I think this was an interesting documental of the early phases of community health here in New York City. Much could be learned from this case in particular, especially in the context of today’s globalized society, where, as I’ll discuss below, one local epidemic could turn into a worldwide pandemic.
I think the city of New York, through its Health Department, acted in an appropriate manner in dealing with Mrs. Mary Mallon—“Typhoid Mary”—, especially given her unwillingness to cooperate with the authorities. She was a health public threat to the residents of the city, and the Health Department was forced to quarantine her for their protection.
But even when she was given an opportunity to regain her freedom—with her assurance that she wouldn’t work as a cook anymore—, Mrs. Mallon when back to work and kept infecting even more people, with some of them eventually dying. Some might say she was treated unfairly, that she was restricted of her freedom.
True, but we have to take into account that this was the early years of community health in this country, when infectious diseases were poorly understood, and antibiotics were yet to be discovered. New York City had to do something to stop the spread of typhoid among its residents, and once they pin-pointed the source of this outbreak, they tried in good faith to have Mrs. Mallon to cooperate, to which she refused, paying ultimately with her own freedom. Had she cooperated, probably she wouldn’t have spent all those years of her in life in quarantine.
Her case is relevant today, as the world is dealing with this new outbreak of the Ebola hemorrhagic fever in Africa, and there have been some cases of its transmission here in the U.S. We’ve seen how a failure to detect early infection, and enforce quarantine, has contributed to the spread of the disease, resulting in more than 4,555 death worldwide.
Here in the United States we can see how the public health authorities and law enforcement are dealing with this threat: The CDC has created task force teams that, once someone has been diagnose with the disease, he or she is isolated and transported to a specialty facility designed specifically for the treatment of this infection.
Health authorities in different states have been educating healthcare providers in identifying signs and symptoms for early detection and quarantine. Law enforcement authorities have also been involved. For instance, in different airports throughout the country, custom and immigration authorities have been trained to detect passengers with possible signs and symptoms of Ebola infection, so they can be isolated.
In regards to patient treatment as a human being with inherent rights to freedom and access to healthcare, I think the approach should be in a way that his/her rights are respected as much as possible, while maintaining as the highest priority the wellbeing of the population as a whole. We can see an example of this with the treatment of Tuberculosis, where patients are isolated (quarantined) when they have the active disease, are provided proper medications to get better, and are followed up to ensured adherence to treatment.
In conclusion, I think the overall health of the population is priority, and health authorities, law enforcement, and patients, must work together to contain any communicable disease, within the frame of basic respect for human life and the patient’s dignity.