Will There Be a National Quarantine for Coronavirus in the US?

Clinicians across the United States are petitioning the federal government to follow the lead of South Korea, China, and other nations by imposing an immediate nationwide quarantine to slow the inevitable spread of COVID-19.

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MARCH 21, 2020 -- Clinicians across the United States are petitioning the federal government to follow the lead of South Korea, China, and other nations by imposing an immediate nationwide quarantine to slow the inevitable spread of COVID-19. Without federal action, the creators say, their lives and the lives of their colleagues, patients, and families are being put at increased risk.

In addition to the quarantine, the petition, posted on the website Change.org, calls on US leaders to institute emergency production and distribution of personal protective equipment for healthcare workers and to rapidly increase access to testing.

The petition, which garnered more than 40,000 signatures in just 12 hours and as of this writing was approaching 94,000, was started by an apolitical Facebook group to focus attention on what members see as the most critical issues for clinicians: slowing the spread of the virus through a coast-to-coast quarantine; protection of medical personnel with adequate supplies of essential equipment; and widespread testing.

"We started this group last Friday out of the realization that clinicians needed information about the outbreak and weren't getting it," said coadministrator Jessica McIntyre, MD, a pediatric hospitalist at Elliot Hospital in Manchester, New Hampshire.

"We wanted to get ahead of it and connect with people before we were in the trenches experiencing it and to see what other programs were doing. From a local perspective, it has been really hard to see what people are doing in other states, especially when the protocols in our own states are changing every single day as we collect more information," she said in an interview with Medscape Medical News.

The Horse Has Bolted

A family medicine physician in Illinois helped launch the Facebook group. She asked that her name not be used but told Medscape Medical News that earlier actions may have prevented or at least delayed the need for the more draconian measures that her group is recommending.

"Clearly South Korea is one of the superstars as far as response has gone, but the concern we have in the United States is that we're well beyond that point ? we needed to be testing people over a month ago, in the hope of preventing a quarantine," she said in an interview.

According to National Public Radio, as of March 13, South Korea had conducted 3600 tests per million population, compared with five per million in the United States.

"I think the most concerning part is to see where Italy is now and where we are in comparison. Our ICUs have not yet overflowed, but I think we're definitely looking at that in the next few weeks ? hopefully longer, but I suspect that it will happen shortly," she continued.

She cited work by Harvard University biostatistician Xihong Lin, PhD, that shows that when health authorities in Wuhan, China ? widely cited as the epicenter of the global pandemic ? cordoned off the city, the infection rate dropped from one person infecting 3.8 others to one infecting 1.25, thereby significantly slowing the rate of transmission.

"This is absolutely what we need to be doing," she said.

Real News

Within 3 days of its creation, the online group had accrued more than 80,000 members with advanced medical training, including MDs, DOs, physician assistants, nurse practitioners, and certified registered nurse anesthetists.

"A lot of us were already very busy with our day-to-day work outside of COVID-19, and I think a lot of us felt unsure about where to get the best information," said coadministrator David Janssen, MD, a family medicine physician in group practice in Sioux Center, Iowa.

"If you turn on the TV, there's a lot of politicizing of the issue, and there's a lot of good information, but also a lot of bad information. When healthcare providers talk to other healthcare providers, that's often how we get our information and how we learn," he told Medscape Medical News.

The COVID-19 US Physicians/APP Facebook group includes 20 volunteer moderators who handle hundreds of posts per hour from persons seeking information on the novel coronavirus, what to tell patients, and how to protect themselves.

"It's been wonderful to see how providers have been helping other providers sort through issues. Teaching hospitals have their hands on the latest research, but a lot of people like myself are at small community hospitals, critical-access hospitals, where we may have a lot of questions but don't necessarily have the answers readily available to us," Janssen said.

Janssen told Medscape that his community of about 8000 residents initially had only four COVID-19 testing kits, or one for every 2000 people. The situation has since improved, and more tests are now available, he added.

McIntyre, Janssen, and the Illinois family physician have disclosed no relevant financial relationships.

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