Isolation facilities for covid-19: towards a person centred approach

Abstract

Chuan De Foo and colleagues argue that isolation facilities have the potential to interrupt the transmission of infectious agents, particularly in the earlier stages of infectious disease outbreaks, but they must deliver person centred care. Two years into the covid-19 pandemic, footage from isolation centres in Shanghai showing unrest have raised questions about the safety, utility, and appropriate use of such facilities. Confining people infected with a pathogen in a dedicated facility is not a new idea, nor are debates about the ethical basis or how such policies should be implemented while also safeguarding human rights. Historical examples of isolation include patients with tuberculosis, those with influenza in the 1918 pandemic, and typhoid carriers. The use of isolation to limit community spread of infectious diseases has not, however, been consigned to history. Isolation facilities were used in the 2003 severe acute respiratory syndrome (SARS) outbreak, and, on a larger scale, Ebola treatment centres were extensively used in West Africa in 2014-15 to break the chains of Ebola transmission.