# Man with TB behind bars for not wearing protective mask?



## ftmomma (Jan 4, 2007)

Is this old news and somehow I missed it?

I read an article in People last night about a man named Robert Daniels that is afflicted with a drug-resistant strain of TB and has been locked up for the last 8 months because he didn't wear a protective mask? He was "caught" without his mask a few times and for "the good of public health" and now he is in the jail section of a Phoenix hospital. He has a wife and son he can not be with and he is in isolation other than maked medical technicians delivering meals and medicine.

The last sentence of the article has me totally freaked out..."Ultimately it is public health's responsibility to protect people from a potentially lethal disease". So they are locking people up??? Is this article telling the WHOLE story? If so, how would it be different from someone with a Vaccine AVAILABLE Disease to be a "threat to the public"?

OT but has anyone read the fiction book "Blindness"?? Makes me think of that...no wonder I had nightmares last night!

I'm glad I don't live too far from the Canadian border.


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## Plummeting (Dec 2, 2004)

That's pretty much the whole story. Right now, there are no transmissible VPDs that are both as transmissible _and_ as difficult to treat as treatment-resistant TB, so they aren't going to be locking up people with VPDs any time soon.

I think what they're doing is wrong, but I personally have to approach it with some balance. What if had infected _my_ child while we were out in public and he coughed in her face? I'm not _afraid_ of TB, but I sure as hell don't want my kid to catch it! So the man does have a responsibility to protect the public. Does that mean he should be locked up forever? *Absolutely not*, IMO. But they did need to do _something_ to convince him to wear the stupid mask. Locking him up for possibly the rest of his life is not that "something". I believe if they would've simply _told_ the man, "Hey, wear the mask or we're going to be _forced_ to quarantine you in your home until you're better, because we have to protect the public," then he would've worn it. The guy didn't want to hurt anyone. He really just didn't get the seriousness of it all, since it's treated so differently where he's from.


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## Peony (Nov 27, 2003)

I go back and forth on this for the reasons Plummeting listed. This man came over over to the US because he thought he would get better treatment for his TB, or so the info I've said read stated that. He ignored warnings to wear a mask, and was eventually locked up for it. He does not just have TB, but a particularly nasty drug reistant strain that obviously no one wants more people to have.

It's a hard call to make, I wouldn't want to be locked up for having a disease, but then again I would want to make sure that I wasn't passing it on to anyone else and would wear a mask.


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## InfoisPower (Nov 21, 2001)

Anyone remember Typhoid Mary? http://www.pbs.org/wgbh/nova/typhoid/mary.html

Principle is the same. Infectious individual passing on a communicable illness to the unknowing public. TB is not a picnic and certainly not a drug resistant strain.


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## onelilguysmommy (May 11, 2005)

but i still cant see why he cant have a tv and phone and comuter...you cant transmit anything through electrnics over wires... and all of thoe thigs could be wireless even!


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## Plummeting (Dec 2, 2004)

Oh, I totally agree with you. I don't even think he should be in prison at all. I do think they could've warned the guy what would happen if he didn't comply, then enforced quarantine in his own home if he still wouldn't comply. Imprisonment is wrong, IMO.


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## grniys (Aug 22, 2006)

I read an article about this a while back, and I have to say, I agree with the guy being locked up. He knowingly ddin't wear a mask out in public after being warned to. That could have been disasterous for many people! I heard someone mention back when I first read the article that the reason for the lack or tv & internet had something to do with the special filters and ventilation system they have to use in the room. Not sure if it's true or not though.


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## ftmomma (Jan 4, 2007)

Is there a vaccine for TB in the works??


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## Scattershoot (Jul 22, 2006)

This situation creates a mindset and a precedent. When a person, or persons, assume(s) authority over another and then physically removes almost all vestiges of freedom from that person then the situation must be scritinized from every angle. We don't know the complete truth concerning this situation. Just because we read an article does not really mean we know anything. What we do know is that the man is in prison. We sit here and read all these terrible things about non-vaxers and what measles and chicken pox can do and we see how silly that is, but we do not know how sick this man is, or all that he did or didn't do or even what the tb he supposedly has is like. Are we all running and hiding from SARS even after an avalanche of fear from news articles?

Fifteen years ago, while working with people living in horrible living conditions I was told I had contracted tb and that I was in big trouble. It turned out to be completely wrong.

I don't argue that some diseases are not worse than others, what I cannot accept is a prison sentence for someone who is supposedly ill. They are not done with the bird flu. With the BioShield Project and legislation that forces vaccines on everyone in certain circumstances, I think the assumption of rightness and authority must be looked at carefully.


