Recent epidemics of contagious infectious diseases have threatened our nation. In 2003, SARS was on our doorstep, then in 2009 the avian influenza pandemic, and after that, we had the MERS threat. Now a potential massive and deadly epidemic from COVID-19 looms before us.
This coronavirus reminds us that we are ill-prepared for massive epidemics, that our capacity to respond can be overwhelmed, and that social disruption indeed can occur.
Government must have the means to react quickly and decisively to contain a catastrophic disease outbreak—actions that might infringe on individual freedoms. These might include the isolation and quarantine of large numbers of people or even whole cities and states. As we now know all too well, social distancing through restriction or prohibition of gatherings and the closure of certain businesses, schools, sporting events and cultural institutions might be required.
With the advent of antibiotics and vaccinations, these public health measures became largely a thing of the past. But with the realities of deadly epidemic diseases without effective treatments or vaccines, renewed value is placed on these restrictions.
The importance of isolation and quarantine was demonstrated in the successful containment of the SARS epidemic. A perfect example of the value of social distancing also occurred in 1918. Philadelphia, not heeding the warnings of public health officials, held a parade in support of the World War I effort. Two-hundred-thousand people crowded together to watch. By the end of the week 4,500 people died. Concurrently, St. Louis instituted stringent social distancing measures and had only a fraction of that death count.
Under our American constitutional structure, the primary authority to control disease rests with local and state governments. Indiana law provides public health officials with broadly worded authority. It also confers wide-ranging and specific executive-order powers to the governor when declaring a public health emergency.
Gov. Eric Holcomb followed several other governors in issuing stay-at-home orders. The federal government, which also has jurisdiction to prevent the spread of disease, closed the Canadian and Mexican borders to non-essential travel and suspended travel from European and other selected countries.
The vast majority of individuals is willingly complying with these public health orders. However, there are those, mostly the young, who discount the seriousness of COVID-19. Others, even some legislators, have additionally criticized Holcomb’s executive orders on the basis of limitation of personal liberties.
These are ignorant and foolish positions.
While our individual freedoms are fundamental, they are not absolute and are always placed in the context of the common good. Supreme Court rulings have recognized the need to carefully balance the community’s right to be protected with the individual’s constitutionally protected freedoms. Coercive powers might be necessary, especially when the normal systems of civil governance might break down under the pressure of widespread death or illness.
A catastrophic coronavirus epidemic will test the limits of our freedom. But these social distancing measures are necessary and must be done as early as possible.•
Feldman is a family physician, author, lecturer and former Indiana State Department of Health commissioner for Gov. Frank O’Bannon. Send comments to [email protected]