Dr John Simon, the British Government’s Chief Medical Officer from 1855–1876, described quarantine as "a mere irrational derangement of commerce". Global unwillingness to respond to coronavirus with swift restrictions on movement and trade shows a more 'rational' derangement is still preferred by free-market economies: preserve free trade, even at the expense of public health.
The result – as it ever was – is a policy of public 'ill-health' which increases the risk of a pandemic and fosters racism, while protecting the free market above human subjects. Although coronavirus appears to lack the 'virility' of a true pandemic, liberal economics facilitates viruses going global, as pathogens flow across borders like commerce.
Eyam, in the Peak District, is a creepy village with a claim to fame: a quarantine that stopped the bubonic plague’s spread in Northern England. Morbid tourists bring their children to Eyam to hear residents dressed as plague doctors describe the villagers’ historic sacrifice. When the plague arrived in the Devil’s year – 1666 – Eyam’s residents committed to quarantining themselves inside the village’s walls until the plague passed to prevent the disease spreading.
The villagers’ action was “remarkably effective” at stopping an epidemic in Northern England, Dr. Michael Sweet, wildlife disease specialist at the University of Derby, told the BBC. Eyam's sacrifice had a high human cost. Direst estimates suggest 260 of Eyam’s 350 residents died during the quarantine; one woman lost 6 children and her husband. Today, the tragedy has lost its sting; Eyam’s residents are evidently, giddily, obsessed with the plague. Plastic rats menace jars of pickled eggs in Eyam’s pubs and spearmints on shop counters. During Eyam’s Plague Commemoration, the town’s children dress up as little rats; the adults as Plague victims. Will Wuhan’s children dress up as little bats on Coronavirus Commemoration Day, in 500 years? It’s hard to imagine, not only because heroism appears to be in short supply (medics, excepted). American Expats in Wuhan, like Flora – herself ‘going viral’ – lost their minds online (“They’ll kill all of us before they let it spread more in China”!) and only one British citizen (perhaps from Eyam) turned down a charter flight back to the U.K., afraid of spreading the disease. Expat passengers leaving on charter flights to Western countries are tested for fever before boarding, and because Coronavirus is asymptotic for 14 days, they are to be held in quarantine after landing.
Perhaps when they leave quarantine, they’ll sue their local government, as Kaci Hickox did in 2015. When Hickox returned from Ebola-stricken Sierra Leone, where she’d worked as a volunteer nurse, she was first detained in New Jersey, and then in her home state of Maine. Ebola takes up to 3 weeks to develop after exposure; Hickox tested negative for the disease while detained in New Jersey. According to her lawyer, Hickox was willing to be quarantined ‘if she had any symptoms’, but as she didn’t, she was not. Hickox first sued the state of Maine to revoke her strict 3-week home confinement. Her order was then modified, with some restrictions on movement still applied. Then, she sued New Jersey’s Christie Administration for $250,000 in compensatory and punitive damages, with the support of the American Civil Liberties Union. Hickox reached an agreement with the State of New Jersey, which the ACLU described as ‘A Bill of Rights’ for those quarantined. In the end, there was no financial settlement.
In my mind, suing the state for detention under quarantine measures, which intend to prevent an outbreak of infectious disease (even though the disease is, in all likelihood, woefully misunderstood by the civil servants writing the legislation), grossly over-esteems the rights of the individual above the rights of the body populace. Cases like Hickox’s suggest how compelling the concept that liberty must be preserved at all costs remains in the American imaginary – even when it’s thanatotic. The infectious logic that dictates liberty is worth pursuing, no matter what the price, has seen 1,219 more measles cases recorded in 2019 than 2010, with the rise of vaccine denialism. American Expats repatriated from Wuhan were ‘voluntarily’ quarantined for 3 days (perhaps a condition of boarding the charter flight) – despite the virus’ known 14 day incubation period – and I wonder if the Hickox case, and others like it, influenced the State of California’s approach. Individual liberty and economic liberalism have always been historic bedfellows and why they are typically remains unarticulated in the liberal economist’s dark heart: “Because masters must keep the freedom to impose their will on the undetermined, ignoble mass for individual benefit – that’s why.” Individual liberty is consistently framed as analogous to the liberty of the market; when one goes, so does the other. Even so, the flows of capital that propel the modern financial market move across borders with greater ease across than an individual third-world subject, and no pragmatic liberal denies it. Individual liberty remains, as it ever was, an illusion to personalise the inhuman forces of the financial market, which benefit a precious few ‘masters’.
