# 701
In a pandemic, there are two strategies used to sequester those who are infected, and those who are potentially exposed, from infecting the general population.
Isolation is used when someone actually has the disease.
Quarantines are used to keep those who have been exposed, but are not yet showing signs of illness, from spreading the disease.
This from the Des Moines Register.
Health officials look for quarantine site in Des Moines area
DES MOINES, Iowa - The search is on in Iowa's capital for a quarantine site in case of a bird-flu epidemic.
Health officials want to set up alternative housing for people who couldn't or wouldn't stay home. Possible locations include Veterans Memorial Auditorium, hotels and vacant public-housing units.
Jails were ruled out because of fears the virus would infect inmates, then continue to spread.
Quarantine possibilities were discussed last week at a monthly meeting of about 30 leaders, mainly from health care and law-enforcement agencies.
Polk County has joined other Iowa counties in passing an ordinance giving officials the power to order people into quarantine if needed.
Terri Henkels, the county health director, hopes to have detailed response plans finished by late summer.
"We don't want to be figuring this out at the moment it's happening," Henkels said.
Information from: The Des Moines Register, http://www.desmoinesregister.com
Quarantines are a hot-button issue. The word generally invokes images of cities or neighborhoods cordoned off, and presumably healthy people trapped inside the `hot zone'. That, for now, doesn't appear to be the intent here.
The quarantines envisioned by most public health officials involve family members staying home when anyone in their household has an infection.
Now, we have seen larger quarantines in other countries. Entire villages have been sealed off, and egress restricted by armed para-military types. But for now, those sorts of plans do not appear to be in the United States's playbook.
Will we see larger quarantines here?
Early in a pandemic, if there is an isolated outbreak in the United States, I wouldn't completely discount the possibility. But quarantines on that sort of scale are unlikely to work, and if the virus pops up in an adjacent town, or state, there would be little point.
While there are laws on the books, enforcing household quarantines is going to be difficult. For now, the guidelines issued by the CDC speak mostly about `voluntary quarantines'. Once a pandemic starts, there may be too few public health officials, and too many households, to monitor them all 24 hours a day.
It isn't clear from this article exactly how officials in Iowa intend to use these quarantine facilities. Having a secure location where healthy, but exposed, individuals could go to wait out the incubation period would seem to make some sense.
The use of household quarantines could dramatically reduce the spread of the virus. People need to be prepared, with adequate food, water and medicines, to be sequestered in their homes for two weeks or longer.
Of course, nobody wants to be quarantined. It goes against our nature to sit around and wait to see if more family members come down with the disease.
Yet, if we are to slow the spread of a pandemic, that is exactly what we will need to do.
