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The Yellow Flag of Quarantine: an Analysis of the Historical And University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School January 2012 The elY low Flag of Quarantine: An Analysis of the Historical and Prospective Impacts of Socio-Legal Controls Over Contagion Peter Oliver Okin University of South Florida, [email protected] Follow this and additional works at: http://scholarcommons.usf.edu/etd Part of the American Studies Commons, and the Public Health Commons Scholar Commons Citation Okin, Peter Oliver, "The eY llow Flag of Quarantine: An Analysis of the Historical and Prospective Impacts of Socio-Legal Controls Over Contagion" (2012). Graduate Theses and Dissertations. http://scholarcommons.usf.edu/etd/4190 This Dissertation is brought to you for free and open access by the Graduate School at Scholar Commons. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. The Yellow Flag of Quarantine: An Analysis of the Historical and Prospective Impacts of Socio-Legal Controls Over Contagions by Peter Oliver Okin A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Environmental and Occupational Health College of Public Health University of South Florida Major Professor: Raymond D. Harbison, MS, Ph.D. Giffe Johnson, MPH, Ph.D. Steve Morris, M.D., RN Thomas Truncale, D.O., MPH Date of Approval: April 2, 2012 Keywords: Plagues, Epidemics, Infections, Communicable Diseases Copyright © 2012, Peter Oliver Okin DEDICATION I dedicate this Dissertation to Drs. Raymond Harbison and Giffe Johnson, who actively supported my long quiet quest to complete this work and to obtain the Ph.D. in the field that inspires me most, public health. ACKNOWLEDGEMENTS I want to thank Dr. Thomas Bernard of the Department of the Environmental and Occupational Health for extending support to me to complete my doctoral studies. I would also like to thank the members of my doctoral and examining committees, Dr. Raymond Harbison, Dr. Giffe Johnson, Dr. Steve Morris, Dr. Thomas Truncale, and Dr. James V. Hillman, for reading my Dissertation, hearing my defense of it, and approving them. This required an understanding acceptance of my macroscopic and cross-disciplinary approach to public health and its issues. Dr. Harbison and Dr. Johnson were also very helpful in preparing the manuscript for formatting, and Dr. Harbison’s staff, including Jennie White, helped me in formatting the final manuscript. Finally, I want to express my deep gratitude to my late parents, Robert and Josee Okin, and to my late aunt Vera Okin, for their generosity and devotion during my childhood and young adulthood. Table of Contents List of Tables ..................................................................... xii List of Figures ................................................................... xiii Abstract ........................................................................... xiv Introduction ....................................................................... 1 A. Summary of the Historical Theory of this Dissertation ...... 2 B. Objectives and Structure of this Dissertation-Hypothesis . 15 1. Hypothesis ............................................................... 15 C. Stages in the Assessment of Quarantines ...................... 17 1. Bio-scientific Considerations of Quarantines ................. 17 2. Legal- Ethical Considerations of Quarantines ................ 19 a. Quarantine Conflicts Between Individuals and Collectives ............................................................ 20 b. Quarantine Conflicts Between Jurisdictions ................ 21 3. Sociocultural Pragmatic Considerations of Quarantines .. 23 D. Summary Statement of Purpose .................................. 26 1. A Need to Prepare a Multi-Pronged Plan in Advance of Crises ......................................................... 26 2. A Need for Inter-Disciplinary Cooperation in Quarantine Preparation ........................................................... 28 E. Content of Chapters: Some Proposed Working Taxonomies ........................................................... 30 1. Chapter I: A Taxonomy and History of Quarantines ....... 30 a. Historical Backgrounds of Each Quarantine “Dimension and Type .............................................................. 31 b. Some Present- Day Examples of Each Dimensional Type of Quarantines ....................................................... 32 2. Chapter II: A Taxonomy of Contagious Diseases (Strictly Functional) .............................................. 32 a. Realistic Qualifications to the Above Objectives .......... 34 Chapter I: Quarantines and Other Socio-Behavioral Procedures for Controlling Contagions: A Proposed Taxonomy... 