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Published in: BMC Public Health 1/2009

Open Access 01-12-2009 | Research article

Public perceptions of quarantine: community-based telephone survey following an infectious disease outbreak

Authors: C Shawn Tracy, Elizabeth Rea, Ross EG Upshur

Published in: BMC Public Health | Issue 1/2009

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Abstract

Background

The use of restrictive measures such as quarantine draws into sharp relief the dynamic interplay between the individual rights of the citizen on the one hand and the collective rights of the community on the other. Concerns regarding infectious disease outbreaks (SARS, pandemic influenza) have intensified the need to understand public perceptions of quarantine and other social distancing measures.

Methods

We conducted a telephone survey of the general population in the Greater Toronto Area in Ontario, Canada. Computer-assisted telephone interviewing (CATI) technology was used. A final sample of 500 individuals was achieved through standard random-digit dialing.

Results

Our data indicate strong public support for the use of quarantine when required and for serious legal sanctions against those who fail to comply. This support is contingent both on the implementation of legal safeguards to protect against inappropriate use and on the provision of psychosocial supports for those affected.

Conclusion

To engender strong public support for quarantine and other restrictive measures, government officials and public health policy-makers would do well to implement a comprehensive system of supports and safeguards, to educate and inform frontline public health workers, and to engage the public at large in an open dialogue on the ethical use of restrictive measures during infectious disease outbreaks.
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Literature
1.
go back to reference Mandavilli A: SARS epidemic unmasks age-old quarantine conundrum. Nat Med. 2003, 9: 487-10.1038/nm0503-487.CrossRefPubMed Mandavilli A: SARS epidemic unmasks age-old quarantine conundrum. Nat Med. 2003, 9: 487-10.1038/nm0503-487.CrossRefPubMed
2.
go back to reference Bayer R, Colgrove J: Public health vs. civil liberties. Science. 2002, 297: 1811-10.1126/science.1074274.CrossRefPubMed Bayer R, Colgrove J: Public health vs. civil liberties. Science. 2002, 297: 1811-10.1126/science.1074274.CrossRefPubMed
3.
go back to reference Bensimon CM, Upshur RE: Evidence and effectiveness in decision-making for quarantine. Am J Public Health. 2007, 97 (Suppl 1): S44-48. 10.2105/AJPH.2005.077305.CrossRefPubMedPubMedCentral Bensimon CM, Upshur RE: Evidence and effectiveness in decision-making for quarantine. Am J Public Health. 2007, 97 (Suppl 1): S44-48. 10.2105/AJPH.2005.077305.CrossRefPubMedPubMedCentral
4.
go back to reference Cetron M, Landwirth J: Public health and ethical considerations in planning for quarantine. Yale J Biol Med. 2005, 78: 329-334.PubMedPubMedCentral Cetron M, Landwirth J: Public health and ethical considerations in planning for quarantine. Yale J Biol Med. 2005, 78: 329-334.PubMedPubMedCentral
5.
go back to reference Gostin LO, Sapsin JW, Teret SP, Burris S, Mair JS, Hodge JG, Vernick JS: Balancing public health and civil liberties. Science. 2002, 298: 2129-10.1126/science.298.5601.2129c. author reply 2129CrossRefPubMed Gostin LO, Sapsin JW, Teret SP, Burris S, Mair JS, Hodge JG, Vernick JS: Balancing public health and civil liberties. Science. 2002, 298: 2129-10.1126/science.298.5601.2129c. author reply 2129CrossRefPubMed
6.
8.
go back to reference Markel H, Lipman H, Navarro J, Sloan A, Michalsen J, Stern A, Cetron M: Nonpharmaceutical interventions implemented by U.S. cities during the 1918-1919 influenza pandemic. JAMA. 2007, 298: 644-654. 10.1001/jama.298.6.644.CrossRefPubMed Markel H, Lipman H, Navarro J, Sloan A, Michalsen J, Stern A, Cetron M: Nonpharmaceutical interventions implemented by U.S. cities during the 1918-1919 influenza pandemic. JAMA. 2007, 298: 644-654. 10.1001/jama.298.6.644.CrossRefPubMed
9.
go back to reference Hatchett RJ, Mecher CE, Lipsitch M: Public health interventions and epidemic intensity during the 1918 influenza pandemic. Proc Natl Acad Sci USA. 2007, 104: 7582-7587. 10.1073/pnas.0610941104.CrossRefPubMedPubMedCentral Hatchett RJ, Mecher CE, Lipsitch M: Public health interventions and epidemic intensity during the 1918 influenza pandemic. Proc Natl Acad Sci USA. 2007, 104: 7582-7587. 10.1073/pnas.0610941104.CrossRefPubMedPubMedCentral
