The world is watching anxiously to see what happens with the coronavirus that originated in Wuhan, China. As scientists and public health officials in the United States learn more about the virus, and as we all see how bad the outbreak turns out to be, it is important that public policymaking remain firmly centered around science.
Unfortunately, our history of reactions to infectious disease outbreaks suggests that if this outbreak becomes severe, we’re likely to see strong pressure to the contrary. In particular, we can expect three things:
We can expect some to panic.
Unfortunately, there tends to be disproportionate hysteria and exaggerated fear around infectious diseases — especially when they are new. In 2009, the appearance of the H1N1 (aka “swine flu”) virus prompted some to call for measures like closing the U.S.-Mexico border, an enormously disruptive measure that, among other things, would have led to billions of dollars in lost economic activity. The H1N1 turned out to be a normal strain of the seasonal flu virus. In late 2014, many panicked over the Ebola outbreak ravaging West Africa, including a number of U.S. governors who imposed politically-motivated quarantines on health care workers and others returning from West Africa. Those quarantines were completely unjustified by science. (In 2015 the ACLU, the Yale School of Public Health, and Yale Law School released a major report analyzing the response to Ebola.)
Every disease is different and merits different public health responses. A person infected with Ebola, for example, is not contagious until after fever and other symptoms begin. That appears not to be the case with the coronavirus, and scientists’ recommendations will no doubt differ as a result. But no matter how bad any disease outbreak may get, responding in ways that are not supported by science is never the right thing to do.
We can expect pressure for counterproductive responses.
Most panicky responses to disease outbreaks, according to epidemiologists and other experts, only make things worse. In particular, law enforcement-type approaches to stopping the spread of communicable disease such as quarantine and forced treatment are, as three preeminent public health experts put it, “generally acknowledged by experts to be either completely ineffective or only potentially marginally effective” in slowing the spread of disease.
Public panic will predictably spark calls for “tough,” even draconian measures that treat the problem like a law enforcement or national security issue rather than a public health matter. We at the ACLU have always acknowledged that civil liberties must sometimes give way when it comes to fighting a communicable disease — but only in ways that are scientifically justified. And the public health community has learned over time that treating sick people like potential enemies only spurs them to “go underground” and avoid the authorities, which exacerbates the spread of disease. The evidence is clear that travel bans and quarantines are not the solution. Also counterproductive are the targeting and stigmatization of vulnerable populations, another historically frequent response to frightening epidemics.
We can expect that Trump will lead the panic, not calm it.
In previous disease scares, Donald Trump has been among the most panicky and scientifically ungrounded public voices in the United States. During the West African Ebola outbreak in 2014-15, he opposed allowing American doctors infected with the disease to be airlifted back to the United States for lifesaving treatment (tweeting, “KEEP THEM OUT OF HERE”). He also called for blocking all air traffic from West Africa.
As one expert advised in 2015, “Officials should avoid unrealistic reassurances or taking unnecessarily stringent measures so as to appear decisive.” Even in the earliest stages of the present outbreak, President Trump managed to violate the first half of that guidance, rashly and unrealistically telling the nation of the Wuhan virus, “We have it totally under control.” If things get worse, history suggests he’ll violate the second half as well and react with theatrical, counterproductive “toughness.”
The job of our political leaders is to solicit and follow the guidance of public health experts in crafting a calm and rational response to an outbreak, to help the public understand the scientific facts of this disease, and to present an honest and mature appraisal of risk and the limits of human power to curb nature. Unfortunately, Trump and his administration have a terrible record when it comes to listening to scientists.
We don’t know how bad this outbreak will be. If this one is not severe, another one probably will be in the future. And the more dangerous an actual outbreak, the more important it is that our authorities respond with cool heads and based on science, and not intrude any more than strictly necessary on people’s civil liberties.