The Extraordinary History (and Possibly Busy Future) of Quarantine

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Quarantine can be lifesaving; it can also be dangerous, an extraordinary use of force in the name of disease control, a presumption of guilt rather than innocence.

In “Until It’s Safe,” a new book about the past and future of quarantine, Geoff Manaugh and Nicola Twilley impressively make sense to explain exactly why quarantine fears are understandable and historically justified, while also showing “almost how we will live” in the years to come they are doing a job. We certainly find ourselves more dependent on quarantine, not less.” Quarantine is about risk and uncertainty, and its logic is simple: “There may be something dangerous inside you – something contagious – on the verge of being free.”

As advances in medicine make some diseases more diagnosable and less deadly, newly discovered information may also highlight the depths of our ignorance. The more we know, the more we know that we don’t know – not to mention that modern life, with increasing numbers of people and goods circulating around the world, has increased opportunities for contamination.

Quarantine is different from isolation, although the terms are often used interchangeably. when someone is isolated known to be ill; when someone is quarantined maybe Maybe, but we can’t be sure. Manaugh, an architecture and technology blogger, and Twilley, co-host of a podcast about food science and history, brings an impressively broad range of interests in a topic that includes not only infectious diseases but also their assertive lives. yet the perfect narrative – politics, agriculture, surveillance and even space.

The authors begin by tracing the history of quarantine through its geography. The first known mandatory quarantine provisions date back to 1377 in Dubrovnik, a city on the Adriatic coast, where visitors were told to spend a month on a nearby town or islet before it was considered acceptable. The Black Death was ravaging the continent. With its constellation of small islands separated by lagoons, Venice became the site of the first permanent islands. lazzarettoor quarantine hospital; The word quarantine itself comes from the Italian word. quarantine, abbreviation quaranta giornior “40 days”.

Quarantine was often miserable for those exposed; conditions can be miserable or even cruel. (As Byron recalls in his poem “Goodbye to Malta”: “Goodbye, damn quarantine, / That gave me a fever and spleen!”) But this book suggests that quarantine need not be such a humiliating experience. . If anything, for quarantine to be a truly effective measure for public health, it needs to be done with compassion and respect – otherwise people will understandably do everything they can to avoid it, possibly exacerbating the problem the quarantine was designed to solve.

Credit…Jenny GG

One episode about volunteer nurse Kaci Hickox, who was forcibly held in an isolation tent in 2014 after arriving in New Jersey from Sierra Leone, where she treated Ebola patients, is unexpectedly poignant; At the time, most Americans did not understand why Hickox was resisting quarantine, showing no symptoms and testing negative for Ebola when he arrived. The prevailing argument for why Hickox should follow New Jersey governor Chris Christie’s self-isolation orders seemed to be “safer than sorry,” even though medical experts have repeatedly insisted these orders were scientifically incorrect.

What becomes clear in “Until Proven Safe” is that telling someone else to shut up and quarantine is much easier than doing it yourself. Any use of such terrible power also brings with it the possibility of abuse. The book contains historical examples of disease control measures paired with current biases. In 1900, a security guard in San Francisco’s Chinatown zigzagged around white-owned businesses; During World War I, under the auspices of protecting men who might be called up to fight overseas, local American authorities had the authority to quarantine young women “reasonably suspected” of having a sexually transmitted disease.

More recently, in 1991, an “HIV POW camp” was established by Attorney General William Barr to detain asylum seekers – the same William Barr, the authors helpfully reminding us, “refusing to self-quarantine after potential exposure to the coronavirus” in October 2020. ”

Credit…Gleb Kuznetsov

Manaugh and Twilley began their research on the subject years ago and acknowledge the certain irony of finishing a book on quarantine while living in quarantine due to COVID-19. Quarantine infrastructures tend to adapt to the previous outbreak rather than predict what will happen. The first shiny new federal quarantine facility built in the United States in more than a century in Omaha was completed in January 2020, just in time to pick up 15 American passengers from the coronavirus-infected Diamond Princess cruise ship. This National Quarantine Unit has a total of 20 beds. It offers a “boutique experience” ideal for simultaneously managing one or two patients, for example after exposure to Ebola. The facility can’t do much to contain a severe epidemic. As Manaugh and Twilley pointed out, the first American evacuation flight out of Wuhan alone carried 195 passengers.

“Until Safely Proven” includes sections on pests and agricultural blight, including forecasts of an upcoming “chocolate”. (The cacao plant is particularly prone to disease.) Another chapter on space travel recalls that astronauts were quarantined in powered Airstreams after their lunar missions for fear of contaminating Earth with extraterrestrial life and sparking a “celestial epidemic.”

But when Manaugh and Twilley describe their visit to a nuclear waste facility where quarantine has taken dimensions that feel both urgent and fantastic at the same time. How do you store radioactive materials that can remain deadly for thousands of years? And if you manage to figure it out, how will you convince curious people not to open it millennia from now? If you find it difficult to build trust right now, imagine what it takes to build trust with future generations.

“A message must survive, be found and understood,” one geophysicist tells the authors. “It also has to be believed – that’s the hardest part.”

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