
mandatory health check ups and inoculations. This could be part of the
universal health care system the U.S. is likely to institute in the next 5 to 20
years.
We have proven our willingness to sacrifice freedom in the fight
against terrorism (in fact, we've almost certainly gone overboard in doing so). We
must now face up to the facts that we're overdue for a natural
pandemic and that today's subway bombings pale in comparison to tomorrow's bio-terrorism. We have to
be prepared to limit the spread of contagious lethal
diseases.
Seed Newsvine