The extent to which someone is ‘free’ not to suffer illness or disease often depends on the public health policy of their nation. Basic public health policies account for water processing and waste disposable facilities, which minimise the chance disease will spread. At their most sophisticated, public health policies provide free universal healthcare for citizens. Who protects public health and how they do it – whether a private business, a NGO or a government – often depends on the ideological position of the governing body (or occupying force) in a locale, as opposed to the actual material wealth or wealth-producing resources in that area.
However, public health policies are only successfully implemented by individual nations if the global market and the forces which protect them (the World Bank, the International Monetary Fund, the World Trade Organisation, the European Commission etc.) deem them to cohere with the demands of the market. The illusion that liberal democracy is truly democratic was firmly shattered in 2015, when 61% of Greek voters voted against the continued implementation of austerity, only to have it imposed anyway. Austerity increases mortality rates in pensioners, as social care and social spending are reduced, and widens pre-existing inequalities in health (i.e. susceptibility to disease, mortality rates, etc.) between people of different economic backgrounds. The European Commission determined the Greek people can't decide what’s best for themselves, and that the Greek government must impose stricter austerity measures than those which had existed before. Austerity was implemented in Greece, to the enrichment of the private sector; and at the expense of public health.
Americans are better positioned than most to understand how public health policy intersects with liberal economics. The mundane evil of a health system that places the financial burden of health on individuals makes itself visceral in sums like $12,000 to treat an allergic reaction or $32,000 to give birth in a safe environment. For Britons, the National Health Service mercifully does its bit to conceal the impact liberal economics has on public health, until a loved one dies because of hospital staff shortages or they become ill because of the hazardous conditions in rental accommodation. However, even the keenest political observers of the intersection between public health and economic policy have been blindsided by the ways in which liberal economics has facilitated the spread of coronavirus. Now that human to human transmission has occurred in Germany, Taiwan, Vietnam, the United States, and France, mankind is staring down the barrel of a pandemic, not a localised epidemic.
So far, I’ve failed to find a left-wing argument that earlier restrictions on travel and trade might have halted a pandemic, and the far-right have filled the void with their typical bile. Quarantines (when they are respected), are an effective method of ‘social distancing’ which protects the general population from infected individuals and can stop entirely the spread of disease. Although China has now implemented the largest quarantine in human history, it is perhaps too late to be truly effective. The first case of coronavirus outside China occurred in Thailand on January 13th; Hubei province (coronavirus’ ‘ground zero’) was not placed under quarantine until January 20th.
As of the 1st February, 101 (out of 132) global cases of coronavirus had travelled to China in the 14 days before becoming ill; of those, 81 had been in Hubei province. If a quarantine had been implemented earlier, perhaps even as late as the 13th January, the date of the first detected case outside of China, it’s highly likely there would not be so many cases outside of the country as there is now. As it was, the quarantine was implemented when the virus was already an epidemic. Quarantines are basically a futile exercise once an epidemic is declared, as those have already escape generate the equivalent amount of new infections as instances where no quarantine has been imposed. When liberal economists insist quarantines and travel bans are ineffective, this is usually why. ‘Too little, too late’ is a very real danger when faced with an epidemic wanting to go global. However, countries far from the locus of an epidemic still have time to implement restrictions that stop a disease becoming a pandemic, and protect their population’s health in the process. Yet, liberal economic governing bodies, like the European Union, will assure financial presses that there’s “no need for blanket travel restrictions” while admitting there remains a “moderate” likelihood of case importation. In short, liberal governments are often unwilling to implement effective control measures until the disease is already on the doorstep.
