In the last three months—from August through October 2017—nearly 1200 people in Madagascar, an island nation off the southeast coast of Africa, have contracted plague, a highly infectious disease that causes fever, chills, coughing, and swollen lymph glands. Of these, 124 people have died.
The “good” news is that only about 10 percent of the patients die, thanks to quick treatment with antibiotics. The bad news is:
- 124 people have died of plague.
- There are three forms of plague and two—pneumonic and bubonic—have been spreading. Pneumonic plague spreads from person to person, bubonic plague by fleas.
- The World Health Organization (WHO) has placed eight nearby countries, including South Africa and Kenya, on high alert.
How is this frightening tragedy related to the US Constitution? Chapter 17 of Fault Lines in the Constitution, which is called “At War With Bugs,” tells the story of an American nurse named Kaci Hickox, who treated patients suffering from Ebola in the West African country of Sierra Leone in the fall of 2014. As an experienced infectious disease specialist, she protected herself carefully and returned to the United States tired but healthy.
She knew she had not contracted Ebola because she had no symptoms: no fever, no Ebola. Nevertheless, as soon as she landed in Newark, New Jersey, Governor Chris Christie quarantined Hickox in an unheated tent on a hospital parking lot. Although she was released after three days and allowed to go to her home in Maine, she was told to stay put there as well. Worried that other people might be handled the same way, Hickox sued the State of New Jersey.
We tell this story to show that the Constitution is not clear about circumstances under which the government is allowed to detain people during a state of emergency and refuse to release them. The Constitution states that people who are imprisoned have the right to ask for a writ of habeas corpus, which requires the government to explain their detention or release them. But, during times of “rebellion or invasion” we lose that right. Is a pandemic one of those times?
Fault Lines went to press in June 2017, before Hickox’s lawsuit was decided. In July, she learned that she won. Rather than get paid for her pain and suffering, she decided to change the government’s policies. At her request, the court told the state of New Jersey that it must allow people who are quarantined to contest the order confining them. Hickox is working with other states to develop similar requirements to protect people’s freedom.
In a way, Ebola was an easy case. With no symptoms, Hickox knew she wasn’t sick and, therefore, wouldn’t make anyone else she came in contact with sick. Plague, however, is different. Unless patients are treated very quickly, they can die within twelve hours of being infected. But, it might be hard for people who have a cough and a fever to realize they have plague. Meanwhile, they could infect others without realizing it.
In Madagascar, pneumonic plague victims are isolated. People they’ve come in contact with are tracked down and given antibiotics, if needed. “It’s a huge job,” an expert said.
It is very unlikely that plague will land here. But other complicated diseases might. What is the job of the government?