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## Plummeting (Dec 2, 2004)

ITA, Scattershoot!


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## InfoisPower (Nov 21, 2001)

Oh I totally agree the imprisonment is wrong on many levels. However, if he was unwilling to comply with precautions against transmission, then he should be under house quarantine until his treatment is completed. Depriving him of his civil rights and treating him worse than many petty criminals is not he way to go.
IIRC there was a vaccine for TB, totally useless and they've not used it for a good while.


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## Plummeting (Dec 2, 2004)

Yes, there is a TB vaccine, but it doesn't prevent TB. It might be able to prevent severe TB infection in infants (or something like that) but that's questionable and it doesn't seem to do much, if anything at all for adults. It's not routinely used in the US, but _is_ routinely given in some countries.


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## Crisstiana (Jan 18, 2007)

This case does not "create a mindset and a precedent". The incarceration of people with TB, in varying degrees of comfort and duration, has been around for a long time. In the last post on this thread I linked and quoted several articles and studies on past incarceration of TB patients. With the rise of multidrug-resistant TB, it is an idea that is being revisted in many areas.


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## Scattershoot (Jul 22, 2006)

Quote:


Originally Posted by *Crisstiana* 
This case does not "create a mindset and a precedent".

I believe it does create a mindset and a precedent. To say there are varying degrees of comfort rationalizes this man's confinement condition. The argument that this man could have hurt someone so we had to stop him and incarcarate him under these conditions is the same argument that could be utilized in almost any circumstance to justify physically controlling another.

At one level, just because someone states he has a deadly, drug-resistant strain of tb does not necessarily make it so. Labs and doctors can be wrong. Beyond that, this is a maybe argument. No hard evidence presented showed this man to have injured anyone. It could be argued in return that "Are we suppose to wait for a mushroom cloud before we do anything," but maybe arguments create an awful lot of leeway to do just about anything to another human.

The response that this does not create a mindset proves that it creates a mindset, because only under certain mental conditions can one rationalize such treatment.


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## Crisstiana (Jan 18, 2007)

Maybe we are misunderstanding each other.

I said it does not "create a mindset or set a precedent" because that mindset already exists in certain places and the precedent has already been established in much more influential cases. The debate over individual freedom and control of one's body versus a public interest in containment of disease has a long history that includes confinement for TB, as the links I provided the other post show. I'm not trying to rationalize anything. But this is part of an ongoing dispute in public health and medical circles and that history, some of it truly shameful, should be remembered.


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## tiffer23 (Nov 7, 2005)

I agree with Plummeting. Seems a bit extreme, but he needs to get a grip and do what he is suppose to. On what planet is it okay for someone to knowingly spread a really scary disease? As Plummeting did, I think of MY child. How would I feel if he had given TB to my son? Obviously I can't stop him from getting things, but I'm not going to sit back and say that this guy is innocent. He's been completely irresposible.


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## prettypixels (Apr 13, 2006)

So what is the difference between punching someone in the face, and coughing in their face when you know that you are sick? I don't think this sounds like (sounds like, and here is my disclaimer: I have not read the article and am basing this post solely on posts I've read) a civil rights issue. If he knows he should be wearing a mask and chose not to wear a mask, isn't he potentially committing a form of assault on the people around him? If he had HIV and were having unprotected sex, wouldn't that be the same thing? If any of you were in his shoes with a drug-resistant strain of TB, would you wear the mask or not? What if it weren't drug-resistant... TB still sucks and would be a burden on many people...?

I mean, it's a mask, it is not that cumbersome for him in the grand scheme of things...

Great topic for discussion, anyways...


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## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *prettypixels*
So what is the difference between punching someone in the face, and coughing in their face when you know that you are sick?

The man wasn't going around coughing in people's faces, prettypixels. That kind of hyperbole isn't helpful in a serious conversation about the line between civil rights and public health.

Quote:


Originally Posted by *prettypixels*
I have not read the article and am basing this post solely on posts I've read) a civil rights issue. If he knows he should be wearing a mask and chose not to wear a mask, isn't he potentially committing a form of assault on the people around him?