Why China took so long to implement quarantine procedures and why restrictions on travel were first implemented by private businesses instead of governments is simple: governments are required to protect the economy, even to the extent of endangering human subjects. Article 5 of the World Trade Organisation’s Application of Sanitary and Phytosanitary Measures (known as the SPS Agreement) discourages governments from implicating precautionary trade restrictions or travel restrictions during epidemics. Governments of WTO Member states (164 nations, worldwide) are encouraged to consider the economic cost of lost production/sales in event of a disease’s entry, and the general cost of the disease spreading, against ‘the cost-effectiveness of alternative approaches’ – other than restrictions on trade. Governments are obliged to consider how much it will cost if the disease is established against the effect that restrictions on trade will have on the financial markets. Even more worrisome, all governments are required to believe the validity of exporting Members’ claims that there are ‘disease-free’ areas and not impose restrictions based on that claim – regardless of the clear economic incentive which exists to claim this. The ‘cost’ the WTO is concerned with is never human cost, but the market value of the metallic cash which hurtles around the globe. All 164 WTO Members are obliged to honour the SPS agreement. The mouthpiece of financial power has determined trade and travel restrictions, which effectively halt pandemics when decisively implemented (which is, to halt over 90% of all travel from infected areas), are simply bad for business.
Beyond the physical public health implications, a policy of restricted movement might have decreased the racist responses to coronavirus which are currently spreading across the West, to the detriment of the social body. Exploiting ethnic divisions as a tactic to preserve free trade is all part of the capitalist playbook. 19th-century European colonial powers frequently rejected restrictions on trade as a valid approach to combat plagues, while framing non-Western victims as unsanitary. When the Ottoman Empire implemented a quarantine in 1838, the colonial powers of Britain and France were quick to profess on the international stage that sanitary measures that did not interfere with free trade were more effective than quarantines. The effect was to profess to European subjects that ‘this cannot happen here’; that Europeans are simply too clean and civilised for a plague – in contrast with the unclean, impoverished, Muslim Ottoman, who’s very being makes him susceptible.
The furore over ‘bat soup’ as coronavirus’ cause has similarly framed the Chinese victim of coronavirus as ‘barbaric’ and so, worthy of disease. When epidemics are framed as the province of ‘bat soup-eaters’ and ‘unsanitary Muslims’, the blame for a disease is rooted in an Occidental Other, while Western subjects are conditioned to believe their own ‘superior’ eating and hygiene practices will protect them; which they will not. The very young, the vulnerable and the old still die during pandemics. What will protect people from pandemics is restrictions on travel and trade, to the benefit of health globally. Restrictive measures could reframe non-Western subjects at the disease’s ‘ground zero’ as heroes, which might deflect some of the abhorrent racist profiling normalised across Europe during the coronavirus outbreak.
At the time of writing, the US and Australia have just closed their borders to foreign nationals who have recently visited China. Without concurrent restrictions on trade or a blanket ban, this policy should be seen as little more than political theatre to placate a fearful and racist public, rather than pragmatic public health policy. Small restrictions are as ineffective as no restrictions at all. For quarantines and embargoes to work, their application has to be total. When restrictions on movement are decisively implemented, they are the only effective method of stopping an epidemic from going global – to the benefit of everyone’s health, worldwide. Regardless, coronavirus may – mercifully – lack the ‘virility’ to become a true pandemic. The World Health Organisation are cautiously optimistic that there may be no asymptomatic infection, which stymies the disease’s ability to spread. Deaths seem to be restricted to the very vulnerable. The sky is not yet falling. When, or if, the sky does fall, when there's a new virus so foul that the reaper's rattling everyone's door, be grimly assured that it won't be stopped in a liberal economy. Pathogens will flow across borders like commerce, and people will suffer.