37 i A. Preliminary Considerations of Nomenclature .................. 37 1. Range of Methods of Contagion- Control ...................... 37 a. Partial List of Contagion- Control Methods ................. 40 2. Another Note on Nomenclature: Definitions of “Quarantines” ........................................................ 43 a. Brief History and Etymology of “Quarantines” ............ 43 b. Focus of Quarantines of Humans Only ....................... 45 3. Quarantines in Present Day American Law-Definitions ... 46 a. “Quarantines” vs. “Isolation”: A Definitional Difference with Policy Implications ........................... 47 (1) The Unitary Concept of “Quarantines” ................. 47 (2) Distinguishing between “Quarantine” and “Isolation” ........................................................ 48 (3) Arguments for and Against a Unitary Definition of Quarantines .................................................. 50 (a) Arguments Favoring a Bifurcated Conceptual Approach to “Quarantines” and “Isolation” ............................................... 50 (b) Arguments Favoring a Unitary Approach to “Quarantines” ........................................... 54 (c) The Usage of “Quarantine” in this Dissertation ............................................. 57 B. A Practical Model of Disease- Control Methods by “Dimensions”—General Description .............................. 57 1. “Depth” of Quarantines (Severity) ............................... 58 2. “Breadth” of Quarantines (Individuals and Areas Covered) ................................................................. 58 3. “Temporality” of Quarantines (Duration) ...................... 60 4. “Objectives” of Quarantines (Who Is Being Protected?) .. 60 a. Protective Quarantines ............................................ 61 5. “Culpability” of Quarantinees (in a Legal Sense) ........... 61 C. The Independence of the “Dimensions” of Contagion- Control ..................................................................... 62 D. The “Dimensions” of Contagion- Control: Detailed Structure .................................................................. 63 1. “Depth” of Quarantines .............................................. 63 a. “Modified” or “Partial” Quarantines ........................... 63 (1) Occupational Restrictions to Control Contagions ...... 64 (a) Occupational Restrictions to Control Contagions .............................................. 64 (i) The Case of “Typhoid Mary” Mallon . 64 (ii) People ex rel Barmore v. Robertson 64 (iii) School Bd. Of Nassau, FL v. Airline 65 (b) Some Present-Day U.S. Occupational ii Restriction Laws ....................................... 65 (2) Public Place Closures and Bans of Public Gatherings ..................................................................... 66 (a) Some Historical Examples of Public Place Closures and Bans on Public Gatherings .............................................................. 67 (b) Some Present-Day U.S. Laws for Closing Public Places During Epidemics ................... 68 (c) Analysis of Laws Closing Public Places and Banning Gatherings .................................. 69 b. “Strict” or “Classic” Quarantines ............................... 70 (1) Location of the Quarantine or Isolation ................ 70 (a) Historical Illustration of Various Types of Quarantine “Depth”—A Close-Up View of the Case of “Typhoid Mary” Mallon ................... 72 (b) Some Present-Day U.S. “Strict” Quarantine Laws ....................................................... 75 2. “Breadth” of Quarantines ............................................ 76 a. Individual Quarantines ............................................ 77 (1) The Writ of Habeas Corpus in Individual Quarantines ...................................................................... 78 (a) Historical Review of Some Individual Quarantines—Responses to Particular Contagions .............................................. 80 (i) Leprosy ............................................... 80 ((a)) A Classic Individual Quarantine System: Hawai’I and the Lazaretto at Kalaupapa ................................... 84 ((b)) Analysis of the Hawaiian Leprosy- Segregation Program ..................... 94 (ii) Tuberculosis ........................................ 97 ((a)) Some illustrative Cases of Individual TB Confinements: Benton v. Reid and State v. Snow ............................ 104 ((b)) A Modern-Day TB Quarantine: The Speaker Episode ......................... 105 (iii) Syphilis and Gonorrhoea .................... 106 (b) Some Present- Day Individual Quarantine Laws for TB and VD ................................ 112 (i) Maryland ..........................................
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