It's hard to be meaningfully involved in a conversation about something without understanding the context, PP, but since no article is linked in this thread, I'll explain it to you. The man didn't wear a mask because he did not understand the importance of wearing a mask. One can say all day long, "He was told he needed to wear one," but he's not American. He's from Russia, where those kinds of precautions are NEVER taken. (Or at least he'd been living there since he was a child, although I believe he may have been born in the US.) He did not understand the seriousness of the situation. For some reason people from Westernized nations always seem to think that people from other Westernized nations are living in the same culture. That's not the way it is. The fact that he was a white man from a mainly Westernized nation does not mean that his culture was the same as American culture.

He came from somewhere where TB is endemic (that means it's _constantly_ present, PP) and where precautions such as wearing a mask are not taken to prevent its spread, because the bacteria is everywhere. When he came over here and a doctor told him to wear a mask, he did not understand that he HAD to do it to prevent TB outbreaks. He _did not understand_ that TB is so uncommon here and that he would be exposing people who had never been exposed before and would likely _never_ be exposed in the future.

Because of that, you can't say "he knows he should be wearing a mask," because that's a culturally biased statement. You're assuming that he really understood the importance of wearing a mask, just because most people in your culture would understand the importance of wearing a mask. He's not from your culture. He didn't understand the importance of wearing the mask. A doctor simply telling him to do something does not equate to him possessing the knowledge that would allow him to see the necessity of it. Doctors tell people to do stupid sh*t all the time and anyone who automatically believes something is necessary just because a doctor says it is...well, I'll keep my opinion on that to myself.

Robert Daniels was 26 years old and wasn't told how TB spreads and how he could prevent its spread, according to him. He didn't realize he was endangering the public. It's putting waaaaayyyy too much faith in doctors to believe that they gave him a detailed explanation of why the mask was important, when he says they did no such thing. So he wasn't given a good explanation of the necessity of wearing a mask and he came from a culture in which wearing masks was unheard of. He was young and he didn't think the doctor was saying anything important. He was not purposefully endangering the public.

He's on lockdown with no tv, no telephone, no computer, no contact whatsoever with his family, no mirror and no way to even bathe himself other than with baby wipes. That is NOT acceptable. He was young, dumb and careless. He should be quarantined. He should not be locked up like an animal.


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## Scattershoot (Jul 22, 2006)

This is such an important issue. There are people holed up all over Eastern Europe right now without any rights at all. No court to hear their case, no personal communication with anyone, living in horrific conditions, perhaps physically tortured, and no idea of what will become of their lives. The people who put them in those conditions may believe they have the right to do so because a threat may exist. This may sound irrelevant but it is not. It is the mindset of power and authority.

Everyone deserves the right to defend themselves. This man is holed up indefinitely in what could be considered barbaric conditions. How is this acceptable? Is this the Inquisition? Maybe he screwed up. Maybe the doctors screwed up in some capacity. People make mistakes and like I wrote earlier, where is the proof that he hurt anyone?

It's one thing to isolate someone because he may be a threat, but it's quite another to treat him like an animal (like Plummeting said). Has this man even been given access to a doctor on his behalf (through a lawyer) to verify the claims of his condition. If he truly is ill, how can living like he is possibly help him? There is ample research to prove that a person's mental and emotional condition has great bearing on health and healing.

Habeas Corpus is very important. We need to have certain protections, and what can happen to one can happen to many.


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## Crisstiana (Jan 18, 2007)

The man, Robert Daniels, is being held in the prison section of the county hospital under a court order. The court ordered the involuntary confinement after Daniels violated the agreed upon terms of his voluntary confinement. After that, a petition was filed for the involuntary lock-up under Arizona's state statutes (36-726: Petition for court ordered examination, monitoring, treatment, isolation, or quarantine).

The statute has several provisions to protect the rights of the accused. The petition must include "grounds and underlying facts demonstrating that the afflicted person presents a substantial danger to another person or to the community". This includes sworn affidavits that must "detail the evidence that indicates that the person is an afflicted person and evidence that indicates that the afflicted person is a substantial danger to another person or to the community". Except for certain circumstances, a detention hearing must be held within 15 days after filing the petition. In this hearing, the burden in on the public health officials and they must prove their case by "clear and convincing evidence that detention is necessary". The person in question must be given due notice within 5 days of the initial filing, and this noticed cannot be waived. The person has the right to be evaluated by an independent physician, and if that person can't afford one, one will be found that is acceptable to the person free of charge. This includes lab studies. The indepedent physician may be called by the person as a witness at the hearing.

Daniels has praised the care he is receiving by the physicians and other medical staff. He admits that he did not understand the gravity of his disease when he initially agreed to voluntary quarantine, although he doesn't dispute that this was explained to him several times. He now claims to understand. It seems to me that he should be given a second chance at voluntary confinement in a more humane location, but with plenty of monitoring.