10.
go back to reference Pang X, Zhu Z, Xu F, Guo J, Gong X, Liu D, Liu Z, Chin DP, Feikin DR: Evaluation of control measures implemented in the severe acute respiratory syndrome outbreak in Beijing, 2003. JAMA. 2003, 290: 3215-3221. 10.1001/jama.290.24.3215.CrossRefPubMed Pang X, Zhu Z, Xu F, Guo J, Gong X, Liu D, Liu Z, Chin DP, Feikin DR: Evaluation of control measures implemented in the severe acute respiratory syndrome outbreak in Beijing, 2003. JAMA. 2003, 290: 3215-3221. 10.1001/jama.290.24.3215.CrossRefPubMed
11.
go back to reference Svoboda T, Henry B, Shulman L, Kennedy E, Rea E, Ng W, Wallington T, Yaffe B, Gournis E, Vicencio E, Basrur S, Glazier RH: Public health measures to control the spread of the severe acute respiratory syndrome during the outbreak in Toronto. N Engl J Med. 2004, 350: 2352-2361. 10.1056/NEJMoa032111.CrossRefPubMed Svoboda T, Henry B, Shulman L, Kennedy E, Rea E, Ng W, Wallington T, Yaffe B, Gournis E, Vicencio E, Basrur S, Glazier RH: Public health measures to control the spread of the severe acute respiratory syndrome during the outbreak in Toronto. N Engl J Med. 2004, 350: 2352-2361. 10.1056/NEJMoa032111.CrossRefPubMed
12.
go back to reference Day T, Park A, Madras N, Gumel A, Wu J: When is quarantine a useful control strategy for emerging infectious diseases?. Am J Epidemiol. 2006, 163: 479-485. 10.1093/aje/kwj056.CrossRefPubMed Day T, Park A, Madras N, Gumel A, Wu J: When is quarantine a useful control strategy for emerging infectious diseases?. Am J Epidemiol. 2006, 163: 479-485. 10.1093/aje/kwj056.CrossRefPubMed
13.
go back to reference Hsieh YH, King CC, Chen CW, Ho MS, Hsu SB, Wu YC: Impact of quarantine on the 2003 SARS outbreak: a retrospective modeling study. J Theor Biol. 2007, 244: 729-736. 10.1016/j.jtbi.2006.09.015.CrossRefPubMed Hsieh YH, King CC, Chen CW, Ho MS, Hsu SB, Wu YC: Impact of quarantine on the 2003 SARS outbreak: a retrospective modeling study. J Theor Biol. 2007, 244: 729-736. 10.1016/j.jtbi.2006.09.015.CrossRefPubMed
14.
go back to reference Cava MA, Fay KE, Beanlands HJ, McCay EA, Wignall R: Risk perception and compliance with quarantine during the SARS outbreak. J Nurs Scholarsh. 2005, 37: 343-347. 10.1111/j.1547-5069.2005.00059.x.CrossRefPubMed Cava MA, Fay KE, Beanlands HJ, McCay EA, Wignall R: Risk perception and compliance with quarantine during the SARS outbreak. J Nurs Scholarsh. 2005, 37: 343-347. 10.1111/j.1547-5069.2005.00059.x.CrossRefPubMed
15.
go back to reference Robertson E, Hershenfield K, Grace SL, Stewart DE: The psychosocial effects of being quarantined following exposure to SARS: a qualitative study of Toronto health care workers. Can J Psychiatry. 2004, 49: 403-407.PubMed Robertson E, Hershenfield K, Grace SL, Stewart DE: The psychosocial effects of being quarantined following exposure to SARS: a qualitative study of Toronto health care workers. Can J Psychiatry. 2004, 49: 403-407.PubMed
16.
go back to reference Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R: SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004, 10: 1206-1212.CrossRefPubMedPubMedCentral Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R: SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004, 10: 1206-1212.CrossRefPubMedPubMedCentral
17.
go back to reference Tansey CM, Louie M, Loeb M, Gold WL, Muller MP, de Jager J, Cameron JI, Tomlinson G, Mazzulli T, Walmsley SL, Rachlis AR, Mederski BD, Silverman M, Shainhouse Z, Ephtimios IE, Avendano M, Downey J, Styra R, Yamamura D, Gerson M, Stanbrook MB, Marras TK, Phillips EJ, Zamel N, Richardson SE, Slutsky AS, Herridge MS: One-year outcomes and health care utilization in survivors of severe acute respiratory syndrome. Arch Intern Med. 2007, 167: 1312-1320. 10.1001/archinte.167.12.1312.CrossRefPubMed Tansey CM, Louie M, Loeb M, Gold WL, Muller MP, de Jager J, Cameron JI, Tomlinson G, Mazzulli T, Walmsley SL, Rachlis AR, Mederski BD, Silverman M, Shainhouse Z, Ephtimios IE, Avendano M, Downey J, Styra R, Yamamura D, Gerson M, Stanbrook MB, Marras TK, Phillips EJ, Zamel N, Richardson SE, Slutsky AS, Herridge MS: One-year outcomes and health care utilization in survivors of severe acute respiratory syndrome. Arch Intern Med. 2007, 167: 1312-1320. 10.1001/archinte.167.12.1312.CrossRefPubMed
