An agent with an infectious disease confers a negative externality on the rest of the community. If the cost of infection is sufficiently high, they are encouraged and in some cases required to quarantine themselves. Is this the efficient outcome? One might wonder if a Coasian approach would generate it instead. Define a right to walk around when infected which can be bought and sold. Alas, infection has the nature of public bad which is non-rivalrous and non-excludable. There is no efficient, incentive compatible individually rational (IR) mechanism for the allocation of such public bads (or goods). So, something has to give. The mandatory quarantine of those who might be infected can be interpreted as relaxing the IR constraint for some.

If one is going to relax the IR constraint it is far from obvious that it should be the IR constraint of the infected. What if the costs of being infected vary dramatically? Imagine a well defined subset of the population bears a huge cost for infection while the cost for everyone else is minuscule. If that subset is small, then, the mandatory quarantine (and other mitigation strategies) could be far from efficient. It might be more efficient for the subset that bears the larger cost of infection to quarantine themselves from the rest of the community.