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January 09, 2024

How Not to Control Disease

Overstrict rules are counterproductive.

“All of the countries we’re visiting have a mandatory 10-day quarantine if you test positive for COVID,” said the cruise ship captain during the safety briefing just after we were instructed on how to don lifejackets. “The quarantine does not allow air travel.”

“COVID is just a bad cold.” he continued. “Remember, your captain told you that you will be quarantined for 10 days with no possibility of flying out if you test positive for COVID.”

Don’t test. Don’t test. Don’t test… people in the family groups whispered to each other. This was no MAGA crowd of vaccine-deniers; the vacationers on the US-flagged ship were mainly over-educated coasties like us as far as I could tell. As much as they were looking forward to seeing a different part of the world, they didn’t want to be stuck there, perhaps in an inferior hotel.

“You should take normal precautions against infectious disease, “the ship’s doctor said. “Wash your hands often. Use the hand sanitizers which are deployed around the ship. Cover up if you cough.” No mention of masks nor any visible supply of them. Nothing about staying in your cabin if you feel sick. And certainly no mention or sign of COVID test kits.

None of us had symptoms so I don’t know whether we would have insisted on testing if we did. Quite possibly not; we all had plans after the trip. Mary and I would have had a real dilemma (beside the ethics of possibly infecting other people) because we’re old enough so that COVID is not just a cold and we should get Paxlovid immediately if, despite our many rounds of vaccination, we are infected.

The point of this parable is that the 10-day quarantine rule, at least since we’ve gone from pandemic to endemic, is so strict that it’s counterproductive. It discourages people from testing and then taking reasonable steps if they’re infected with COVID or something else. Rules aimed at eliminating rather than just reducing risk are often riskier than the danger they seek to avoid.  

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