can include patients with a weakened immune system and may be at risk for serious complications. health care workers who become infected with certain contagious agents may not be permitted to work with patients for a period of time. the occupational safety and health administration (osha) has implemented several standards and directives applicable to protecting health care workers from the spread of infectious agents. these include bloodborne pathogens, personal protective equipment, and respiratory protections. the cdc has also released resource for health care facilities to assist in assessing and reducing risk for occupational exposure to infectious diseases. the purpose of these standards and guidelines is to prevent the spread of disease to others in a health care facility. consequences "quarantine fatigue" redirects here. for fatigue related to social distancing, see social distancing § drawbacks. disease isolation is rarely disputed for its importance in protecting others from disease. however, it is important to consider the consequences disease isolation may have on an individual. for instance, patients may not be able to receive visitors, and in turn, become lonely. patients may experience depression, anxiety, and anger. small children may feel their isolation is a punishment. staff may need to spend more time with patients. patients may not be able to receive certain types of care due to the risk that other patients may become contaminated. this includes forms of care that involve use of equipment common to all patients at the facility, or that involve transporting the patient to an area of the facility common to all patients. given the impact of isolation on patients, social and emotional support may be needed. although a majority of health care professionals advocate for disease isolation as an effective means of reducing disease transmission, some health care professionals are concerned with implementing such control protocols given the possible negative consequences on patients. patients isolated with methicillin resistant staphylococcus aureus (mrsa) can also be negatively impacted by having less documented care/bedside visits from attending and residents. ethics the new ebola isolation ward in lagos, nigeria provides more space and better treatment. disease isolation serves as an important method to protect the general community from disease, especially in a hospital or community-wide outbreak. however, this intervention poses an ethical question on rights of the individual versus rights of the general community. in cases of disease outbreaks, isolation can be argued as an ethical and necessary precaution for protecting the community from further disease transmission. this can be seen during the 2014 disneyland measles outbreak and 2014 ebola outbreak. this can be justified using felicific calculus to predict the outcomes (consequences) of moral action between the individual rights versus the rights of the general public during disease isolation. this justifies that disease isolation is most likely to result in the greatest amount of positive outcomes for the largest number of people. disease isolation can also be justified as a morally legitimate ethical practice in public health based on the reciprocal relationship between the individual and the state. the individual is obligated to protect others by preventing further spread of disease, respect the instructions from public health authorities and sequester themselves in their homes and not attend public gatherings, and act as a first responder (if a healthcare professional) by providing services to protect and restore public health. the state, on the other hand, is obligated to provide support to individuals burdened as a result of restrictive measures (e.g. compensation for missed work, providing access to food and other necessities for those medically isolated, assistance for first responders to balance personal/professional obligations), ensure several legal protections are in place for those subjected to restrictive measures and communicate all relevant information regarding the necessity of restriction. the united nations and the siracusa principles guidance on when and how human rights can be restricted to prevent the spread of infectious disease is found in the siracusa principles, a non-binding document developed by the siracusa international institute for criminal justice and human rights and adopted by the united nations economic and social council in 1984. the siracusa principles state that restrictions on human rights under the international covenant on civil and political rights must meet standards of legality, evidence-based necessity, proportionality, and gradualism, noting that public health can be used as grounds for limiting certain rights if the state needs to take measures "aimed at preventing disease or injury or providing care for the sick and injured." limitations on rights (such as medical isolation) must be "strictly necessary," meaning that they must: respond to a pressing public or social need (health) proportionately pursue a legitimate aim (prevent the spread of infectious disease) be the least restrictive means required for achieving the purpose of the limitation be provided for and carried out in accordance with the law be neither arbitrary nor discriminatory only limit rights that are within the jurisdiction of the state seeking to impose the limitation. in addition, when medical isolation is imposed, public health ethics specify that: all restrictive actions must be well-supported by data and scientific evidence all information must be made available to the public all actions must be explained clearly to those whose rights are restricted and to the public all actions must be subject to regular review and reconsideration. finally, the state is ethically obligated to guarantee that: infected people will not be threatened or abused basic needs such as food, water, medical care, and preventive care will be provided communication with loved ones and with caretakers will be permitted constraints on freedom will be applied equally, regardless of social considerations patients will be compensated fairly for economic and material losses, including salary.