By Thomas Appleyard
Across Canada, public health officials are urging people who have been in Hubei province or in close contact with someone diagnosed with novel coronavirus to “self-isolate”. Words matter here. The term “self-isolate” appears to be new in the public health lexicon, replacing, at least in Canada, the term quarantine.
“Self-isolate” may sound less daunting than the draconian quarantine, particularly in the context of Wuhan’s mass quarantines; however, “self-isolate” has its own baggage. It sounds like something that is really nobody’s else’s business. It sounds like a decision someone can make outside of the context of a broader health structure. It’s the cousin of self-medicate.
This removes the act of social distancing during a potential incubation period from its context and the need for reciprocity. We owe something to people who are quarantined. We owe nothing to people who self-isolate.
In Ontario, people who are quarantined under an order of the Health Protection and Promotion Act during a declared emergency receive job protection under the Employment Standards Act. During SARS, the federal government rolled out extensions to the Employment Insurance program to ensure benefits for people facing quarantine orders. While these interventions are imperfect, they recognize that because of the principle of reciprocity we owe something to those who face quarantine.
There is much more that all levels of government could do to ensure income support, job protection and food security for those following public health advice.
Ontario’s public health guidance says “the [public health unit] should ask close contacts to consider the steps that they would need to take to be able to isolate themselves. This might include discussion with employers, making alternate arrangements to support children/dependents and ensuring an adequate supply of groceries and other necessities.” Many people living in Ontario are in no position to do any of these things.
Ontario and other levels of government have a real opportunity, and some time, to ensure that coronavirus and the interventions they put into place to address it do not exacerbate existing health equities.
We owe this to people who follow public health advice to quarantine to keep us all safe.