19.
go back to reference Gostin L: Public health strategies for pandemic influenza: ethics and the law. JAMA. 2006, 295: 1700-1704. 10.1001/jama.295.14.1700.CrossRefPubMed Gostin L: Public health strategies for pandemic influenza: ethics and the law. JAMA. 2006, 295: 1700-1704. 10.1001/jama.295.14.1700.CrossRefPubMed
20.
go back to reference Blendon RJ, Benson JM, DesRoches CM, Raleigh E, Taylor-Clark K: The public's response to severe acute respiratory syndrome in Toronto and the United States. Clin Infect Dis. 2004, 38: 925-931. 10.1086/382355.CrossRefPubMed Blendon RJ, Benson JM, DesRoches CM, Raleigh E, Taylor-Clark K: The public's response to severe acute respiratory syndrome in Toronto and the United States. Clin Infect Dis. 2004, 38: 925-931. 10.1086/382355.CrossRefPubMed
21.
go back to reference DiGiovanni C, Conley J, Chiu D, Zaborski J: Factors influencing compliance with quarantine in Toronto during the 2003 SARS outbreak. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. 2004, 2: 265-272. 10.1089/bsp.2004.2.265.CrossRef DiGiovanni C, Conley J, Chiu D, Zaborski J: Factors influencing compliance with quarantine in Toronto during the 2003 SARS outbreak. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. 2004, 2: 265-272. 10.1089/bsp.2004.2.265.CrossRef
22.
go back to reference Blendon R, Desroches C, Cetron M, Benson J, Meinhardt T, Pollard W: Attitudes toward the use of quarantine in a public health emergency in four countries. Health Affairs. 2006, 25: w15-w25. 10.1377/hlthaff.25.w15.CrossRefPubMed Blendon R, Desroches C, Cetron M, Benson J, Meinhardt T, Pollard W: Attitudes toward the use of quarantine in a public health emergency in four countries. Health Affairs. 2006, 25: w15-w25. 10.1377/hlthaff.25.w15.CrossRefPubMed
23.
go back to reference Gostin LO, Bayer R, Fairchild AL: Ethical and legal challenges posed by severe acute respiratory syndrome: implications for the control of severe infectious disease threats. JAMA. 2003, 290: 3229-3237. 10.1001/jama.290.24.3229.CrossRefPubMed Gostin LO, Bayer R, Fairchild AL: Ethical and legal challenges posed by severe acute respiratory syndrome: implications for the control of severe infectious disease threats. JAMA. 2003, 290: 3229-3237. 10.1001/jama.290.24.3229.CrossRefPubMed
24.
go back to reference Annas GJ: Bioterrorism, public health, and human rights. Health Aff. 2002, 21: 94-97. 10.1377/hlthaff.21.6.94.CrossRef Annas GJ: Bioterrorism, public health, and human rights. Health Aff. 2002, 21: 94-97. 10.1377/hlthaff.21.6.94.CrossRef
25.
go back to reference Upshur RE: Principles for the justification of public health intervention. Can J Public Health. 2002, 93: 101-103.PubMed Upshur RE: Principles for the justification of public health intervention. Can J Public Health. 2002, 93: 101-103.PubMed
26.
go back to reference Ries NM: Public health law and ethics: lessons from SARS and quarantine. Health Law Rev. 2004, 13: 3-6.PubMed Ries NM: Public health law and ethics: lessons from SARS and quarantine. Health Law Rev. 2004, 13: 3-6.PubMed
27.
go back to reference Singer PA, Benatar SR, Bernstein M, Daar AS, Dickens BM, MacRae SK, Upshur RE, Wright L, Shaul RZ: Ethics and SARS: lessons from Toronto. BMJ. 2003, 327: 1342-1344. 10.1136/bmj.327.7427.1342.CrossRefPubMedPubMedCentral Singer PA, Benatar SR, Bernstein M, Daar AS, Dickens BM, MacRae SK, Upshur RE, Wright L, Shaul RZ: Ethics and SARS: lessons from Toronto. BMJ. 2003, 327: 1342-1344. 10.1136/bmj.327.7427.1342.CrossRefPubMedPubMedCentral
29.
go back to reference Joint Centre for Bioethics Pandemic Ethics Working Group, Upshur R: Public engagement on social distancing in a pandemic: a Canadian perspective. Am J Bioeth. 2009, 9 (11): 15-17. 10.1080/15265160903197598.CrossRef Joint Centre for Bioethics Pandemic Ethics Working Group, Upshur R: Public engagement on social distancing in a pandemic: a Canadian perspective. Am J Bioeth. 2009, 9 (11): 15-17. 10.1080/15265160903197598.CrossRef
Metadata
Title
Public perceptions of quarantine: community-based telephone survey following an infectious disease outbreak
Authors
C Shawn Tracy
Elizabeth Rea
Ross EG Upshur
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2009
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-9-470

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