Global

Of Quarantines Past and Present

Restricting movement: from medieval Italy to COVID-19

by Stranger’s Guide

As large portions of the planet grapple with the new reality of self-isolation to help stem the transmission of COVID-19, here is a brief survey of some remarks about quarantine, from medieval Italy to the latest crisis.

 

Isolation is used to separate ill persons who have a communicable disease from those who are healthy. Quarantine is used to separate and restrict the movement of well persons who may have been exposed to a communicable disease to see if they become ill.

— U.S. Department of Health and Human Services, “What is the difference between isolation and quarantine?” 

Quarantine laws—from the Italian “quaranta giorni,” meaning 40 days—were first developed in Venice in 1370, to keep the bubonic plague at bay by banning any ships and goods for the time it seemed to take most epidemics to burn themselves out.

—Dr. Howard Markel, “Will the Largest Quarantine in History Just Make Things Worse?” New York Times, January 27, 2020

The reason for deciding on the number forty as being the correct number of days in the period of detention, from which the entire procedure derives its name, is as obscure as is the history of the early practices of that institution. The number forty has considerable prominence in the Bible, for instance: the forty days of the flood; the forty years’ duration of the crossing of the wilderness by the Children of Israel; the forty days which, according to the law of Moses, were necessary for certain purification processes; and the forty days’ fast of Christ.

—Edward Huber, “The Control of Communicable Diseases Prevalent in Massachusetts,” The Massachusetts Medical Society, July 15, 1926

Against acute, fatal diseases such as bubonic plague attempts were made by healthy communities to prevent entry of goods and people from infected communities. In the VII century A.D. armed guards were stationed between plague-stricken Provence and the diocese of Cahors.

—Gian Gensini et al., “The Concept of Quarantine in History: from Plague to SARS,” Journal of Infection, November 2004

Anticontagionists, who disbelieved the communicability of cholera, contested quarantine and alleged that the practice was a relic of the past, useless, and damaging to commerce. They complained that the free movement of travelers was hindered by sanitary cordons and by controls at border crossings, which included fumigation and disinfection of clothes.

—Eugenia Tognotti, “Lessons from the History of Quarantine, from Plague to Influenza A,” Emerging Infectious Diseases, 2013

The CDC has the power to detain people suspected of having a communicable disease, without getting approval from state and local officials. It comes under the public health laws that allow the federal government to impose restrictions either on people coming into the country or traveling from one state to another. However, that authority is rarely used, and when it has been invoked, it was directed at individuals and small groups.

—Pete Williams, “Can the Federal Government Order a National Quarantine?” NBC News, March 17, 2020

Control measures that decrease the impact of these parameters (minimizing contacts with people suspected of the disease or reducing the time before an Ebola-deceased individual is buried) will be quite effective in minimizing disease burden.

—Attila Denes and Abba Gumel, “Modeling the impact of quarantine during an outbreak of Ebola virus disease,” Infectious Disease Modelling, 2019

Quarantine is often an unpleasant experience for those who undergo it. Separation from loved ones, the loss of freedom, uncertainty over disease status, and boredom can, on occasion, create dramatic effects. Suicide has been reported, substantial anger generated, and lawsuits brought following the imposition of quarantine in previous outbreaks. The potential benefits of mandatory mass quarantine need to be weighed carefully against the possible psychological costs. Successful use of quarantine as a public health measure requires us to reduce, as far as possible, the negative effects associated with it.

—Samantha Brooks et al., “The Psychological Impact of Quarantine and How to Reduce It: Rapid Review of the Evidence,” The Lancet, 2020

The idea of putting a possibly sick person in quarantine goes back to the ancient texts. The book of Leviticus tells how to quarantine lepers. Hippocrates covered the issue in a three-volume set on epidemics, though he came from a time in ancient Greece when disease was thought to spread from “miasmas,” or foul-smelling gas that came out of the ground.

—Eleanor Klibanoff, “Awful Moments in Quarantine History,” NPR News, 2014

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