In the spring of 2003, the Singapore government placed thousands of people under house arrest. Residents were required to regularly appear in front of webcams installed in their homes. If they did not, they had to wear an electronic bracelet that would monitor their movements. Failure to comply was punishable with a prison sentence. What had these people done? Some had coughed and sneezed. Others had been close to someone else with pneumonia-like symptoms. They were forcibly quarantined in order to stop the spread of a mysterious new respiratory disease called SARS.

Many credited these measures for the fact that SARS, Severe Acute Respiratory Syndrome, killed less than 800 people worldwide that spring. Quarantines may help slow the spread of a disease, but forcible ones may backfire. If people fear that they or their families may be sequestered with sick patients, many will not come forward even if they develop symptoms. Likewise, doctors and nurses may be discouraged from treating the ill if they suspect that their civil rights will not be protected. When the sick are driven into hiding, diseases spread.

While SARS has faded from headlines, the world is worried about Avian Influenza, or “bird flu” as it is commonly known. If the bird flu virus develops the ability to jump directly from person to person, it could cause a cataclysmic health emergency worldwide. If so, it would join many other infectious diseases such as HIV/AIDS, smallpox, influenza, tuberculosis, malaria, plague, measles, and cholera that first affected animals and then evolved into a devastating human disease.

Bird flu outbreaks are most worrisome in rural areas, but effective containment measures are often impeded by poverty. Poultry farmers in Vietnam and Indonesia are advised to wear plastic gloves when handling flocks, but many cannot afford to buy them. Chickens often live in close quarters with families, giving a virus more chances to spread to people. Infected flocks are usually destroyed, but farmers are not always reimbursed for their loss, making many unwilling to report anything suspicious.

Containment measures pose ethical dilemmas: Is it all right to sacrifice the well-being of some in order to preserve the health of many? Even if some may argue “yes,” harsh measures can produce the opposite effect. Combating diseases successfully within a large population is not merely a medical undertaking, but must also cater to people’s instinct for self-preservation.

Author: Heather Clydesdale