Alexander Lee thought he was doing the responsible thing when he boarded a plane from China to New York City in February. Upon arrival, he would self-quarantine for 14 days, as the Centers for Disease Control and Prevention recommended. He was determined to avoid human contact just in case he carried the highly contagious coronavirus.
Despite his best intentions, self-isolating proved impossible. Lee, who is 45 and a Brookline native, had to rent a car. He had to stop for dinner. He had to check in with the host of his Airbnb. He had to go to the supermarket.
As the coronavirus spreads across the country, thousands of people who may have been exposed to the virus through travel abroad or contact with an infected person have been asked to self-quarantine for two weeks to help contain the outbreak. During that time, they’re tasked by state and local health officials to monitor for symptoms and restrict physical contact with others.
But for most Americans, self-quarantine is entirely voluntary and as such, nearly impossible to enforce. Last Friday, a New Hampshire man who showed signs of coronavirus reportedly ignored medical advice to self-quarantine and instead went to a mixer for doctors and Dartmouth College students. This week, he and a close contact tested positive for the virus, New Hampshire’s first and second confirmed cases. The Vermont club that hosted the mixer has been forced to hire a professional cleaning company and cancel the rest of the week’s events.
The road to Lee’s self-quarantine began on Jan. 31, when a travel advisory from the US Department of State landed in his inbox.
The instructions seemed clear: “Those currently in China should consider departing using commercial means.” By then, Covid-19, the disease caused by the coronavirus, had infected 9,709 people in mainland China and killed 213. The US government had evacuated 195 Americans in the Chinese city of Wuhan, where the virus originated.
Lee has been living and working in China for two and half years, most recently, as a teacher and administrator at a high school in Guangzhou. He weighed his options with his girlfriend, who is Chinese, and they agreed he ought to go to the United States. On Feb. 2, Lee received another travel advisory, emphasizing once again that Americans in China “should attempt to depart." Lee made up his mind. He didn’t want to be trapped in a foreign country if the outbreak spread to Guangzhou.
So Lee contacted a travel agent who found him the last seat on a flight from Guangzhou’s Baiyun International Airport to New York City. He landed at John F. Kennedy International Airport on Monday, Feb. 17. As soon as he got off the plane, American and Chinese passengers were told to split up into two separate lines while they were checked for fever with a temperature gun.
Beyond passport control, women from the CDC wearing khaki vests (he does not recall them wearing masks) waited at a table to speak with travelers from China. They handed him a flimsy packet — six photocopied pages stapled together — with brief instructions to self-quarantine for two weeks. Most of the information was typed in Chinese characters. The CDC workers asked Lee for his phone number — he had to give them his mother’s number because he didn’t have a working US cell phone yet — and reminded him that self-quarantine isn’t mandatory.
“At that point, they should have told me a whole bunch of different stuff,” Lee said.
Lee had been planning to self-quarantine, anyway. He booked an isolated apartment on Airbnb near New York’s Finger Lakes. It was the cheapest place Lee could find with free Wi-Fi so he could teach his classes online. And after much back and forth, his host agreed to allow him to stay despite the possibility that he might be infected.
Still, Lee was surprised that the CDC officials expressed no concern and offered no advice about his plans. Lee rented a car near the airport, stopped for Thai food in Scranton, Pa., and hours later, checked into his Airbnb.
The next day, he ventured to a supermarket in Ithaca, N.Y., for two weeks’ worth of groceries. He wore a face mask and tried to avoid touching too many things. The cashier and the bagger eyed him nervously as he explained that he had just returned from China. He felt like a pariah.
Three days after he arrived in the United States, two nurses from the Seneca County Health Department paid him a visit. They arrived, dressed normally, carrying a Ziploc bag of Clorox wipes, hand sanitizer, gloves, surgical masks, tissues, and a thermometer. They gave Lee a “voluntary isolation/quarantine agreement” to sign and a CDC fact sheet about Covid-19, with advice about hand-washing and covering coughs and sneezes. The nurses instructed Lee to check his temperature twice a day and to call or text every morning with his reading.
“They were so nice and I needed human contact, so I usually called in the morning with the temperature,” Lee said.
Over the next week and a half, Lee spent most of his time online, blogging about his time in voluntary self-quarantine, or on the phone with his girlfriend and her children. He was mostly anxious and lonely. When the weather was good, he explored a local graveyard on the sprawling 75-acre property. His Airbnb host visited him a few times a day to deliver firewood, but Lee said they were careful to stay six feet apart.
Chalk it up to stress or jet lag, but Lee barely slept. Expenses — for the Airbnb, the rental car, the flights, even health insurance in the United States — were adding up. The distance was straining his relationship with his girlfriend.
“One more week to go of this ‘experience’...if I am not sick,” Lee wrote on Feb. 25. “This a lot more stressful than I anticipated so get ready if you are reading this from China and planning to come home for a two-week isolated quarantine.”
Lee reached the end of his 14-day quarantine on March 2. He’s healthy, but he’s still not sure if he made the right decision to leave China, he explained over the phone this week while waiting outside an Ithaca pharmacy for a flu shot.
“It’s very hard to figure out what to do both medically and personally,” he said.
Days earlier, he burst into tears during a phone call to his congressman’s office about the State Department’s confusing travel directives for Americans in China. Now, as the number of confirmed coronavirus cases surges across the United States, Lee wonders if he’s even better off here than in China, where the outbreak is slowing. For now, he plans to return to China on March 18, but “things could change.”
“This country is just completely unprepared for this,” Lee said. “Even if I’d only had contact with the car rental place and my Airbnb host, they’ve had contact with other people. So if I infected them, it would start spreading that way … [Self-quarantine is] not particularly effective, it’s expensive, and it’s extremely mentally challenging.”