...

From the Tuscon Citizen: Man with 'extreme' TB may be jailed until death

A man infected with an especially virulent strain of tuberculosis has spent eight months in a hospital jail ward under a court order and may be held until he dies.

Robert Daniels has not been charged with a crime, but the 27-year-old violated the rules of a voluntary quarantine....Maricopa County public health officials got a court order to keep him locked up....

...Daniels... was sent to a Phoenix halfway house for indigent TB patients under a voluntary quarantine. He was ordered to continue treatment and wear a mask when he went out in public because the disease is spread by airborne contact.

Daniels stopped taking his medication and went unmasked to a restaurant, a convenience market and other stores, court records stated.

Robert England, Maricopa County's tuberculosis control officer, said in court filings that Daniels understands the rules, but "merely refuses to follow them."

England applied for and received a "compulsory detention" order for Daniels, a legal tool used about once a year in Arizona....

...

Daniels has been diagnosed with XDR-TB, multidrug resistant TB. This is an extremely difficult bug to eradicate and most likely can be spread via respiratory droplets. Daniels is fortunate in that he apparently was a healthy adult when he contracted it. I would guess that it would kill most very young children and immune-compromised people that it infects.

From BBC News: 'Virtually untreatable' TB found

...XDR TB is defined as strains that are not only resistant to the front-line drugs, but also three or more of the six classes of second-line drugs.

This, according to Dr Paul Nunn, coordinator of the WHO team at the Stop TB department, makes it virtually untreatable....


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## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *Crisstiana* 
He admits that he did not understand the gravity of his disease when he initially agreed to voluntary quarantine, although he doesn't dispute that this was explained to him several times.


He _has_ disputed that everything was thoroughly explained to him:

Quote:

"Where I come from, the doctors don't wear masks," he said. "Plus, I was 26 years old, you know. Nobody told me how TB works and stuff."
http://www.msnbc.msn.com/id/17915965...915773/page/2/

I would think that explaining "how TB works" in language the patient can understand is just as important, if not more important, than repeating that his disease is serious over and over, if the goal is to gain compliance with the terms of his confinement. So maybe they explained the gravity of his disease, but he _does_ dispute that they explained _everything_ a patient would need to know in order to understand the importance of wearing a mask. Not understanding how TB is spread, how to prevent its spread, etc. is very likely to result in an individual believing that the mask isn't necessary, if he's only been told that his disease is very serious and he should wear one. An explanation of the gravity of the disease without an explanation of how TB is spread and how a mask can prevent that could leave a patient with the impression that the mask was for his _own_ protection - to prevent secondary infections, etc. And realistically, many adults are much more comfortable with chancing secondary infections in _themselves_ than they would be with exposing _others_ to a potentially deadly pathogen.

But yes, I agree with you that he deserves a second chance at closely monitored voluntary confinement. Heck, I have no problem putting an ankle tracker on the man. Just don't lock him up like an animal.


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## Christine&men (Jun 4, 2005)

So, he is 26 years old, living in the US, being told he has a serious disease and he does not look it up (as in Internet)??? Just because somebody is ignorant doesn't mean they get away scot-free.

Both my father and my grandmother on separate occasions were told that they had been exposed to TB. It was not funny to wait for the result... Luckily they are both healthy.

Incarceration is a drastic step and giving him no means of meaningful pastimes is foolish. At least give him a book. But the idea in itself is not completely without merit.


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## WendyC (Jun 16, 2005)

My bf from college was working in NYC as a waitress trying to live the dream of being an actress. She got TB (young, healthy 25 year old). She was in quarantine at the hospital (month or so?) and then for about 3 months in her apartment. She could only leave to go to the health department for meds and checks (wearing a mask) and was let off when her tests came back at a certain level.

What seriously disturbed me about her story was not the confinment - that seemed somewhat reasonable for the seriousness of the disease, but the forced use of crazy amounts of antibiotics to kill the tb strain. She was on these for over a year and her body is totally wrecked now. Home health officials would come out and watch her take her meds to make sure that she was taking them. I am much more "naturally" oriented in my approach to healthcare would first seek out a more holistic approach to treating disease - but had I been in her situation, and refused antibiotics, would i have been arrested and drugged against my will? Or arrested and left to die without access to the foods, homeopathics, accupucture and whatnot that I would be pursing to heal myself?

Its frightening to think about how much control allopathic medicine has in this country.


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