In the wake of the Ebola outbreak last month Andrew Cuomo, the Governor of the State of New York and Chris Christie, the Governor of the State of New Jersey imposed mandatory quarantines against anyone traveling in from West Africa. Public health policy in the US is the purview of individual states. And even though the Center for Disease Control and Prevention (CDC), the central body responsible for the health security of the country, provides national guidelines on how to deal with threats to the health of the nation, the individual States are not legally obliged to follow these guidelines. So the fact that these recent quarantines were instituted only days before the mid-term elections and in blatant opposition to the CDC guidelines, highlights the political nature of these quarantines. Federal authorities had to weigh in on the matter and pressure the states to at least lower their quarantines if not completely do away with them.
While preparing for my class on the history of Public Health I was reading the work of Professor Howard Markel on the use of quarantine by the Health Officer of the Port of New York in 1892 and was struck by the parallels with the situation today. Much like the actions of the Governors of the States of New York and New Jersey in the face of Ebola, the twenty-day maritime quarantine period imposed in 1892 against 'cholera ships' coming from Eastern Europe was not informed by stipulations of contemporary science. In fact it wasn't in the least in line with the medical understanding of cholera transmission, diagnosis or incubation period. Far from being medically sound the quarantine in 1892 was in reality a means of stigmatizing and limiting the entry of Russian Jewish immigrants fleeing from Europe -- not unlike the ways in which the Ebola crisis is singling out and marking out Africans and those traveling to Africa. Driven by the economic fears of lower wages and unemployment for Americans, the United States, that proudly calls itself a nation of immigrants, used the quarantine in 1892 to serve political and economic agendas. What's more it became a site of contestation between federal, state and local authorities as they all tried to assert control over the logistics and length of the quarantine. One of the most significant public health measures of the nineteenth century was driven by the personal and institutional politics of the actors involved.
My own research on cholera policy in nineteenth-century British India also bears out that far from being informed by the science of the time, most of the measures put in place in the name of public health, were in fact the outcome of the politics between colonial officials and institutions. Long after Robert Koch's discovery of the cholera bacillus and the certainty that cholera was water-borne, colonial authorities in India continued to disperse Hindu pilgrimages as they held on to the belief that disease was specific to locality.
We like to think that we've moved on from a time when non-scientific concerns informed the ways in which authorities dealt with the threat of epidemics. We pride ourselves on being rational and scientific. But the recent quarantines in New York and New Jersey in the aftermath of the Ebola outbreak in West Africa clearly show that public health policy does not operate in a silo and is not based on objective science. Like policy in any field it continues to be riven by politics.